title: Impact of breast-feeding on psychomotor and neuropsychological development in children of diabetic mothers: role of the late neonatal period.
abstract: OBJECTIVE
  Previous data from our Kaulsdorf Cohort Study (KCS) suggest that early neonatal ingestion (1st week) of breast milk from diabetic mothers (diabetic breast milk, DBM) may increase the risk of being overweight and delay speech development in offspring of diabetic mothers (ODM). Late neonatal DBM ingestion (2nd-4th week), however, not independently influenced the risk of overweight. We investigated whether late neonatal DBM ingestion might independently influence neuro-development.
  
  
  METHODS
  Achievement of developmental milestones according to late neonatal DBM intake was analyzed in 242 ODM.
  
  
  RESULTS
  No impact of DBM ingestion on psychomotor parameters was observed. In contrast, it negatively influenced onset of speaking (no DBM: median 44.0 weeks, range 31.0-72.0; some DBM: 48.0, 24.0-100.0; DBM only: 52.0, 28.0-84.0; P=0.037) and halved the probability of reaching this milestone at any time point (hazard ratio: 0.53, 95% confidence interval: 0.31-0.91). However, adjustment for DBM volume ingested during the early neonatal period weakened the hazard ratio towards non-significance. In the fully adjusted model, the hazard ratio was halved, but insignificant.
  
  
  CONCLUSIONS
  Our results underscore that neonatal DBM ingestion, particularly during the first week of life, may delay speech development, an important indicator of cognitive development. Further studies are urgently recommended on consequences of breast-feeding for neurodevelopment in ODM.
authors.affiliation: Clinic of Obstetrics, Research Groups Experimental Obstetrics, Charité - University Medicine Berlin, Germany.
authors.forename: Elke
authors.initials: E
authors.lastname: Rodekamp
authors.forename: Thomas
authors.initials: T
authors.lastname: Harder
authors.forename: Rainer
authors.initials: R
authors.lastname: Kohlhoff
authors.forename: Joachim W
authors.initials: JW
authors.lastname: Dudenhausen
authors.forename: Andreas
authors.initials: A
authors.lastname: Plagemann
mesh_terms: D000328:Adult; D001786:Blood Glucose; D001942:Breast Feeding; D002657:Child Development; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D016640:Diabetes, Gestational / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007804:Language Development; D008297:Male; D009483:Neuropsychological Tests; D011247:Pregnancy; D011597:Psychomotor Performance; D013064:Speech Disorders / Q000209:etiology*
chemical_list: D001786:Blood Glucose