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Feeding infants of diabetic mothers

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In general, breast feeding protects against later obesity and diabetes. Infants of diabetic mothers have an increased risk of later obesity and glucose intolerance. It might be thought, therefore, that breast feeding might protect the infants of diabetic mothers from these later developments but the milk of diabetic mothers contains more glucose, insulin, and energy than that of nondiabetic mothers, especially in the early neonatal period, and could be harmful. A study in Berlin (

) has suggested that early breastfeeding by diabetic mothers may have adverse consequences.

Between 1980 and 1989 112 infants of diabetic mothers (83 type 1 diabetes, 29 gestational diabetes) were followed up at a clinic in the then East Berlin. The mothers were encouraged to breastfeed and supplements of banked donor breast milk were given when deemed necessary. Infants who took more of their mother's milk were more likely to be overweight at age 2 years (proportions overweight in first, second, and third centiles for weight of mother's breast milk taken in the first week were 5/37, 11/38. and 14/37). The weight of mother's milk taken in the first week correlated directly with relative body weight at age 2 years whereas the weight of banked donor breast milk taken correlated inversely with relative body weight at age 2 years. Similar associations were found between amounts of mother's and donor milk taken in the first week and the 120 minute blood glucose concentration on oral glucose tolerance testing at 2 years. The risk of impaired glucose tolerance at age 2 years was inversely related to the amount of donor breast milk taken.

Breast feeding by diabetic mothers may increase the risks of later overweight and glucose intolerance in their infants. (The authors of this article are careful to point out that in their opinion the advantages of breastfeeding still outweigh the disadvantages even for diabetic mothers.)

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