Long-Term Impact of Neonatal Breastfeeding on Childhood Adiposity and Fat Distribution Among Children Exposed to Diabetes In Utero
- Tessa L. Crume, PHD1,
- Lorraine Ogden, PHD1,
- MaryBeth Maligie, BS1,
- Shelly Sheffield, MS1,
- Kimberly J. Bischoff, MSHA2,
- Robert McDuffie, MD2,
- Stephen Daniels, MD, PHD3,
- Richard F. Hamman, MD, DRPH1,
- Jill M. Norris, PHD1 and
- Dana Dabelea, MD, PHD1
- 1Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado
- 2Health Services and Behavioral Research, Kaiser Permanente of Colorado, Denver, Colorado
- 3Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
- Corresponding author: Dana Dabelea, .
OBJECTIVE To evaluate whether breastfeeding attenuates increased childhood adiposity associated with exposure to diabetes in utero.
RESEARCH DESIGN AND METHODS Retrospective cohort study of 89 children exposed to diabetes in utero and 379 unexposed youth with measured BMI, waist circumference, skinfolds, visceral (VAT) and subcutaneous (SAT) abdominal fat. A measure of breast milk–months was derived from maternal self-report and used to categorize breastfeeding status as low (<6) and adequate (≥6 breast milk–months). Multiple linear regression was used to model the relationship between exposure to diabetes in utero and offspring adiposity outcomes among youth stratified according to breastfeeding status.
RESULTS Adequate (vs. low) breastfeeding status was associated with significantly lower BMI, waist circumference, SAT, and VAT at ages 6–13 years. Among youth in the low breastfeeding category, exposure to diabetes in utero was associated with a 1.7 kg/m2 higher BMI (P = 0.03), 5.8 cm higher waist circumference (P = 0.008), 6.1 cm2 higher VAT (P = 0.06), 44.6 cm2 higher SAT (P = 0.03), and 0.11 higher ratio of subscapular-to-triceps skinfold ratio (P = 0.008). Among those with adequate breastfeeding in infancy, the effect of prenatal exposure to diabetes on childhood adiposity outcomes was not significant.
CONCLUSIONS Adequate breastfeeding protects against childhood adiposity and reduces the increased adiposity levels associated with exposure to diabetes in utero. These data provide support for mothers with diabetes during pregnancy to breastfeed their infants in order to reduce the risk of childhood obesity.
- Received September 3, 2010.
- Accepted October 31, 2010.
- © 2011 by the American Diabetes Association.
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