Long-Term Impact of Neonatal Breast-Feeding on Body Weight and Glucose Tolerance in Children of Diabetic Mothers
- 1Institute of Experimental Endocrinology, Humboldt University Medical School (Charité), Berlin
- 2Clinic of Obstetrics and Gynecology, Berlin-Kaulsdorf, Berlin, Germany
OBJECTIVE—Offspring born to women with pregnancies complicated by diabetes are at increased childhood risk of developing obesity and impaired glucose tolerance (IGT). In population-based studies, breast-feeding has been shown to be protective against obesity and diabetes later in life. To date, the role of breast-feeding on offspring of diabetic mothers (ODM) has not been investigated in this context.
RESEARCH DESIGN AND METHODS—A total of 112 ODM (type 1 diabetes, n = 83; gestational diabetes, n = 29) were evaluated prospectively for impact of ingestion of either diabetic breast milk (DBM) or nondiabetic banked donor breast milk (BBM) during the early neonatal period (day 1–7 of life) on relative body weight and glucose tolerance at a mean age of 2 years.
RESULTS—There was a positive correlation between the volume of DBM ingested and risk of overweight at 2 years of age (odds ratio [OR] 2.47, 95% CI 1.25–4.87). In contrast, the volume of BBM ingested was inversely correlated to body weight at follow-up (P = 0.001). Risk of childhood IGT decreased by increasing amounts of BBM ingested neonatally (OR 0.19, 95% CI 0.05–0.70). Stepwise regression analysis showed volume of DBM to be the only significant predictor of relative body weight at 2 years of age (P = 0.001).
CONCLUSIONS—Early neonatal ingestion of breast milk from diabetic mothers may increase risk of becoming overweight and, consequently, developing IGT during childhood. Additional studies are needed to assess long-term consequences that might result from the type of neonatal nutrition in ODM.
- BBM, nondiabetic banked donor breast milk
- DBM, diabetic breast milk
- GDM, gestational diabetes
- IGT, impaired glucose tolerance
- ODM, offspring of diabetic mothers
- OGTT, oral glucose tolerance test
- OR, odds ratio
Address correspondence and reprint requests to Andreas Plagemann, MD, Institute of Experimental Endocrinology, Humboldt University Medical School (Charité), Schumannstr. 20/21, 10098 Berlin, Germany. E-mail:.
Received for publication 23 July 2001 and accepted in revised form 25 September 2001.
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