Breastfed children of diabetics might be at increased risk of obesity

NEW YORK (Reuters Health) – Among children of diabetic mothers, those who are principally breast-fed during the first week of life are more likely than those who principally receive banked breast milk to be overweight or to develop impaired glucose tolerance by age 2.

Also, according to the German researchers who published this finding, the effect was seen in children of mothers recovering from gestational diabetes just as much as children of type 1 diabetic mothers.

Previous studies have demonstrated that "intrauterine programming" increases the risk of obesity and impaired glucose tolerance in children of diabetic mothers, Dr. Andreas Plagemann, of Humboldt University Medical School in Berlin, and colleagues note in the January issue of Diabetes Care. But the role of breast-feeding has never been evaluated, they say.

To investigate, they kept detailed feeding records for 112 infants of diabetic mothers during the first 7 days of life. In total, 83 mothers had type 1 diabetes, and 29 had gestational diabetes, of whom 15 had received insulin therapy. All mothers were encouraged to breast-feed, but banked breast milk from nondiabetic donors was given as necessary.

The volume of diabetic breast milk ingested neonatally was positively correlated with the risk of being overweight at age 2 (p < 0.001), Dr. Plagemann's group determined. Similarly, the volume of diabetic breast milk ingested neonatally was positively correlated with the risk of impaired glucose tolerance at age 2 (p = 0.03). By comparison, the volume of neonatal consumption of banked breast milk was inversely correlated with being overweight and the risk of impaired glucose tolerance (p = 0.001 and p = 0.02, respectively).

Long-term studies are needed to investigate the effect of different types of neonatal nutrition in children of diabetic mothers, the authors conclude. "Meanwhile, considering the variety of advantages resulting from breast-feeding in general, in our opinion, breast-feeding should remain the preferred type of infant feeding, even in this particular population."

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