catherine.mcnestry@ucdconnect.ie
What are the key points of your research synopsis?Breastfeeding has a huge effect on the physiology of the breastfeeding woman. Just how great an effect this is has only started to become apparent in the past few decades, as we learn more and more about the many health benefits for both mother and her infant. It is historically a hugely neglected topic in medicine. A dose-response association of breastfeeding duration with lower risk of cardiovascular disease in the mother has recently been confirmed by systematic review. My MD used the results of two studies – the Latch On multicentre RCT and the ROLO Longitudinal Birth Cohort – to explore breastfeeding support in women with overweight and obesity, and the relationship between breastfeeding, cardiovascular risk and mental health in women of later reproductive age. The results of Latch On have shown that breastfeeding support of any form is important for breastfeeding success in women with overweight and obesity, although we did not find this specific intervention to be superior to usual care. We found that breastfeeding was associated with lower fat mass, percentage body fat and visceral fat volume, as well as lower GlycA – a novel inflammatory biomarker. The association with lower GlycA is a novel finding, suggesting a potential inflammatory pathway by which later risk could be mitigated. Inflammation is also associated with type 2 diabetes mellitus, so again this is suggestive of a potential risk reduction mechanism. Our analysis also found an association between longer breastfeeding and lower depression and anxiety in this cohort. Breastfeeding is known to be associated with lower postnatal depression but few studies have examined the association in the longer term. As far as we are aware, this is the first report of such an association in this age group. Breastfeeding is an important risk mitigating behaviour for women at risk of non-communicable disease such as cardiovascular disease and the metabolic syndrome. It is especially valuable as an intervention as it is low cost and accessible to women of all socio-economic backgrounds in all nations. Supporting breastfeeding is essential for improving population health in the years to come.
The highlight of my MD experience was having the opportunity to join an established research department in the UCD Perinatal Research Centre led by my supervisor and Centre Director Professor Fionnuala McAuliffe MD FRCPI FRCOG. I had the opportunity to learn a host of new skills including project management, lab work, multiple forms of data analysis, chairing and minuting research meetings, lecturing and teaching undergraduate medical students as well as benefitting from the expertise of the many esteemed colleagues that Professor McAuliffe collaborates with. I doubt I would have learnt so much in a short two years otherwise. The second highlight was being allowed to change the proposed topic of my MD to follow the research interest that I developed in the first few months, due to a combination of personal interest and also from working on the Latch On RCT. Being absolutely fascinated by my subject matter made the write up the most enjoyable part of the process for me. Finally, the feeling of submitting my hard copy thesis and graduation day, despite torrential December rain, were what made the whole process worth it!
I would advise speaking to a few successful candidates about what the process entails before you start, and make sure you are sure it’s right for you, as it can be tough going as you transition from clinical work to meeting deadlines and balancing a busy teaching and research workload. If you are committed to the process, you will make it through. I had considered pursuing a doctorate degree for a number of years before starting, and the certainty that this is what I wanted is what kept me going during challenging weeks and months. Now that I am out the other side, I am delighted with all of the skills that I developed and improved upon during the process and the research connections that I made which will benefit me for the rest of my career. Having supportive colleagues to lean on and have a laugh with, as well as support from family and friends, was essential, which was another benefit of joining an established department with a number of doctoral candidates. You can seek this out through research candidate coffee mornings within UCD if you are working in a more solitary capacity.
As a UCD undergraduate it was lovely to come back to familiar territory. I was based in the National Maternity Hospital rather than on campus, but I was able to benefit from the wide range of course modules available remotely to improve my statistical knowledge during the MD program. I found the library team extremely responsive to any query I had which was so helpful, and they have produces a huge amount of tutorials and resources to assist research students. Friendliness and collaboration are the defining characteristics of the UCD research ethos, which made the whole process as enjoyable and productive as possible.