Bottle-fed babies 'at higher heart risk'

Sarah Boseleyhealth editor

    Decades of bottle-feeding babies may have left a costly legacy, in both human and financial terms, of a generation of adults at higher risk of death and disability from heart disease and stroke than they should be, according to research published today.

 The paper, published in the Lancet, one of the world's leading medical journals, establishes beyond doubt that breastfed babies become healthier adults.

The study, which has run for 20 years, found that babies given breast milk became adults with cholesterol levels on average 14% lower than bottle-fed babies.

Breastfeeding babies, say the authors, could save many lives. A 10% reduction in cholesterol would cut cardiovascular disease by a quarter. At present it affects 10.7% of the UK population, which is more than 5 million people. It could reduce deaths by 13-14%, saving over 30,000 lives a year in this country alone.

"It is quite possible that hundreds of thousands of deaths in the west are prevented by breastfeeding and many more would be prevented if the uptake of breastfeeding were greater," said Alan Lucas, director of the Medical Research Council's Childhood Nutrition Research Center in London .

Almost a third of new mothers in the UK do not breastfeed their babies at all, and beyond two weeks only half of all babies are breastfed. Around 200,000 babies a year are put on to a bottle from birth.

Professor Lucas says that the study shows that breastfeeding has the effect of "programming" the baby's body so that it will produce less cholesterol in later life.

What is important is not so much the nutritional value of the milk as the signal is sends to the developing system. The study showed the "programming" was in place within as little as four weeks of breastfeeding beginning.

Bottle-fed babies tend to grow faster than those who are breastfed, but the study turns old thinking about small babies on its head. It is not a good thing to feed them up rapidly, to turn them into large and bonny bouncing babies. Slow growth appears to be better for their health as adults.

For Prof Lucas and his team, this study completes a jigsaw, confirming the trend of previous work on high blood pressure, diabetes and obesity. In all of them, breastfed babies had better protection from disease and ill-health than those given bottles.

"What we have shown from all our studies so far is that the diet we are fed in early life is probably one of the most important things we can control," he said. "Diets that promote more rapid growth in early life put you at risk from heart disease and heart attacks.

"It is a revolution in one important respect. If you talk to pediatricians and health professionals, they do think it is best to have a big, strong, bonny baby and grow the baby as fast as you can. We have to be careful not to grow the baby too fast. That would be detrimental."

Prof Lucas' studies were triggered by the results of work on animals as long as 40 years ago, which showed that what they were fed in early life predetermined their pattern of health.

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"I wanted to know if humans could be programmed by early nutrition," he said.

But it would inevitably take decades to find the answer: "Twenty-eight years ago we set up these randomized trials, knowing it would take a long time to get the results. These trials are unique."

The results were more definitive than he had expected: "Even we are really surprised by the size of the effect."

There have been observational studies in the past that have noted that breastfed babies had less heart disease than those who were bottle-fed. This study was a randomized controlled trial - the so-called "gold standard" in science.

It followed up 216 premature babies who had been randomly allocated to either human breast milk or to formula after they were born in the 1980s and compared the cholesterol levels of the two groups.

The significance of the study stems not from the numbers of babies but from the randomization, the timespan and the substantial difference in cholesterol levels (14%) found between the two groups.

The National Childbirth Trust, which works to encourage new mothers to breastfeed, welcomed the research. "This new research adds to the growing body of scientific evidence that demonstrates the numerous benefits of breastfeeding," said Belinda Phipps, chief executive.

"We know that breastfed babies are less likely to be overweight and have less chance of developing diabetes in childhood for example but this research also suggests that breastfeeding can have a major beneficial effect on health in later life too.

"Conversely, formula milk has been linked with a higher incidence of respiratory disease, high blood pressure, ear and urinary tract infections, diarrhea and gastroenteritis.

"We need to see a real shift away from the current bottle-feeding culture in the UK to one where breastfeeding is completely accepted and supported by society so women are able to breastfeed wherever and whenever their baby needs to be fed."