Breastfeeding a baby exposed to diabetes in utero may help protect that infant from becoming obese during childhood, according to a study published in the February issue of Diabetes Care and an accompanying editorial, which noted that population-wide detection and treatment of gestational diabetes takes on even greater importance due to these findings.
Babies that were breastfed for six months or more, after exposure to maternal diabetes in utero, were no more likely to put on extra weight as children (ages 6-13) than those who were not exposed to diabetes, the study found. This effect was not realized, however, for babies breastfed less than six months. The results were consistent across ethnicities.
"Our data suggest that breastfeeding promotion may be an effective strategy for reducing the increased risk of childhood obesity in offspring of mothers with diabetes during pregnancy," said Dr. Dana Dabelea, Associate Professor in the Department of Epidemiology, Colorado School of Public Health, and lead researcher on the study. "Since childhood obesity and in utero exposure to maternal diabetes have both been associated with later development of type 2 diabetes, it follows that breastfeeding these children may also help reduce their future risk for developing type 2. However, further research would be needed to confirm that added protection."
The study also suggests that the early postnatal period may be a critical period for determining future obesity and diabetes risk, the researchers concluded. "The macronutrient composition of breastmilk (i.e. protein, fat, carbohydrate) and bioactive substances not present in formula may influence metabolic programming and regulation of body fatness and growth rate," they wrote.
Previous research has shown that children born to mothers who had diabetes during pregnancy are more prone to childhood obesity than those who are not, perhaps because they are "programmed" to put on extra weight due to exposure to their mother's excessive glucose levels during these critical stages of prenatal development.
In an editorial accompanying this study, Dr. Andreas Plagemann, of the Clinic of Obstetrics, Division of Experimental Obstetrics, Charite-University Medicine Berlin, wrote that the study reinforced the importance of breastfeeding and of testing and treating pregnant women for diabetes "to enhance not only the prenatal but also the neonatal nutritional environment of the offspring."
"Beyond its important role for mother-child binding, breastfeeding as compared to formula has a considerable number of positive short and long term effects on human development, such as a decreased incidence of high respiratory infections, a lower risk of asthma and atopy, and a decreased risk of high blood pressure, type 2 diabetes as well as type 1 diabetes," he wrote. "Moreover, profound evidence exists that breastfeeding has the potential to permanently decrease the long-term risk of developing obesity, as shown by the results of at least for meta-analyses on this issue."
