title: Breastfeeding patterns of mothers with type 1 diabetes: results from an infant feeding trial.
abstract: BACKGROUND
  Both the initiation and maintenance of breastfeeding have been reported to be negatively affected by maternal type 1 diabetes (T1D). The aim of this study was to prospectively examine the breastfeeding patterns among mothers with and without T1D participating in a large international randomized infant feeding trial (TRIGR).
  
  
  METHODS
  Families with a member affected by T1D and with a newborn infant were invited into the study. Those who had HLA-conferred genetic susceptibility for T1D tested at birth with gestation > 35 weeks and were healthy were eligible to continue in the trial. Among the 2160 participating children, 1096 were born to women with T1D and 1064 to unaffected women. Information on infant feeding was acquired from the family by frequent prospective dietary interviews.
  
  
  RESULTS
  Most (>90%) of the infants of mothers with and without T1D were initially breastfed. Breastfeeding rates declined more steeply among mothers with than without T1D being 50 and 72% at 6 months, respectively. Mothers with T1D were younger, less educated and delivered earlier and more often by caesarean section than other mothers (p < 0.01). After adjusting for all these factors associated with the termination of breastfeeding, there was no difference in the duration of breastfeeding among mothers with and without T1D.
  
  
  CONCLUSIONS
  Maternal diabetes status per se was not associated with shorter breastfeeding. The lower duration of breastfeeding in mothers with T1D is largely explained by their more frequent caesarean sections, earlier delivery and lower age and education.
authors.affiliation: Nutrition Unit, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Susa
authors.initials: S
authors.lastname: Sorkio
authors.forename: David
authors.initials: D
authors.lastname: Cuthbertson
authors.forename: Sonja
authors.initials: S
authors.lastname: Bärlund
authors.forename: Antti
authors.initials: A
authors.lastname: Reunanen
authors.forename: Anita M
authors.initials: AM
authors.lastname: Nucci
authors.forename: Carol L
authors.initials: CL
authors.lastname: Berseth
authors.forename: Katriina
authors.initials: K
authors.lastname: Koski
authors.forename: Anne
authors.initials: A
authors.lastname: Ormisson
authors.forename: Erkki
authors.initials: E
authors.lastname: Savilahti
authors.forename: Ulla
authors.initials: U
authors.lastname: Uusitalo
authors.forename: Johnny
authors.initials: J
authors.lastname: Ludvigsson
authors.forename: Dorothy J
authors.initials: DJ
authors.lastname: Becker
authors.forename: John
authors.initials: J
authors.lastname: Dupré
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Krischer
authors.forename: Mikael
authors.initials: M
authors.lastname: Knip
authors.forename: Hans K
authors.initials: HK
authors.lastname: Akerblom
authors.forename: Suvi M
authors.initials: SM
authors.lastname: Virtanen
mesh_terms: D000328:Adult; D000367:Age Factors; D001942:Breast Feeding; D002585:Cesarean Section; D016009:Chi-Square Distribution; D003922:Diabetes Mellitus, Type 1; D005260:Female; D006293:Health Promotion; D006801:Humans; D007231:Infant, Newborn; D008425:Maternal Behavior; D009035:Mothers; D011247:Pregnancy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
references.citation: Curr Opin Pediatr. 2008 Dec;20(6):698-702
references.pmid: 19005338
references.citation: Acta Paediatr. 1994 Jun;83(6):565-71
references.pmid: 7919750
references.citation: Am J Clin Nutr. 1993 Jul;58(1):49-53
references.pmid: 8317389
references.citation: J Hum Lact. 2004 Feb;20(1):9-17
references.pmid: 14974696
references.citation: Pediatr Diabetes. 2007 Jun;8(3):117-37
references.pmid: 17550422
references.citation: Health Care Women Int. 1992 Jul-Sep;13(3):249-60
references.pmid: 1399865
references.citation: Diabet Med. 2007 Jun;24(6):671-6
references.pmid: 17403118
references.citation: BMJ. 1992 Mar 28;304(6830):801-5
references.pmid: 1392706
references.citation: Eur J Clin Nutr. 2005 Jan;59(1):107-13
references.pmid: 15354198
references.citation: Birth. 2004 Dec;31(4):285-92
references.pmid: 15566341
references.citation: Pediatrics. 2005 Jan;115(1):e31-7
references.pmid: 15579667
references.citation: J Hum Lact. 2003 May;19(2):172-8
references.pmid: 12744534
references.citation: Acta Paediatr. 1999 Feb;88(2):203-11
references.pmid: 10102156
references.citation: J Am Diet Assoc. 1998 Jun;98(6):642-8
references.pmid: 9627620
references.citation: Evid Rep Technol Assess (Full Rep). 2007 Apr;(153):1-186
references.pmid: 17764214
references.citation: Am J Clin Nutr. 2003 Dec;78(6):1053-67
references.pmid: 14668264
references.citation: Lancet. 2002 Jul 20;360(9328):187-95
references.pmid: 12133652
references.citation: BMJ. 1998 Jan 3;316(7124):21-5
references.pmid: 9451261
references.citation: Pediatrics. 2008 Jan;121(1):183-91
references.pmid: 18166574
references.citation: Public Health Nutr. 2003 Dec;6(8):773-83
references.pmid: 14641948
references.citation: Eur J Clin Nutr. 2007 Feb;61(2):239-47
references.pmid: 16929247
references.citation: J Hum Lact. 1995 Sep;11(3):195-200
references.pmid: 7669239
references.citation: Eur J Pediatr. 2006 Feb;165(2):114-9
references.pmid: 16211397
references.citation: Matern Child Nutr. 2006 Jul;2(3):181-7
references.pmid: 16881930
references.citation: Birth. 2006 Mar;33(1):37-45
references.pmid: 16499530
references.citation: Lancet Oncol. 2007 Jan;8(1):26-34
references.pmid: 17196508
references.citation: Diabetes Care. 2006 Apr;29(4):771-4
references.pmid: 16567813