Children of mothers with gestational diabetes who were breastfed for at least 6 months were less likely to develop prediabetes or metabolic syndrome in early adolescence vs. children exposed to gestational diabetes who were not breastfed, according to findings published in Pediatric Obesity.
Jaimie N. Davis
Studies have suggested that women with gestational diabetes are less likely to exclusively breastfeed in the first hour postpartum, are more likely to formula feed their children and are more likely to have a delayed onset of lactation mainly due to diabetes, insulin treatment and obesity vs. women without gestational diabetes, Jaimie N. Davis, PhD, associate professor in the department of nutritional sciences at the University of Texas at Austin, and colleagues wrote in the study background.
“There is debate on whether or not mothers with gestational diabetes should breastfeed,” Davis told Endocrine Today. “Our data suggest mothers with gestational diabetes who breastfeed for at least 6 months decrease the prevalence of prediabetes and metabolic syndrome in their offspring who are adolescents.”
Davis and colleagues analyzed data from 229 Hispanic children aged 8 to 13 years between 2004 and 2013 with overweight or obesity and a family history of diabetes who attended an average of four annual visits as part of the Study of Latino Adolescents at Risk for Diabetes (mean age, 11 years; 60% boys; 80.1% with obesity). Researchers assessed data on family history of diabetes, maternal gestational diabetes status, child’s birth weight and breastfeeding initiation. Researchers categorized children into four groups: mothers without gestational diabetes and breastfed; mothers without gestational diabetes and not breastfed; mothers with gestational diabetes and breastfed; and mothers with gestational diabetes and not breastfed. Children underwent a 2-hour oral glucose tolerance test, and metabolic syndrome was categorized using pediatric cutoffs for the Adult Treatment Panel III definition. Prediabetes was defined according to American Diabetes Association criteria. Researchers used logistic regression analyses to evaluate the effects of breastfeeding, gestational diabetes and an interaction between the two variables on the prevalence of metabolic syndrome and prediabetes over time.
Within the cohort, 60 children (26%) were exposed to gestational diabetes, and 130 (57%) were breastfed for at least 1 month (average duration, 5.2 months). Children exposed to gestational diabetes had a higher prevalence of prediabetes at baseline vs. children not exposed to gestational diabetes (58% vs. 33%; P = .03), with 27% of children considered to have intermittent prediabetes and 26% considered to have persistent prediabetes.
Compared with children of mothers with gestational diabetes who were not breastfed, the children of mothers with gestational diabetes who were breastfed were less likely to develop prediabetes (OR = 0.18; 95% CI, 0.04-0.82) and metabolic syndrome (OR = 0.1; 95% CI, 0.02-0.55). Compared with children of mothers with gestational diabetes who were not breastfed, children of mothers without gestational diabetes had lower odds for developing prediabetes and metabolic syndrome, regardless of breastfeeding status, according to researchers.
“Mothers with gestational diabetes should be advised to breastfeed their offspring for at least 6 months to protect them from metabolic diseases,” Davis said. “Most studies simply control for gestational diabetes status, and few examine whether or not the effects of early life feeding on obesity and related diseases differ by gestational diabetes status. More research is needed to test the effects of early life feeding, including breastfeeding and early exposure to sweets, on health outcomes in offspring exposed to gestational diabetes.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.