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This review discusses the long-term health effects of breast feeding, based on the most relevant publications from the second half of 2004 and 2005.The positive effect of breast feeding on later cognitive function continues to be the most consistent and important effect. Also, breast feeding is likely to protect against some immune-related diseases later in life, such as type 1 diabetes, coeliac disease, inflammatory bowel diseases and perhaps cancer. The evidence for an effect on allergic disease continues to be inconclusive. Furthermore, breast feeding seems to be associated with a lower blood pressure and serum cholesterol, but there is no clear association with cardiovascular disease or death. Most new studies and meta-analyses show a protective effect against later obesity, but this seems to be small. A new hypothesis suggests that breast feeding programmes the insulin-like growth factor axis and results in higher growth velocity later in childhood.Evidence is increasing that breast feeding, beyond its well-established beneficial effects during the breast-feeding period, also confers long-term benefits. These effects are not strong at the individual level, but are likely to be of importance at the population level. Since the majority of the studies are observational, however, it is difficult to prove causality.