This was in a note to me from Dr. Lawrence Gartner, chair of Peds in
Chicago.I had originally asked him a question about the relationship between
ingesting cows milk and the liklihood of developing diabetes in a child who
has a diabetic mother and two diabetic siblings.

From: (Lawrence M. Gartner, M.D.)
Subject: Cow milk ingestion and diabetes


There is no question that small to moderate amounts of cow's milk protein
ingested by the lactating mother appears in the breastmilk.  What has not
been investigated is whether this amount of foreign protein is sufficient to
induce the immune reaction that is believed to cause the initiation of
insulin-dependent diabetes.  The estimates that are in the literature
regarding the preventive effects of "exclusive" breastfeeding range from
highs of 25 to 50%.  I have always suspected that the break-throughs that
occur even in exclusively breastfed babies were the result of small amounts
of cow's milk protein that are in so many foods, even when a mother is not
drinking milk or eating cheese, getting into the  breastmilk.  This remains
to be proven, however.
     In the case you forwarded to me, it is most unfortunate that the baby
was offered any cow's milk based formula even though for a brief exposure.
We do not know if one exposure can sensitize or not, but it would be wise to
have avoided it.  The continued exclusive breastfeeding is certainly
indicated since there is a strong genetic predisposition to type I diabetes
and the baby has a high risk of having the same genes as the mother.  For
the same reason, the mother should avoid all cow's milk exposure while she
is lactating for at least the first six months of the baby's life.  This
will minimize risk even though we do not have the evidence that second-hand
cow's milk is a risk factor. Furthermore, there is increasing reason to
suggest to ALL mothers that they minimize the intake of cow's milk while
lactating.  Other immunologic phenomena appear to be triggered by this
second hand exposure, including a variety of skin and respiratory allergic
responses.  In the past year it has also become quite clear that lactating
mothers do not need an increased source of calcium and will not increase
their calcium absorption even when ingesting milk or other sources of
calcium.  This takes away the major rationale for suggestions in the past
that lactating mothers drink milk.  Since this work on calcium absorption
during lactation is quite new, it is has been widely recognized, but it
should be.

     I am off Lactnet for the summer, but will go back on when I get back to
Chicago late in August.  If you want to put this on the net, please feel
free to do so.

                                                                           L
Larry Gartner

Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,Corgi-L,LLLOL, Indep. Consultant
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