My name is Megan Jensen and I am a Junior nursing student at the
University of North Dakota. I chose to join this listserv because I am
interested in working on an OB/Pediatrics floor where breastfeeding
issues will arise. The topic that I am interested in is diabetes and
breastfeeding; and I have found some information regarding this topic
that I would like to share.
There have been recent debates about mothers who breastfeed vs.
mothers
who formula feed and/or introduce cow's milk too soon and how this can
either contribute to or decrease the chance of developing Type I
diabetes. I would like to discuss both ends of the spectrum of this
issue.
The study conducted by McKinney, Parslow, Gurney, Law, Bodansky
& Williams states that breastfeeding within the first 4 months of life
helps to prevent an antibody response to bovine beta-casein, which is a
cow's milk protein responsible for the cellular immune responses that
occur in Type 1 diabetes mellitus (McKinney, Parslow, Gurney, Law,
Bodansky & Williams, 1999). The same study states that decreased body
weight, decreased obesity rate, and a decreased rate for development of
diabetes have been associated in infants that were solely breastfed.
There has been a link shown between an increasing incidence of Type 1
diabetes mellitus and decreasing incidence of mothers who breastfeed
their infants. In summary, the argument is that longer, exclusive
breastfeeding has
been linked as an independent factor that protects against the
development of Type 1 diabetes in childhood (McKinney et al, 1999).
On the other side of the debate, Plagemann, Harder, Franke, &
Kohlhoff (2002), have argued that breast milk from diabetic women
contains an increased glucose concentration, and an increased insulin
concentration which can cross over the intestinal mucous blood barrier
during neonatal life. This consumption of insulin laden milk absorbed
by the baby has been linked to accelerated weight gain and therefore the
increase in glucose exposure may mean an increased risk of developing
obesity and an insulin resistance later in life. Jackson (2004), states
that breastfeeding is a natural and available source protecting against
Type 1 diabetes; claiming its protection should be taken more seriously
and more education should be available. McKinney et al., (1999) states
that children with Type 1 diabetes have had increased levels of cow's
milk antibodies within the first year of life and the early activation
of the immune system was directed related to early exposure to cow's
milk proteins.
In conclusion, because of the numerous advantages of
breastfeeding in general, most health care providers are encouraging
there patients to breastfeed their newborns. My questions are as
follows: What is the advice given to your patients regarding diabetes
and breastfeeding? And, what are the advantages and disadvantages that
you have come across in the literature regarding diabetic mothers who
breastfeed? Thank you for any responses to my questions.
Megan Jensen, Student Nurse
University of North Dakota
References:
Jackson, Wendy. (2004) Breastfeeding and Type 1 diabetes mellitus.
British Journal of Midwifery. 12 (3), 158-165.
Plagemann, A., Harder T., Franke, K., & Kohlhoff, R. (2002). Long-term
impact of Neonatal breastfeeding on body weight and glucose tolerance in
children of Diabetic mothers. Diabetes Care, 25 (1), 16-22.
McKinney, P., Roger, P., Gurney, K., Law, G., Bodansky, H., & Williams,
R. (1999).Perinatal and neonatal determinants of childhood type 1
diabetes. Diabetes Care, 22 (6), 928-932.
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