I have been silently participating in LactNet for a week or two now; I
somehow missed the invitation to introduce myself when I joined. I was in
a history doctorate program when I decided to go to medical school (I
consider my master's in women's history highly relevant to promoting
breastfeeding, however). I trained in family medicine for 2 years before
switiching to preventive medicine. My academic training in preventive
medicine included an MPH in maternal and child health. Breastfeeding for
me is
the intersection of women's health, family medicine, preventive medicine,
and maternal and child health. I am also IBCLC. I am a research associate
at the Stanford Center for Research in Disease Prevention at the Stanford
University School of Medicine. I am co-founder and chair of the founding
board of the Academy of Breastfeeding Medicine. A particular interest is
defining the physician's role in breastfeeding care and promoting
coooperative collaboration among the various breastfeeding care providers
for the benefit of the breastfeeding dyad.

One of my roles at Stanford is attending physician in the preventive
cardiology clinic, a specialty clinic for people with risk factors for
cardiovascular disease, particularly dyslipidemias. I agree with Alicia
Dermer that measurement of cholesterol in a postpartum woman is
inappropriate, unless it is someone with previously dx'd familial
hypercholesterolemia who is a candidate for resuming drug therapy
immediately. Robert H. Knopp at the Univ of Washington has done a number
of small studies on pregnant and postpartum (bf and non-bf) women and
lipids. He has shown that all pregnant women are hypercholesterolemic,
and cholesterol levels return to prepregnant levels within a few months
after birth in the non-lactating woman (with a lot of individual
variability). Lactation does not affect a woman's LDL (low density
lipoprotein cholesterol--the so called "bad cholesterol"), but DOES raise
HDL (high density lipoprotein cholesterol--the "good chol"). An elevation
in HDL will raise total cholesterol which is often used as screening
test. It is impossible to have too much HDL--the more the better, so an
elevated total chol that is due to elevated HDL and nl or low level of
LDL is NOT a problem. HDL remains elevated during lactation, and for
women with a long lifetime duration of lactation, the elevation in HDL
may help protect against atherosclerosis (and of course, heart disese is
the #1 cause of death for women as for men in the US). JAMA Feb 17,
1989--Vol 261, No. 1 has a Q & A regarding cholesterol levels and a
breastfeeding mother, with 7 references at the end.
Elizabeth (Beth) Williams, MD, MPH, IBCLC
[log in to unmask]

On Sat, 8 Apr 1995, Joseph R. Hollen wrote:

> Lactnet is wonderful!  In one brief week, I have learned  so much.  THank
> you for such a valuable forum.  I am an IBCLC since 1991, an RN and
> mother of four, 10, 6,6,3. I started a Not-For-Profit organization
> "Breastfeeding Matters, Inc. " with a warm-line and education for the
> community.  It's interesting.My questions.
> 1. Mom with 7mo old has elevated chol. levels above normal, insurance co.
> increased her rates.  Hachey in AJCN, 1994 and others state these levels
> remain high intil about 4 mo. PP.  But is that in the BF mom?  Any info
> on these levels in the "PP" mom who continues BF.
> 2. Recent infant death here from"Shaking CHild Syndrome".  Apparently
> exclusively bF infant.  Any research about BF and CHild abuse.  I was
> always under the impression BF was associated with Decreased incidence of
> child abuse. I know the non BF community can have a hayday with this case.
> THank you again for this service.
>