(12-03-11) Long-term impact of neonatal breastfeeding on childhood adiposity and fat distribution among children exposed to diabetes in utero.

Crume TL, Ogden L, Maligie M, Sheffield S, Bischoff KJ, McDuffie R, Daniels S,
Hamman RF, Norris JM, Dabelea D.

Corresponding author: Dana Dabelea, [email protected].
Abstract
OBJECTIVE To evaluate whether breastfeeding attenuates increased childhood
adiposity associated with exposure to diabetes in utero. RESEARCH DESIGN AND
METHODS Retrospective cohort study of 89 children exposed to diabetes in utero
and 379 unexposed youth with measured BMI, waist circumference, skinfolds,
visceral (VAT) and subcutaneous (SAT) abdominal fat. A measure of breast milk-
months was derived from maternal self-report and used to categorize
breastfeeding status as low (<6) and adequate (??6 breast milk-months). Multiple
linear regression was used to model the relationship between exposure to
diabetes in utero and offspring adiposity outcomes among youth stratified
according to breastfeeding status. RESULTS Adequate (vs. low) breastfeeding
status was associated with significantly lower BMI, waist circumference, SAT,
and VAT at ages 6-13 years. Among youth in the low breastfeeding category,
exposure to diabetes in utero was associated with a 1.7 kg/m(2) higher BMI (P =
0.03), 5.8 cm higher waist circumference (P = 0.008), 6.1 cm(2) higher VAT (P =
0.06), 44.6 cm(2) higher SAT (P = 0.03), and 0.11 higher ratio of subscapular-
to-triceps skinfold ratio (P = 0.008). Among those with adequate breastfeeding
in infancy, the effect of prenatal exposure to diabetes on childhood adiposity
outcomes was not significant. CONCLUSIONS Adequate breastfeeding protects
against childhood adiposity and reduces the increased adiposity levels
associated with exposure to diabetes in utero. These data provide support for
mothers with diabetes during pregnancy to breastfeed their infants in order to
reduce the risk of childhood obesity.

Source: Diabetes Care. 2011 Mar;34(3):641-5.

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