Breastfeeding May Protect Against Diabetes

Breastfeeding is associated with a reduced risk for developing diabetes among women and their children later in life, according to a new study presented at the World Diabetes Congress in Vancouver, Canada. 

The study findings suggest that breastfeeding initiation should be promoted in the general population, especially among mothers in minority communities who have lower rates of breastfeeding.

“WHO (World Health Organization) recommends exclusive breastfeeding for 6 months or more to receive best health interests for mothers and infants. Our study suggests any length of breastfeeding started at the hospital before discharge is expected to obtain long-term benefits to reduce diabetes in women and children,” said study investigator Garry Shen, MD, PhD, who is a professor of internal medicine and human nutrition sciences at the University of Manitoba in Canada.

The prevalence of diabetes has increased rapidly in Canada, especially among people of First Nation descent, noted Dr Shen. Previous studies have indicated that exclusive or partial breastfeeding may reduce the risk for type 2 diabetes in mothers or offspring. However, the impact of breastfeeding initiation on the development of subsequent diabetes among mothers and offspring has not been determined in a large-scale study. 

The Canadian investigators analyzed the impact of breastfeeding initiation on the development of subsequent diabetes among First Nation and non-First Nation mothers and their offspring in Manitoba from 1987 to 2011.

They studied 334 553 deliveries during the 24-year period in Manitoba province (60 088 First Nation births and 274 465 non-First Nation births). Computer modeling was used to explore the association between breastfeeding initiation and the risk for subsequent incident diabetes in mothers (n=180 107) and their offspring (n=250 392). Diabetes was determined from hospital International Classification of Disease (ICD) codes.

Breastfeeding initiation was recorded in 56% of First Nation mothers and 83% of non-First Nation mothers.

Results showed that breastfeeding initiation was associated with a 14% reduced risk for diabetes among First Nation mothers and a 23% reduced risk among non-First Nation mothers.

A protective effect of breastfeeding initiation was also observed for type 2 diabetes among offspring of the mothers included in the study during up to 24 years of follow-up, reducing the risk for diabetes by 18%.

Dr Shen explained that First Nation status did not significantly affect the association between breastfeeding and incident diabetes. Therefore, the analyses across First Nation and non-First Nation offspring were pooled together. The 18% risk reduction represents the reduction in risk to all children of both ethnicities. 

The protective effects of breastfeeding initiation among mothers and offspring were independent of First Nation status, gestational diabetes, gestational hypertension, family income, location of residence, age of mothers at birth, parity, and the birthweight of offspring.

“It is the first large-scale study to examine the impact of breastfeeding initiation. We are surprised about the findings,” Dr Shen told Endocrinology Advisor. 

The health benefits of breastfeeding are something that must be highly stressed due the enormous increase in prevalence of diabetes worldwide, he noted.

The study also showed that low family income and gestational hypertension independently increased the risk for diabetes in mothers and offspring.

Dr Shen said it is vital that breastfeeding is heavily promoted in urban areas as well as remote ones. Currently, he and his colleagues are promoting breastfeeding in urban and rural or remote First Nation communities in Manitoba using Web- and social media-based approaches. Several groups of Canadian researchers in other provinces also are promoting breastfeeding in various ethnic groups. 

Dr. Shen’s team has developed a multidisciplinary group including endocrinologists, pediatricians, obstetricians, nutritionists, and epidemiologists. The team partners with provincial and First Nation health authorities.

They recently developed a prenatal care and breastfeeding website aiming at promoting breastfeeding among mothers, including rural-living First Nation women in the province. The website is linked with Facebook and provides services for self-registration, online chat, and video and audio educations tools.

Dr Shen and colleagues have made several visits to participating First Nation communities and developed close partnerships with these communities and healthcare workers based there. These simple steps could lead to dramatic differences in diabetes prevalence and a lowering of overall healthcare costs. This approach is also one that could be adopted anywhere in the world thanks to online support and social media, he explained.

Reference

1. Martens P, Shafer LA, Dean H, et al. Breastfeeding initiation reduces incidence of diabetes in mothers and offspring: A population-based study in Manitoba. Presented at the World Diabetes Congress; November 30-December 4, 2015; Vancouver, Canada.