Why Many With Breast Implants Fail at Breast-Feeding

Women with breast implants who think breast-feeding will change how their breasts look are less likely to nurse their babies successfully, according to a new study.

Researchers from the American Society of Plastic Surgeons (ASPS) pointed out that the number of pregnancies a woman has — not whether she breast-feeds — is what causes breasts to sag over time.

“If a woman believes that breast-feeding will adversely affect her breast appearance, she decreases her chances of successful breast-feeding,” study author Dr. Norma Cruz, said in an ASPS news release. “This misconception is unfortunate. Reassuring women that breast-feeding won’t harm their breast appearance, and that it has significant health advantages for both mother and baby, is vitally important.”

Researchers studied the breast-feeding habits of 160 mothers with breast implants. They found that 86 percent of the 97 mothers who failed at breast-feeding thought that it would make their breasts look worse. The researchers noted that this misconception had a direct impact on their success.

On the other hand, of the 63 women studied who exclusively breast-fed their babies for two weeks or more, only 13 percent believed it would harm how their breasts looked.

“It makes sense that breast augmentation patients would be concerned about the effect breast-feeding could have on the appearance of their breasts. After all, these women have invested both time and money into them,” said Cruz, an ASPS member surgeon. “However, available evidence tells us that although breasts sag more with each pregnancy, breast-feeding doesn’t seem to worsen these effects in women with or without breast implants.”

The findings are troubling, the researchers noted, because the U.S. Department of Health and Human Services Office on Women’s Health reports that not only does breast-feeding help strengthen the mother-child bond, it is linked to a number of health benefits for women, including lower risk of type 2 diabetes, breast cancer, ovarian cancer and post-partum depression. The agency adds that breast milk also helps children build their immune systems and fight diseases.

“Now that we know breast augmentation patients’ views on how breast-feeding will impact the look of their breasts, patient education becomes critical to improving perceptions and strengthening the health and lives of both mother and child,” concluded Cruz.

The study was slated to be presented at the American Society of Plastic Surgeons’ annual conference in Denver. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

GOP Presidential Hopeful Rick Perry’s Record On Women’s Health Scrutinized

As the GOP presidential primary campaign continues to heat up, news outlets focus on Texas Gov. Rick Perry’s state policy record: An NPR report today examines his funding for women’s health. Meanwhile, Michele Bachmann offers her take on employer-sponsored health insurance.

NPR: Gov. Perry Cut Funds For Women In Texas
Only 48 percent of Texans have private health insurance and more than a quarter of the state’s population has no insurance at all, more than any other state. To fill this gap, the state’s hospital emergency rooms and dozens of women’s health clinics have stepped in to serve the uninsured across Texas. To understand the health care landscape in Texas it helps to start with context, and perhaps nobody is better suited to explain it than Tom Banning. He is the CEO of the Texas Academy of Family Physicians, a group of about 6,000 doctors and whose members reach into every part of the state (Goodwyn, 9/20).

CBS: Michele Bachmann Says Tax Breaks Should Replace Employer Health Plans
Back in her hometown Monday, Republican presidential contender Michele Bachmann waxed nostalgic for an era when people were responsible for purchasing their own insurance, rather than being tethered to an employer for coverage. “When I grew up here in Iowa, we owned our own health insurance. We didn’t necessarily have it from our employer,” she said. Asked in a round-table with workers at OMJC Signal, a family-owned public-safety equipment manufacturer, how small businesses can afford health care for their employees, the Minnesota congresswoman said they shouldn’t have to buy it. “I think you should be able to own your plan, so your employer doesn’t own it — you get to own it, and you buy it with your own tax-free money,” Bachmann responded. She added, “You should be able to set aside whatever amount of your income you need to purchase the kind of health care you need for yourself, for your family,” (Huisenga, 9/19).

Finally, the HPV controversy continues —

The Associated Press: Bachmann Says Vaccine Retardation Claim Not Hers
Republican presidential candidate Michele Bachmann said Monday she was not arguing that a vaccine intended to prevent cervical cancer caused mental retardation when she repeated the scientifically unfounded claim last week. The Minnesota congresswoman said she was relaying what a distraught woman told her after a GOP presidential debate in Florida in which Bachmann criticized rival Rick Perry for ordering the vaccine in Texas (Beaumont, 9/19).

NPR: HPV Vaccine: The Science Behind The Controversy
Many find the public health case for HPV vaccination compelling. Cervical cancer strikes about 12,000 U.S. women a year and kills around 4,000. Strong backers of the vaccine include the American Academy of Pediatrics, the American Academy of Family Physicians and the Centers for Disease Control and Prevention.The vaccine requires three shots over six months and costs upwards of $400, which is not always covered by insurers or government agencies (Knox, 9/19).

Health Buzz: Depression Ups Stroke Risk

Depression may raise the risk of stroke, a new study suggests. Researchers at the Harvard School of Public Health and Brigham and Women’s Hospital analyzed 28 studies involving more than 317,000 people ages 18 and over who were followed for anywhere from two to 29 years. They found that participants with depression were 45 percent more likely to have a stroke and 55 percent more likely to die of stroke than those without the mood disorder. The study authors speculate that depression inflames hormones in the nervous system, which could increase stroke risk, according to findings published today in the Journal of the American Medical Association. Also: People with depression are likelier to smoke, eat unhealthily, and be overweight—all risk factors for stroke. “We think that in the future, depression should be considered as a risk factor for stroke,” study author An Pan, a research fellow in the department of nutrition at the Harvard School of Public Health, told Time. “We still need more evidence to see whether such screening will be beneficial for patients, but I think our study provides convincing evidence to support further research.”

Stroke: 7 Signs You Could Be at Risk of a Brain Attack

Stroke can hit like a deadly lightning bolt. And if the victim survives, the aftermath can be debilitating—affecting functioning from movement to speech. While stroke is the third-leading cause of death and the leading cause of adult disability in the United States, it trails behind other major diseases in awareness and recognition of symptoms. Being informed, however, can protect you from suffering either an ischemic stroke, caused by a blood clot and the most common form of stroke, or the less common hemorrhagic stroke, caused by bleeding in the brain. Know the factors that may be putting you at risk:

Uncontrolled high blood pressure. As for all cardiovascular disease, high blood pressure is a major risk factor for stroke. The American Heart Association estimates that only 45 percent of people with high blood pressure actually have it under control, U.S. News reported in 2009. Female stroke victims, in particular, tend to have uncontrolled blood pressure, and in general, women who suffer strokes don’t seem to be treated as aggressively as men. High blood pressure doesn’t have any outward telltale signs, so getting it measured by your healthcare provider is essential to determine if you should make lifestyle changes or take medications to bring it down.

Smoking. Puffing on cigarettes is associated with a host of ills. An increased risk of stroke is one of them. When compared to nonsmokers, smokers have double the risk of ischemic stroke. Heavy smokers face an even greater risk: A study of women ages 15 to 49 published in the journal Stroke found stroke risk was proportional to the number of cigarettes smoked per day. The women who smoked two or more packs a day had nine times the risk of stroke of a nonsmoker. And a study in Neurology found that smokers with a family history of brain aneurysm, abnormal bulging of an artery in the brain, are six times as likely to have a subarachnoid hemorrhage, a kind of stroke caused by a bleed between the brain and the tissue that covers it. These types of stroke are deadly nearly 40 percent of the time.

FDA panel unclear on osteoporosis drug labels

Labels on bisphosphonates, a type of medication used to treat and prevent osteoporosis, should further clarify how long patients can take them, an FDA advisory panel voted today.

But the panel backed off giving any specific time limits.

Bisphosphonates include Aclasta, Actonel, Altevia, Boniva, Fosamax, and Reclast. Four million to 5 million Americans fill prescriptions for the drugs every year, according to the FDA

The FDA convened the meeting because of emerging safety concerns related to long-term use — generally considered more than three to five years — of bisphosphonates.

In particular, the agency has received reports of osteonecrosis, or bone death, of the jaw and unusual fractures of the femur, or thigh bone, in women who had taken the drugs for several years or more.

Meanwhile, some research suggests that because bisphosphonates remain in bone for years, women could still benefit after they stop taking them.

More Information Needed on Labels

The panel, made up of the Advisory Committee for Reproductive Health Drugs and the Drug Safety and Risk Management Advisory Committee, voted 17 to 6 in favor of recommending additional labeling information about the drugs’ long-term safety and effectiveness.

The FDA usually but not always follows its advisory committee’s recommendations.

The agency’s own analysis concluded that in women who continue bisphosphonate therapy after five years of use there’s no clear benefit or evidence of harm and no subset of patients who have a “clear and consistent” reduced fracture risk, FDA scientist Theresa Kehoe, MD, told the panel.

Bisphosphonate labels mention that safety and effectiveness information is based on one to four years — depending on the drug — of clinical trial data, Kehoe said, but optimal length of use is unknown.

“This is really an issue that’s front and center in primary care,” said Douglas Bauer, MD, a University of California, San Francisco, primary care doctor invited by the FDA to address the advisory panel.

While not an ideal study to examine long-term use, the only published study to do so involved Fosamax, Bauer said. That study randomly assigned women who’d taken Fosamax daily for five years in a clinical trial to either continue taking the drug for another five years or stop.

For fractures other than those of the spine, there was no evidence overall of continued benefit after five years, Bauer said.

But there was a 55% reduction in spine fracture risk in women who continued taking Fosamax for the extra five years, said Arthur Santora, executive director of clinical research for diabetes and endocrinology drugs at Merck, which makes the drug.

And in studies of up to 10 years of use, Santora said, there were no reports of jawbone death and no difference in the risk of unusual thigh fractures between women who took the drug and those who didn’t.

Long-Term Use of Bisphosphonates

Panelists noted that it’s difficult to predict which women will benefit from long-term bisphosphonate use. The Fosamax study did find that women’s bone mineral density at the time they discontinued the drug was strongly related to their fracture risk over the next five years, Bauer told panel members.

The findings probably can be generalized to weekly dosing of Fosamax, he said, but it’s unclear how they relate to other bisphosphonates.

Paul Miller, MD, medical director of the Colorado Center for Bone Research, noted that long-term use wasn’t an issue when bisphosphonates first came on the market. At that time, “we didn’t treat a lot of women in their 50s or early 60s with bisphosphonates,” said Miller, who was representing Warner Chilcott, maker of Actonel. “We treated sicker women in their 70s and 80s.”

In July 2002, the first published results from the Women’s Health Initiative changed all that, he said. The study found that Premarin, the top-selling brand of postmenopausal estrogen, increased heart attack, stroke, and breast cancer risk. Postmenopausal women who had been on hormone therapy to protect their bones flooded doctors’ offices in search of an alternative, Miller said.

Most of the bisphosphonate patients who testified before the panel about their unusual thigh fractures said they had started taking the drugs in their 50s or 60s. Some of the women said they’d been prescribed the drugs for osteopenia, which means their bone mineral density was lower than normal but not low enough to be classified as osteoporosis.

Advisory committee member Clifford Rosen, MD, director of the Center for Clinical and translational Research at the Maine Medical Center Research Institute in Scarborough, questioned the wisdom of prescribing bisphosphonates simply to prevent osteoporosis, as opposed to treating it.

“A prevention indication, I think, is being revisited all the way around, including by the FDA,” Kehoe said in response. “Certainly it’s something we’re struggling with and dealing with.”

Women’s Health pushes out one-shot pregnancy mag Bump

Pacific Magazines is targeting pregnant women with a new one-shot magazine titled Women’s Health Bump.

The extension of Women’s Health will be on sale from next Monday for the next three months at newsagents and selected supermarkets.

Felicity Harley, editor Women’s Health said: “Our research tell us that there is a gap in the market for a magazine that’s just about the woman’s pregnancy experience.”

“Women’s Health Bump won’t tell you about prams, baby bags and cots, but rather it’s the personal journey through the three stages of pregnancy – before, during and after.”

The title will feature editorial on fertility, bump-friendly fitness, health and nutrition as well as beauty, style, sex and love.

Michelle Meyercord, senior vice president, Rodale International added: “Bump is another example of how this team [Women’s Health] has grown this brand and how they continue to make Women’s Health the most relevant and engaging brand for women in Australia.

“We expect it will connect with readers and we are looking at ways we can expand this great idea to markets all around the world.”

Expo teams up with Women’s Wellness Initiative

On Saturday, Oct. 1, the Civic Arena will bring wellness and fashion together under one roof.

As both target the same audience, the 2011 Josephine Expo and Heartland Health’s Women’s Wellness Initiative decided to coordinate their annual events this year.

The ninth Women’s Wellness Initiative, “Just Her Health,” will be held in the south side of the arena. Its doors open at 9 a.m., and Dr. Jane Schwabe will welcome guests at 9:30 a.m.

Venue and time of year rank among the Initiative’s biggest changes. For the past few years, it’s been held at Missouri Western State University and touted as a “holiday prep camp.” Doctors’ panels to discuss women’s health topics, such as arthritis, heart disease, cancer and weight loss, will remain the same. Cardiovascular specialist Dr. Francisco Lammoglia and medical oncologist Dr. Rony Abou-Jawde are among the specialists who will answer questions.

An afternoon panel on weight loss will highlight success stories and surgical options for patients offered by recent hire, bariatric surgeon Dr. Phillip Hornbostel.

“Most people really like it,” Dr. Schwabe said of the physician panels. “They get new information. I think they really like the open forum, asking doctors questions in a not-very-threatening format. So if there’s some question they’ve got that they’re very curious about, we’ll do our best to try to answer it.”

Women who pre-register for the free health event by calling (816) 271-4098 will get a free pass to the Expo. The Initiative will break for the Expo’s fashion show, held at 11 a.m., and give participants time to explore the vendors. Participants are also free to come and go as they please, Dr. Schwabe noted, particularly as this year’s Initiative will be on the same day as Paint the Parkway Pink, and the Initiative doesn’t want to compete with it or the Expo.

Those who bring five or more canned goods to benefit Second Harvest Community Food Bank are invited to attend a Zumba session following the Initiative and the end of the Expo at 4 p.m.

Expo doors open at 10 a.m. for women who do not want to participate in the Wellness Initiative. Tickets cost $5 and can be purchased at Hy-Vee and at the News-Press. Children age 12 and under are free.

The 2011 Expo, with the theme “Just Her Style,” will feature around 100 booths and vendors, along with the East Hills’ sponsored fashion show. The popular show, performed again at 2 p.m., will showcase items from Dillard’s, Sears, J.C. Penney, Charming Charlie and Rue 21, among other stores.

“We see it as no matter what your style is, whether it’s fashion or personal, we’ll have something at the Expo for you,” said Carole Dunn, special projects advertiser for the News-Press and co-coordinator of the event.

One of the sponsors, Randy Reed, will have the Chevy Volt, an electric car, on display. Live music will also be performed throughout the day; The Phil Vandel Band will play at 10 a.m., Marcus Words at noon and the Wood Pile at 3 p.m.