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Breast-feeding may cut diabetes risk in child: Pima Indian population.

STANFORD, CALIF. -- Women may lower the chances of their children eventually developing diabetes by exclusively breast-feeding them for 2 months or more during infancy, if data from studies in Pima Indians hold up in other populations, Dr. David J. Pettitt said at a conference on perinatal and pediatric nutrition.

His studies of diabetes in Pima Indians have found a number of associations between maternal diabetes, breast-feeding or bottle-feeding, and diabetes in offspring.

Surveys of Pima Indians found that offspring who were exclusively breast-fed for at least 2 months in infancy were much less likely to develop diabetes over time. By ages 20-24 years, 5% of breast-fed offspring developed diabetes compared with 15% of bottle-fed offspring, said Dr. Pettitt of Sansum Medical Research Institute, Santa Barbara, Calif.

Overall, bottle-feeding doubled the rate of diabetes in offspring compared with exclusively breast-feeding for 2 or more months--10% vs. 5%--after adjusting for other factors that contribute to the risk for diabetes including age, birth date, sex, obesity, birth weight, parental diabetes, and maternal diabetes in pregnancy, he said at the meeting, jointly sponsored by Symposia Medicus and Stanford University.

The 50% reduction in diabetes with breast-feeding occurred mainly in offspring of women who were not diabetic during pregnancy--the large majority of women in this study. Smaller benefits were seen in offspring of women with diabetes during pregnancy: approximately a 20% reduction with breast-feeding compared with bottle-feeding, which produced diabetes in 40% of offspring after adjusting for other risk factors. That 20% difference was not statistically significant, probably because of the small sample size, Dr. Pettitt said.

"If this were to hold up in a much larger sample, then it's possible that by getting women who have diabetes during pregnancy to breast-feed their infants, we might prevent one out of rive cases of diabetes that would otherwise occur in offspring," he said.

The form of infant feeding also helped predict which offspring would go on to have diabetic pregnancies. Pima Indian women who had been exclusively breast-fed in infancy did not have diabetes when carrying their own children if they delivered before age 20 years, and approximately 2% had diabetes in pregnancies carried after age 20 years. Among women who had been bottle-fed as infants, more than 3% were diabetic when carrying their own children regardless of their age at pregnancy.

Data first presented earlier this year from Dr. Pettitt's studies showed that offspring of women with diabetes during pregnancy were much more likely to develop obesity and diabetes as they grew up compared with children born to nondiabetic or prediabetic mothers. By ages 20-24 years, the prevalence of diabetes exceeded 30% in offspring of Pima Indian women with diabetes during pregnancy, compared with approximately 5% in children of women who were nondiabetic or prediabetic during pregnancy, he said.

Other data from a more diverse population in Chicago in 1995 found a sixfold higher rate of impaired glucose tolerance among children of diabetic mothers as they grew up, compared with offspring of nondiabetic mothers. By ages 10-16 years, 20% of offspring of diabetic mothers developed impaired glucose tolerance, compared with approximately 3% of mothers with nondiabetic pregnancies.

In the general population, rates of type 2 diabetes in children are similar to rates seen in Pima Indians 35 years ago, and are increasing, Dr. Pettitt said. The prevalence of type 2 diabetes among Pima Indian youth has doubled among 15- to 19-year-olds and quadrupled among 10- to 14-year-olds since he began following this population in the 1960s.
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Title Annotation:Obstetrics
Author:Boschert, Sherry
Publication:OB GYN News
Date:Dec 1, 2003
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