title: Lack of association between duration of breast-feeding or introduction of cow's milk and development of islet autoimmunity.
abstract: The hypothesis that early exposure to cow's milk or lack of breast-feeding predisposes to type 1 diabetes remains controversial. We aimed to determine prospectively the relationship of, first, duration of exclusive breast-feeding and total duration of breast-feeding, and second, introduction of cow's milk protein as infant formula, cow's milk, or dairy products, to the development of islet antibodies in early life. Some 317 children with a first-degree relative with type 1 diabetes were followed prospectively from birth for 29 months (4-73). Mothers kept a home diary and answered infant feeding questionnaires at 6-month intervals. No systematic feeding advice was given. Insulin autoantibodies (normal range <5.5%), anti-GAD antibodies (<5.0 U), and anti-IA2 antibodies (<3.0 U) were measured at 6-month intervals. Cox proportional hazards model of survival analysis detected no significant difference between children who did not develop islet antibodies (225 of 317 [71%]), children with one islet antibody raised once (52 of 317 [16.4%]), children with one antibody raised repeatedly (18 of 317 [5.7%]), or children with two or more antibodies raised (22 of 317 [6.9%]), in terms of duration of exclusive breast-feeding, total duration of breast-feeding, or introduction of cow's milk-based infant formulas, cow's milk, or dairy products (relative risk: 0.91-1.09). Four of the children with two or more islet antibodies developed type 1 diabetes. We conclude that there is no prospective association between duration of breast-feeding or introduction of cow's milk and the development of islet autoimmunity in high-risk children.
authors.affiliation: Department of Endocrinology, Women's and Children's Hospital, North Adelaide SA, Australia. jcouper@medicine.adelaide.edu.au
authors.forename: J J
authors.initials: JJ
authors.lastname: Couper
authors.forename: C
authors.initials: C
authors.lastname: Steele
authors.forename: S
authors.initials: S
authors.lastname: Beresford
authors.forename: T
authors.initials: T
authors.lastname: Powell
authors.forename: K
authors.initials: K
authors.lastname: McCaul
authors.forename: A
authors.initials: A
authors.lastname: Pollard
authors.forename: S
authors.initials: S
authors.lastname: Gellert
authors.forename: B
authors.initials: B
authors.lastname: Tait
authors.forename: L C
authors.initials: LC
authors.lastname: Harrison
authors.forename: P G
authors.initials: PG
authors.lastname: Colman
mesh_terms: D000375:Aging; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D001942:Breast Feeding; D002417:Cattle; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000276:immunology*; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006680:HLA Antigens; D006650:Histocompatibility Testing; D006801:Humans; D007225:Infant Food; D007231:Infant, Newborn; D007515:Islets of Langerhans / Q000276:immunology*; D008137:Longitudinal Studies; D008297:Male; D008892:Milk; D013997:Time Factors
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens; C024211:islet cell antibody; D005968:Glutamate Decarboxylase