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Impact of Early Neonatal Breast-Feeding on Psychomotor and Neuropsychological Development in Children of Diabetic Mothers

¹ Clinic of Obstetrics, Division of Experimental Obstetrics, Charité-University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
² Clinic of Obstetrics and Gynecology, Berlin-Kaulsdorf, Germany

Address correspondence and reprint requests to Prof. A. Plagemann, MD, Clinic of Obstetrics, Head of Experimental Obstetrics, Charité-University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany. E-mail: andreas.plagemann{at}charite.de

OBJECTIVE—In general, breast-feeding positively influences development of psychomotor function and cognition in children. Offspring of diabetic mothers (ODM) have delayed psychomotor and cognitive development. Recently, we observed a dose-dependent negative effect of early neonatal ingestion of breast milk from diabetic mothers (diabetic breast milk [DBM]) on the risk of overweight during early childhood. Here, we investigated the influence of early neonatal intake of DBM on neurodevelopment in ODM.

RESEARCH DESIGN AND METHODS—A total of 242 ODM were evaluated for age of achieving major developmental milestones (Denver Developmental Scale) according to the volume of DBM ingested during the first week of life, using Kruskal-Wallis and Kaplan-Meier analysis.

RESULTS—Children in the upper tertile of early neonatal ingestion of DBM achieved early psychomotor developmental milestones ("lifting head while prone," "following with eyes") earlier than those in lower tertiles (P = 0.002). In contrast, a delay in the onset of speaking was observed in children who had ingested larger volumes of DBM compared with those with lower DBM intake (P = 0.002). This negative impact of DBM ingestion was not confounded by birth characteristics, total milk intake, or socioeconomic/educational status.

CONCLUSIONS—Our data indicate differential effects of early neonatal DBM ingestion on psychomotor and cognitive development. Ingesting larger compared with smaller volumes of DBM may normalize early psychomotor development in ODM but delays onset of speaking as a parameter indicative of cognitive development. This effect may result from qualitative alterations in the composition of DBM. Further studies are urgently recommended on the benefits and harms of breast-feeding in ODM.

Abbreviations: DBM, diabetic breast milk • GDM, gestational diabetes mellitus • ODM, offspring of diabetic mothers

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