Breastfeeding patterns of mothers with type 1 diabetes: results from an infant feeding trial.
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.
Sorkio
Susa
S
Nutrition Unit, National Institute for Health and Welfare, Helsinki, Finland.
Cuthbertson
David
D
Bärlund
Sonja
S
Reunanen
Antti
A
Nucci
Anita M
AM
Berseth
Carol L
CL
Koski
Katriina
K
Ormisson
Anne
A
Savilahti
Erkki
E
Uusitalo
Ulla
U
Ludvigsson
Johnny
J
Becker
Dorothy J
DJ
Dupré
John
J
Krischer
Jeffrey P
JP
Knip
Mikael
M
Akerblom
Hans K
HK
Virtanen
Suvi M
SM
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
Curr Opin Pediatr. 2008 Dec;20(6):698-702
19005338
Acta Paediatr. 1994 Jun;83(6):565-71
7919750
Am J Clin Nutr. 1993 Jul;58(1):49-53
8317389
J Hum Lact. 2004 Feb;20(1):9-17
14974696
Pediatr Diabetes. 2007 Jun;8(3):117-37
17550422
Health Care Women Int. 1992 Jul-Sep;13(3):249-60
1399865
Diabet Med. 2007 Jun;24(6):671-6
17403118
BMJ. 1992 Mar 28;304(6830):801-5
1392706
Eur J Clin Nutr. 2005 Jan;59(1):107-13
15354198
Birth. 2004 Dec;31(4):285-92
15566341
Pediatrics. 2005 Jan;115(1):e31-7
15579667
J Hum Lact. 2003 May;19(2):172-8
12744534
Acta Paediatr. 1999 Feb;88(2):203-11
10102156
J Am Diet Assoc. 1998 Jun;98(6):642-8
9627620
Evid Rep Technol Assess (Full Rep). 2007 Apr;(153):1-186
17764214
Am J Clin Nutr. 2003 Dec;78(6):1053-67
14668264
Lancet. 2002 Jul 20;360(9328):187-95
12133652
BMJ. 1998 Jan 3;316(7124):21-5
9451261
Pediatrics. 2008 Jan;121(1):183-91
18166574
Public Health Nutr. 2003 Dec;6(8):773-83
14641948
Eur J Clin Nutr. 2007 Feb;61(2):239-47
16929247
J Hum Lact. 1995 Sep;11(3):195-200
7669239
Eur J Pediatr. 2006 Feb;165(2):114-9
16211397
Matern Child Nutr. 2006 Jul;2(3):181-7
16881930
Birth. 2006 Mar;33(1):37-45
16499530
Lancet Oncol. 2007 Jan;8(1):26-34
17196508
Diabetes Care. 2006 Apr;29(4):771-4
16567813