Ability to breast-feed may be influenced by hormones

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Whether or not a mother can successfully breast-feed her infant may have to do with her concentrations of testosterone, according to a new study from researchers at the Norwegian University of Science and Technology. The study, published in the journal Acta Obstetricia and Gynecologica Scandinavica, followed 180 women from pregnancy through the first six months of their infants’ lives, and found that, even when controlling for factors such as age or smoking, women with higher levels of testosterone had significantly lower levels of breast-feeding success. What’s more, the team of researchers, led by Sven Carlsen, also conducted a review of 50 studies on the health impact of breast-feeding, and concluded that the benefits may be overemphasized, and that often, benefits attributed to breast-feeding may in fact be as a result of the mother’s healthy pregancy. As Carlsen told the BBC:

“These health differences are really not so significant in any event… When you look at the epidemiological studies and try to strip away the other factors, it is really hard to find any substantial benefits among children who were breastfed as babies.”

Most expectant mothers and mothers of newborns are well aware of the dominant medical mantra when it comes to breast-feeding: the World Health Organization and the American Academy of Pediatrics (AAP) both recommend exclusively breast-feeding infants for the first six months of life, and incorporating complementary foods and sources of nutrients while continuing to breast feed through the first year or two of life. Studies show that, for babies, being breast-fed can reduce the risk for diarrhea, ear infection, meningitis and possibly even diabetes and obesity. For mothers, the benefits are considerable as well: studies suggest that breast-feeding can reduce a mother’s risk for breast and ovarian cancer, and even potentially reduce the likelihood of developing osteoporosis.

Because of the prevailing recommendations on breast-feeding, however, too often when mothers struggle to breast-feed or ultimately are unsuccessful, they suffer a sense of guilt at not being able to provide the best possible nutrients for their infants. Yet, authors of this new study hope that their findings will remove some of the stigma from this issue. Carlsen and colleagues suggest that higher levels of testosterone may limit a mother’s development of milk glands, inhibiting her ability to breast feed. And while babies who are breast-fed may be healthier, Carlsen concedes, he argues that the correlation is misplaced. That is, he suggests that a baby’s overall health has more to do with its mother having a healthier pregnancy. The problems that cause women to have more difficult pregnancies, give birth to underweight babies or struggle with illness themselves may also impact their ability to breast-feed, he argues. And, one factor contributing to breast-feeding difficulties may simply be hormones, he says, telling the BBC:

“Basically a mother who finds she has difficulty shouldn’t feel guilty—it probably is just the way it is, and her baby will not suffer for being fed formula milk… A mother should do what makes her happy.”

Of course, Carlsen and his fellow researchers aren’t the first to make a case for reexamining the benefits of breast-feeding. In April 2009 Hanna Rosin wrote in her Atlantic article, “The Case Against Breast-Feeding,” that, “…overall, yes, breast is probably best. But not so much better that formula deserves the label of ‘public health menace,’ alongside smoking.” In response to her article, Dr. David J. Tayloe, Jr., president of the AAP, wrote a letter to the Atlantic refuting her argument that breast-feeding was only nominally preferable, and reiterating what continues to be the dominant medical perspective on the issue. Tayloe wrote:

“The evidence for the value of breastfeeding is scientific, it is strong, and it is continually being reaffirmed by new research work. The American Academy of Pediatrics encourages women to make an informed decision about feeding their infants based on scientifically established information from credible resources.”

Yet, regardless of the best medical advice, the fact remains that for some women, how they ultimately nourish their infant is not so simple as making an informed decision. Instead, it can be a harrowing process of determining the best course for their families based on a wide range of factors—including both physical and emotional.