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Alison Stuebe, M.D.
Written by Margot Carmichael Lester for UNC Health Care
Alison Stuebe, M.D., assistant professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill School of Medicine, is investigating how breast-feeding impacts diabetes, heart disease, stress and metabolism. Stuebe, who works in the Division of Maternal Fetal Medicine, used longitudinal data from the Nurses’ Health Study, one of the largest and longest-running investigations of factors that influence women’s health.
“It’s apparent that nursing may help the mother's metabolism shift out of pregnancy mode faster,” she says. Stuebe’s findings show that breastfeeding can mitigate the effects of these conditions:
Heart Disease: “Women who breast-fed for two years or more had a 23 percent lower risk of heart attack,” Stuebe says. “That’s pretty big when you consider that heart disease is the leading killer of women.” Other studies have found that post-partum women who breastfeed have better cholesterol levels that women who don’t.
Diabetes: Stuebe also did a study, the first to show a long-term metabolic benefit for mother, which found that women who nursed had a lower risk of developing Type-2 diabetes. Nursing mothers had a 15 percent lower risk per year of breast-feeding; and women who breastfed a single child for a year had a lower risk than women who breastfed two children for shorter periods totaling a year.
Stress: “There is clear evidence that women who breastfeed have a different response to stress than those who bottle-feed,” she says. Oxytocin – a hormone that reduces fear and increases trust – is probably the key since it’s released during breast-feeding.
While the relationships are clear, why they exist is not. “Is it something about the breast-feeding itself, or the something about the mothers who breastfeed?” Stuebe asks. “Is it the lifestyle of nursing mothers or the milk itself? These questions are hard to answer in observational studies. But the protective aspects of breastfeeding are becoming clear.”
Given the benefits, Stuebe has teamed up with the UNC Hospitals’ lactation consultants to launch a breastfeeding clinic to help women begin and continue nursing. The UNC Lactation Clinic is available to mothers whether or not they delivered at UNC Hospitals. Its midwives, lactation consultants and OB/GYNs meet with mothers, develop a plan and follow up as necessary. To make an appointment, women can call the Breastfeeding Warmline at 866-428-5608.
Many mothers, like Anne-Marie Meyer of Carrboro, come to the clinic in pain.
“I was having recurring infections, and before I went to the clinic, I saw three primary care/internal medicine physicians, a midwife, an immunologist, two dermatologists and an OB/GYN,” she recalls. “None of them could help me.”
The Lactation Clinic team not only began investigating the source of Meyers’s symptoms, but also provided pain management, and emotional and lactation support. Stuebe determined that Meyer was suffering from a staph infection that presented in an unusual way. Meyer was given immediate treatment and the infection was eradicated.
“The clinic team really put the big picture together,” Meyer says. “This was the most difficult and excruciating medical experience I’ve had to navigate in my life, but I felt I had the most personal and genuine care at the clinic.”
While Meyer is more than satisfied with her experience at the clinic, Stuebe wants to be able to provide even more comprehensive care. She’s hoping to secure funding for a study on managing breast pain.
“About one-third of women who stop breast-feeding in the first month attribute the decision to pain,” she says. Working with a microbiologist and the UNC lactation consultants, she will try to find out how to appropriately diagnose and treat infection-related pain. That descriptive data would then be used to launch a clinical trial.
“There’s a paucity of good literature on how to manage this kind of thing,” Stuebe laments. “We’re hoping to develop protocols for breast infection and other common issues so the health care community can begin to work in the same way. We want to gather data and come up with evidence-based guidelines for treatment and education that we can disseminate throughout the community.”
Expanding the research base on the benefits and problems of nursing is critical, Steube says. “Breastfeeding affects two generations – mother and baby,” she asserts. “There’s just not as much good science as this topic deserves.”
To learn more about lactation services at UNC, call the Breastfeeding Warmline at 866-428-5608 or visit http://www.med.unc.edu/fammed/for-patients/maternal-childcare/lactcon. For more information on women’s health, visit http://www.nchealthywoman.org.