On Fri, 7 Jul 2000, Michelle Leifur Reid wrote:

> Does breastfeeding raise cholesterol levels?  I have a mom that has
> posed this question and I can't find any information on it.  She has
> one child and has been breastfeeding for 3 months.  At a recent check
> up her cholesterol levels were elevated significantly.

Michelle: How high was her cholesterol?  Did they check not only the total
but also the HDL ("good") and the LDL ("bad") fractions?  There is one
study I know of which did show a higher *total* cholesterol in
breastfeeding women (I believe it was true also of pregnant women), but
the heart protective HDL fraction was increased, accounting for the
increase in the total.  This suggests that there is no increased risk of
heart disease -- in fact, this may be yet another benefit of
breastfeeding/risk of artificial feeding.  The reference is: Oyer D, Stone
NJ.  Cholesterol levels and the breast-feeding mom.  JAMA, Feb.
17, 1989;261(7):1064.

In view of the evidence about the blood pressure lowering and
stress-reducing effects of oxytocin, the improved glucose metabolism
during breastfeeding and the decreased risk for women with gestational
diabetes of ultimately developing Type II diabetes if they breastfed, I
wouldn't be surprised if a study came out showing that women who
artificially fed their babies have higher rates of heart attacks.  As we
have said before, breastfeeding is the norm and is physiologically normal.
Just as we now know that breastfeeding not only doesn't increase the risk
of osteoporosis but may actually *decrease* it, I would reassure mothers
that if their cholesterol is higher while breastfeeding, that is probably
a normal and possibly even beneficial phenomenon.  So even if the
cholesterol is higher, she is probably better off breastfeeding for as
long as she and her little one want to continue.

> The only changes since her last screening were the pregnancy and her
> breastfeeding.

Why was this woman having screenings prior to her pregnancy?  How old is
she?  Is there a family history of early heart attacks and/or high
cholesterol?

> She eats a well rounded diet and watches her cholesterol intake.  I
> would hazard to guess that the pregnancy had more to do with the
> cholesterol levels than the nursing.

You're probably right.  Furthermore, if her HDL is higher in accordance
with the findings of the study, and her LDL is not in a high risk range
(current thinking is that the LDL should be below 160 for people with no
other heart disease risk factors, below 130 for those with at least one
other risk factor -- e.g. high blood pressure, smoking, diabetes -- and
less than 100 for those who have documented coronary artery disease
including a previous heart attack or a positive cardiac catheterization),
then she really doesn't need to do anything at all.  Of course, a low
animal fat, high fiber diet is good for a lot of other reasons, so she can
certainly continue on that.

If she has a low HDL or an LDL which is in the high risk category despite
whatever her HDL level is, then she probably needs to be even more careful
with her diet (perhaps see a dietitian -- so many people think they are on
a low cholesterol diet but are still getting a lot of hidden sources of
saturated or trans-fatty acids) and increase her aerobic exercise.
Needless to say, if she smokes or has other risk factors, she needs to
work on eliminating those.  Unless she has a family history of women with
premenopausal heart attacks and she is nearing the age at which those
relatives had their heart attacks, there should be no need for more
aggressive treatment such as cholesterol-lowering medications.

Hope this helps.  Regards, Alicia Dermer, MD, IBCLC.






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