Open Access Highly Accessed Research article

A prospective population-based cohort study of lactation and cardiovascular disease mortality: the HUNT study

Tone Natland Fagerhaug1*, Siri Forsmo1, Geir Wenberg Jacobsen1, Kristian Midthjell2, Lene Frost Andersen3 and Tom Ivar Lund Nilsen4

Author Affiliations

1 Department of Public Health and General Practice, Norwegian University of Science and Technology, PO Box 8904 MTFS, 7491 Trondheim, Norway

2 Department of Public Health and General Practice, HUNT Research Centre, Forskningsveien 2, 7600 Levanger, Norway

3 Department of Nutrition, University of Oslo, Postboks 1046, Blindern 0317, OSLO, Norway

4 Department of Human Movement Science, Norwegian University of Science and Technology, Dragvoll 7491 Trondheim, Norway

For all author emails, please log on.

BMC Public Health 2013, 13:1070  doi:10.1186/1471-2458-13-1070

Published: 13 November 2013



Recent studies suggest that lactation has long-term effects on risk for cardiovascular disease in women, but the effects on cardiovascular mortality are less well known.


In a Norwegian population-based prospective cohort study, we studied the association of lifetime duration of lactation with cardiovascular mortality in 21,889 women aged 30 to 85 years who attended the second Nord-Trøndelag Health Survey (HUNT2) in 1995–1997. The cohort was followed for mortality through 2010 by a linkage with the Cause of Death Registry. Adjusted hazard ratios (HR) for death from all causes and cardiovascular disease were calculated using Cox regression.


During follow-up, 1,246 women died from cardiovascular disease. Parous women younger than 65 years who had never lactated had a higher cardiovascular mortality than the reference group of women who had lactated 24 months or more (HR 2.77, 95% confidence interval [CI]: 1.28, 5.99). There was some evidence of a U-shaped association, where women who reported lactating 7–12 months had a HR of 0.55 (95% CI: 0.27, 1.09). No clear associations were observed among women 65 years or older.


Excess cardiovascular mortality rates were observed among parous women younger than 65 years who had never lactated. These findings support the hypothesis that lactation may have long-term influences on maternal cardiovascular health.

Breastfeeding; Cardiovascular death; Maternal health