Preventing chronic disease in babies

Will breastfeeding prevent my baby from developing  chronic  diseases?

Many studies suggest breastfeeding can help protect your baby against developing chronic diseases. These include allergic diseases such as eczema, asthma, and hay fever. Diabetes and obesity are less common in people who have been breastfed, and some studies have found that breastfed babies tend to eat a larger number of healthy foods. Other studies have linked breastfeeding with a reduced risk of bowel disease (Crohn’s disease and ulcerative colitis), multiple sclerosis, and rheumatoid arthritis. A few studies have shown that compared to breastfed babies, the genes of infant formula-fed babies showed signs of premature aging and changed in ways that increased the babies’ susceptibility to stress.

A) Allergic diseases

1) Describing allergic diseases 

Some people have immune systems that are over-stimulated or overreact to certain items found in food or that are inhaled. This overreaction makes them more prone to allergic diseases such as eczema, asthma, and food and environmental allergies. Allergic diseases can have a significant impact on a person’s mental and physical health (Silverberg 2017).
Breastfeeding appears to protect babies from a variety of allergic diseases (Hu 2021).

2) Protection from allergic diseases

a) Eczema

Eczema, an itchy skin rash, can develop in the first months after birth. Estimates are that 15% of children and 3.5% of adults have it (Barbot 2018; de Lusignan 2020).

It is thought to have both genetic and environmental causes. Exclusive breastfeeding appears to reduce the risk of babies developing eczema (Blakeway 2019; Flohr 2018; Greer 2019; Lin 2019; Lodge 2015).
Babies with eczema are more likely to develop egg and peanut allergies and other allergic diseases as they grow.

b) Asthma

Many studies show that breastfeeding reduces the risk of wheezing and asthma (Greer 2019; Güngör 2019c; Harvey 2021; Peters 2020). Breastfeeding can further protect the lungs by reducing the negative effects of air pollution on lung function (Zhang 2019; Zhao 2021; Zielinska 2019).

c) Food allergy

There is no clear evidence that exclusive breastfeeding for at least four to six months reduces the risk of food allergy (Fleischer 2020). However, studies have found that mothers who peanuts while pregnant and while breastfeeding will reduce the risk of peanut allergies in their babies (Azad 2020; Frazier 2014). 

d) Environmental allergies

Breastfeeding has been reported to lower the risk of hay fever (allergic rhinitis) (Han 2019; Hummel 2021).

3) How breastfeeding protects against allergic diseases 

Environmental factors, the method of delivery, the mother’s health, how the baby is fed, and the genetic makeup of the baby can all play a role in the development of allergic diseases (Shroba 2018; Sitarik 2018). 

Breastfeeding may protect babies from allergic diseases by: 

  • Containing many agents that prevent the baby's immune system from over-reacting (Wood 2021).  
  • Supporting the growth of health-promoting microbes (the microbiome) (Thorsen 2019; van den Elsen 2019).  
  • Presenting very small amounts of allergy-causing items to the baby, pre-digested, bound to antibodies, and surrounded by a soup of molecules, so that the immune system learns to recognize but not over-react (Macchiaverni 2021)
  • Reducing:
    • The number of chest or stomach infections (den Dekker 2016; Pan 2019) and; 
    • The use of antibiotics to treat them (Zven 2019).
  • Having a positive effect on the baby’s genes which may prevent allergic diseases (Hatmal 2019).

B) Bowel disease

Crohn disease and ulcerative colitis are the two types of inflammatory bowel disease (IBD). Both often cause major health problems requiring medication, hospitalization, and surgery and have a significant impact on a person’s life. The risk of developing IBD is reduced by breastfeeding (Agrawal 2021; Güngör 2019a; Piovani 2019).

Breast milk prevents infections, promotes the barrier function of the bowel, and protects against inflammation. This latter effect may be caused by breast milk adjusting the genes of the baby’s gut cells (Chen 2019; Gimeno-Alcañiz 2019). These effects may all play a role in preventing IBD.

Breastfeeding may delay the onset of celiac disease (Popp 2019).

C) Other diseases related to the immune system

1) Multiple sclerosis

Breastfeeding may delay or prevent the development of multiple sclerosis (Brenton 2017; Conradi 2013; Dalla Costa 2019).

2) Rheumatoid arthritis 

Breastfeeding may protect against rheumatoid arthritis and reduce the severity of the disease if children develop it (Chen 2015; Horton 2019; Rocha 2019). 

D) Diabetes

Diabetes can have major negative health consequences.

In the short term, if poorly managed, diabetes can cause emergencies such as very high or very low blood sugars.

Long term complications can include:

  • Blindness
  • Kidney disease
  • Loss of feeling in the feet which can result in:
    • Ulcers
    • Infection
    • Amputation
  • Blockages in blood vessels to the heart, brain, legs, and feet

Breastfeeding decreases a baby’s risk of type 1 and type 2 diabetes (Craig 2019; Güngör 2019b) and mothers who breastfeed have a lower risk of developing type 2 diabetes.

E) Obesity and rapid growth

1) Protection from obesity 

Babies who are breastfed are less likely to become obese children (Dewey 2021; Eny  2018; Hummel 2021; Poorolajal 2020; Verducci 2021). One survey (Rito 2019) of roughly 100,000 children found that those who were never breastfed were 25% more likely to be obese than those who were exclusively breastfeeding until 6 months.

Breastfeeding for more than six months appears to decrease the waist size and increase fitness in older children (Berlanga-Macías 2020; Pluymen 2019; Snyder 2019).

Breastfeeding reduces the risk of obesity in teens (Byrne 2018; Eidelman 2012; Ma 2020).

Breastfeeding decreases the risk of obesity in babies who are at higher risk of it. These include babies who are (Liu 2018; Wang 2019; Yang 2019):

  • Born to mothers with gestational diabetes (Dugas 2017; Kaul 2018).
  • Born to obese mothers (Reifsnider 2017).
  • Genetically prone to obesity (Horta 2018; Wu 2020).
  • Born very large (Goetz 2018; Lee 2019).
  • Given a diet high in sugar (Kong 2021).

2) How breastfeeding protects from obesity

There are a number of ideas about how breastfeeding works to protect against obesity. Compared with infant formula-fed babies, breastfed babies:

  • Do not have changes in their genes that can lead to obesity (Marousez 2019; Pauwels 2019; Sherwood 2019).
  • Have blood hormone levels that decrease the likelihood of obesity (leptin, ghrelin, adiponectin, insulin growth factor 1, insulin) (Mazzocchi 2019).
  • Take in milk that has:
    • Hormones that prevent the development of unhealthy fat cells (Yu 2019).
    • Special sugars (HMOs) (Gridneva 2019).
    • A unique microbiome (Miro-Blanch 2019)
    • Slightly fewer calories or less protein (Koletzko 2019; Totzauer 2018).
  • Avoid excess calories from infant formula that is too rich and concentrated because of mixing errors (Altazan 2019).
  • Require fewer antibiotics (Chelimo 2020)

Bottle-feeding may also contribute to obesity, since babies who are fed breast milk in a bottle have been found to take in more milk than those who are fed at the breast.

The more rapid weight gain caused by the baby taking in extra calories, especially in the first few days after birth, may result in the baby being programmed to continue gaining, increasing the risk of long-term obesity (Feldman-Winter 2018; Watchmaker 2020).

A small number of breastfed babies have shown very rapid growth that may be related to breast milk properties.

3) Preventing early puberty

Breastfeeding decreases the risk of early puberty (Aghaee 2019; Hvidt 2021). As with obesity, there is a pattern of rapid growth in children who are not breastfed. Early puberty is associated with poorer health and behavioural outcomes.

F) Metabolic syndrome 

1) Describing metabolic syndrome 

Metabolic syndrome is a group of risk factors including:

  • High blood sugar
  • High blood pressure
  • Being overweight
  • Having high levels of certain fats in the blood

Metabolic syndrome increases the chances of having blockages of the blood vessels resulting in:

  • Heart disease (heart attack and angina) 
  • Stroke 
  • Blockages of the arteries to the legs and feet (peripheral artery disease)

The likelihood of artery blockages is greater if individuals have more than one risk factor.

2) How breastfeeding protects babies from metabolic syndrome 

Research about breastfeeding’s ability to reduce the risk of heart disease and stroke in breastfed individuals is not conclusive (Van Horn 2018). Nevertheless studies have shown that: 

  • Breastfeeding reduces the risk of children and adolescents developing metabolic syndrome (Wisnieski 2017).
  • Breastfeeding reduces the risk of diabetes.
  • Breastfed babies have less fat inside their tummies at six months (Breij 2017).
  • Rapid weight gain is seen more commonly in infant formula-fed babies than in breastfed babies and is associated with higher blood pressure in childhood (de Beer 2016; Sun 2020).
  • Older children and teens who were breastfed as babies have healthier blood fat levels (Hui 2019; Umer 2018; Vard 2020).
  • Children and teens who were breastfed have lower blood pressure (James 2019; Miliku 2021).

One study showed the energy factories (mitochondria) in the cells of teenagers who were breastfed as babies had more DNA. Lower levels of DNA can result in diabetes, hypertension, heart disease and metabolic syndrome (Cosemans 2020).

G) Better nutrition

1. Protection from malnutrition

With very few exceptions, breast milk contains unique nutrients to support a baby's optimal growth and development, and program the baby for future health.

Breastfeeding gives babies food security. It protects them from malnutrition due to infant formula manufacturing and mixing errors.

2. Long-term food preferences

Breast milk is flavoured by the food the mother eats, while infant formula is much more limited in flavour (Spahn 2019). Breastfeeding has been described as a flavour-bridge (Birch 2014) as early exposure to different tastes seems to produce babies who are more willing to try different foods (Mennella 2014).  

Some research has shown that breastfed babies tend to eat a larger number of healthy foods  and eat more vegetables (Beckerman 2020; de Wild 2018;Jones 2015). There is mixed evidence that infant formula-fed babies are more picky eaters (Bell 2018; de Barse 2017; Emmett 2018). They may prefer softer foods (Marquezin 2019). 

H) Teeth, mouth, and bone development

1) Teeth development

Some studies show that breastfed children are less likely to have abnormal alignment of the milk teeth (deciduous teeth) and may be less likely to need orthodontic treatment (Abate 2020; Parker and Chia 2020).

2) Mouth, throat, and head development

The muscles of the mouth and face function differently when breast- or bottle-feeding (Gomes 2006). Compared to bottle-feeding, breastfeeding promotes healthy jaw and mouth development (Garcia Rincon 2020; Vinha 2017). Babies who are breastfed for at least six months are less likely to breathe through their mouths as children (Park 2018; Savian 2021).

3) Bone development

Breastfed babies have been shown to have stronger bones later in life (Blanco 2017; Carter 2020; Yang 2020).

I) Other chronic diseases

Baby girls who are breastfed have been reported to have a lower risk of endometriosis (Olšarová 2020; Sasamoto 2020). This is a condition in which tissue that is normally found lining the uterus, grows in other parts of the tummy. This tissue responds to a woman’s period hormones and will grow and bleed causing pain as women go through their cycles. Endometriosis can also cause scarring, infertility, heavy periods, and bowel and bladder problems.

J) Improved structure and function of the baby’s genes

It is fascinating to see that breastfeeding, or the lack thereof, has an effect at the genetic level. Breast milk is thought to guide how the baby’s genes (chromosomes) work (Hartwig 2020; Mallisetty 2020; Sherwood 2020). This may be one way that breast milk and breastfeeding allow for the optimal health of babies and helps them throughout their lives.

K) The risk of early cow’s milk-based formula supplements after birth

A small number of babies struggle to breastfeed in the early days after birth and need temporary treatment with milk supplements.
Cow's milk-based infant formula use shortly after delivery may increase the risk of the following:

  • Cow’s milk protein allergy (Burris 2020; Halken 2021; Sakihara 2021) 
  • Asthma and wheezing (Tachimoto 2020) 
  • A gut microbiome that is less likely to promote health (Chin 2021; Forbes 2018)

Short-term supplementation with infant formula while in hospital does not appear to increase the risk of later obesity (Azad 2018). 


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