Women who develop gestational diabetes during pregnancy may think that the condition ends once the baby is born and blood sugar levels return to normal. However, the effects of gestational diabetes can continue beyond pregnancy. Women with a history of gestational diabetes have a higher risk of developing type 2 diabetes, abnormal cholesterol levels and cardiovascular disease later in life. Also, there can be changes in blood fats that can appear within weeks after delivery. A new study published in JAMA Network Open has now found that breastfeeding may be linked to a healthier cholesterol and triglyceride profile in these women.

The study suggests that women who breastfed more intensively had lower triglyceride levels, higher levels of HDL, often called "good" cholesterol, and a more favourable balance between LDL and HDL cholesterol. The study looked at 470 women in Japan who had experienced gestational diabetes and underwent metabolic testing around six to nine weeks after giving birth. Researchers examined how the amount of breast milk given to babies was associated with the mothers' blood lipid levels.

High-intensity breastfeeding was defined as getting at least 80% of the baby's milk from breast milk. Among the participants, 369 women met this definition. Their average triglyceride level was 67.2 mg/dL, compared with 116.1 mg/dL among women who did not breastfeed at high intensity. They also had higher HDL cholesterol and a lower LDL-to-HDL ratio. The researchers found that this association was present even after accounting for insulin sensitivity and other factors.

Why Gestational Diabetes Affect Heart Health

Gestational diabetes is diabetes that develops during pregnancy. Although blood sugar often returns to normal after delivery, having gestational diabetes indicates that the body may have underlying problems with insulin sensitivity and glucose metabolism. Women with a history of gestational diabetes are more likely to develop type 2 diabetes and cardiovascular problems later in life. Abnormal blood lipid levels are also common soon after delivery. In the new study, 74 per cent of the women had some form of postpartum dyslipidemia, including high LDL cholesterol, high triglycerides or an unfavourable LDL-to-HDL ratio.

This makes the period after childbirth particularly important for identifying and managing future cardiometabolic risks.

What Did The Study Find About Breastfeeding?

The researchers found a clear link between greater breastfeeding intensity and healthier levels of certain blood fats. Women who breastfed at high intensity had:

  • Lower triglycerides: 67.2 mg/dL compared with 116.1 mg/dL among women who did not breastfeed at high intensity.
  • Higher HDL cholesterol: 73.9 mg/dL compared with 63.0 mg/dL.
  • A lower LDL-to-HDL ratio: 1.8 compared with 2.3.
  • Lower odds of hypertriglyceridemia: after adjustments, high-intensity breastfeeding was associated with about 75% lower odds of having triglycerides of 150 mg/dL or higher.
  • Lower odds of an elevated LDL-to-HDL ratio: the adjusted odds were also substantially lower among women who breastfed at high intensity.

Also, the study did not find a significant trend in total cholesterol across the different breastfeeding categories. The findings were more pronounced for triglycerides, HDL cholesterol and the LDL-to-HDL balance.

How Breastfeeding May Impact Metabolism?

Breastfeeding requires the mother's body to use energy and nutrients to produce milk. Lactation involves changes in glucose and fat metabolism, which may influence how the body handles circulating fats and energy stores. The study found that the association between breastfeeding and a healthier lipid profile remained after researchers adjusted for insulin sensitivity. This is important because insulin resistance is one of the metabolic problems linked with gestational diabetes.

However, the exact biological mechanisms are not fully understood. The researchers found an association rather than proving that breastfeeding directly lowers triglycerides or improves cholesterol levels. Other factors related to breastfeeding and postpartum health could also contribute.

What Do The Findings Mean For Mothers?

The findings suggest that breastfeeding may offer mothers with previous gestational diabetes an additional metabolic benefit during the early postpartum period. This is important because these women already have a higher risk of future metabolic and cardiovascular problems.

However, breastfeeding should not be viewed as a replacement for regular health checks. Women who have had gestational diabetes should continue monitoring blood sugar, cholesterol, blood pressure, weight and other cardiovascular risk factors as recommended by their doctor. It is also important to recognise that breastfeeding is not possible or suitable for every mother. Difficulties with milk production, medical conditions, medications and other circumstances can affect feeding choices.

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