Impact of breast-feeding on psychomotor and neuropsychological development in children of diabetic mothers: role of the late neonatal period.
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.
Rodekamp
Elke
E
Clinic of Obstetrics, Research Groups Experimental Obstetrics, Charité - University Medicine Berlin, Germany.
Harder
Thomas
T
Kohlhoff
Rainer
R
Dudenhausen
Joachim W
JW
Plagemann
Andreas
A
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*
D001786:Blood Glucose