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© 2005 by the American Diabetes Association, Inc.
Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes |
Long-Term Impact of Breast-Feeding on Body Weight and Glucose Tolerance in Children of Diabetic Mothers
Role of the late neonatal period and early infancy
1 Clinic of Obstetrics, Division of Experimental Obstetrics, Campus Virchow-Klinikum, Charité–University Medicine Berlin, 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, Augustenburgerplatz 1, 13353 Berlin, Germany. E-mail: andreas.plagemann{at}charite.de
OBJECTIVE—Offspring of diabetic mothers (ODM) are at increased risk of developing overweight and impaired glucose tolerance (IGT). Recently, we observed that early neonatal ingestion of breast milk from diabetic mothers (DBM) may dose-dependently increase the risk of overweight in childhood. Here, we investigate whether DBM intake during the late neonatal period and early infancy also influences later adipogenic and diabetogenic risk in ODM.
RESEARCH DESIGN AND METHODS—A total of 112 ODM were evaluated for influence of DBM ingestion during the late neonatal period (2nd–4th neonatal week) and early infancy on relative body weight (RBW) and glucose tolerance in early childhood.
RESULTS—Exclusive breast-feeding was associated with increased childhood RBW (P = 0.011). Breast-fed ODM had an increased risk of overweight (odds ratio 1.98 [95% CI 1.12–3.50]). Breast-feeding duration was also positively related to childhood RBW (P = 0.004) and 120-min blood glucose during an oral glucose tolerance test (P = 0.022). However, adjustment for the DBM volume ingested during the early neonatal period, i.e., 1st week of life, eliminated all these relations with late neonatal breast-feeding and its duration. Interestingly, no relationship was observed between maternal blood glucose in the middle of the third trimester and the outcome.
CONCLUSIONS—Neither late neonatal DBM intake nor the duration of breast-feeding has an independent influence on childhood risk of overweight or IGT in ODM. Therefore, the 1st week of life appears to be the critical window for nutritional programming in ODM by ingestion of maternal "diabetic" breast milk.
Abbreviations: AUCG, area under the curve of glucose • DBM, diabetic breast milk • GDM, gestational diabetes mellitus • IGT, impaired glucose tolerance • ODM, offspring of diabetic mothers • OGTT, oral glucose tolerance test • RBW, relative body weight
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