“Treat the gut” and “breast is best” are both common mantras in the Functional Medicine practitioner’s office offering insight into the primary location of foundational imbalance for many chronic illnesses (in the gut) as well as a potential mechanisms to prevent these imbalances in the first place (breastfeeding).  Delving into both of these areas more deeply, it has been shown that human breastmilk reduces permeability of the infant’s intestine and its predominant antibody, sIgA, gives immunoprotection to the gut; reducing adherence of and infection from pathogenic bacteria.  Breastmilk encourages the proliferation of a favorable microbiome environment leading to a reduction in the risk of asthma, otitis media and respiratory infections; GI tract infections, obesity and type 2 diabetes (T2D). [1]  Studies have also linked breastfeeding to reduced risk of rheumatoid arthritis with a possible association to lower rates of type 1 diabetes and celiac disease. [2]  Less clear, however, is whether the benefits of breastfeeding extend to lowering risk of inflammatory bowel disease (IBD).

IBD is comprised of two inflammatory gastrointestinal diseases: Crohn’s disease (CD) and ulcerative colitis (UC).  Incidence of IBD in the recent past has been most prominent in industrialized regions but is quickly becoming a global health concern. 1  The cause of IBD is not completely understood although the current theory is that these inflammatory conditions arise due to multiple factors intersecting: genetic susceptibility, environmental exposures, dietary and lifestyle habits and microbiome disturbances.

A meta-analysis published in 2017 looked at the association of breastfeeding in infancy and risk of CD and UC later in life.  Thirty five studies were reviewed in the analysis and included 7536 people with CD, 7353 with UC and a total of 330,222 controls.

Results from the study indicated the following:

  • There was a significantly lower risk of IBD in those who had been breastfed at any time in comparison to those who had never been breastfed
  • When comparing the length of time of breastfeeding, a dose-dependent association was seen; a progressively greater reduction in IBD risk was associated with longer time breastfeeding 

Why is this Clinically Relevant?

  • Breastfeeding should be encouraged for all infants
  • Health care providers should encourage mothers to breastfeed for as long as possible; at least up to 1 year of the child’s age and especially in those families with a history of IBD or other inflammatory or auto-immune disorders
  • Nutrients extracted from breastmilk may play a role in IBD treatment protocols

Article reviewed:  Xu L, Lochhead P, Ko Y, Claggett B, Leong RW, Ananthakrishnan AN. Systematic review with meta-analysis: breastfeeding and the risk of Crohn’s disease and ulcerative colitis. Aliment Pharmacol Ther. 2017;46:780–789. https://doi.org/10.1111/apt.14291

Article link: http://onlinelibrary.wiley.com/doi/10.1111/apt.14291/epdf

[1] Dieterich C, et al. Breastfeeding and Health Outcomes for the Mother-Infant Dyad.  Pediatr Clin North Am. 2013 Feb; 60(1): 31–48. doi:  10.1016/j.pcl.2012.09.010

[2] Xu L, Lochhead P, Ko Y, Claggett B, Leong RW, Ananthakrishnan AN. Systematic review with meta-analysis: breastfeeding and the risk of Crohn’s disease and ulcerative colitis. Aliment Pharmacol Ther. 2017;46:780–789. https://doi.org/10.1111/apt.14291

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