title: Associations of infant milk feed type on early postnatal growth of offspring exposed and unexposed to gestational diabetes in utero.
abstract: OBJECTIVE
  Infants on prolonged breastfeeding are known to grow slower during the first year of life. It is still unclear if such effects are similar in offspring exposed to gestational diabetes (GDM) in utero. We examined the associations of infant milk feeding on postnatal growth from birth till 36 months of age in offspring exposed and unexposed to GDM.
  
  
  METHODS
  Pregnant mothers undertook 75 g 2-h oral glucose tolerance tests at 26-28 weeks of gestation for GDM diagnosis. Up to 9 measurements of offspring weight and length were collected from birth till 36 months, and interviewer-administered questionnaires were used to ascertain the duration of breastfeeding.
  
  
  RESULTS
  There was a statistically significant interaction between GDM status and breastmilk intake by any (pinteraction= 0.038) or exclusive/predominant breastfeeding (pinteraction= 0.035) for the outcome of conditional weight gain. In offspring of non-GDM mothers (n = 835), greater breastmilk intake (BF ≥ 4 milk months) was associated with lower conditional gains in weight [B (95 % CI) -0.48 (-0.58, -0.28); p < 0.001] within the first year of life, as well as decreasing weight SDS velocity [-0.01 (-0.02, -0.005); p < 0.001] and BMI SDS velocity [-0.008 (0.01, -0.002); p = 0.008] across age in the first 36 months. In offspring of GDM mothers (n = 181), however, greater breastmilk intake was associated with increased conditional gains in weight [0.72 (0.23, 1.20); p = 0.029] and BMI SDS [0.49 (0.04, 0.95); p = 0.04] in the first 6 months and did not demonstrate the decreasing weight and BMI SDS velocity observed in offspring of non-GDM mothers.
  
  
  CONCLUSIONS
  The reduced weight gain in the first year of life conferred by greater breastmilk intake in non-GDM children was not observed in GDM children.
  
  
  BACKGROUND
  This study is registered under the Clinical Trials identifier NCT01174875; http://www.clinicaltrials.gov/ct2/show/NCT01174875?term=GUSTO&rank=2 .
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.|Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block - Level 12, Singapore, 119228, Singapore.
authors.forename: Izzuddin M
authors.initials: IM
authors.lastname: Aris
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.|Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block - Level 12, Singapore, 119228, Singapore.
authors.forename: Shu E
authors.initials: SE
authors.lastname: Soh
authors.affiliation: Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Mya Thway
authors.initials: MT
authors.lastname: Tint
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
authors.forename: Seang Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Victor S
authors.initials: VS
authors.lastname: Rajadurai
authors.affiliation: MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.|Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.affiliation: Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.|Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Yap Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore. paeleeys@nus.edu.sg.|Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block - Level 12, Singapore, 119228, Singapore. paeleeys@nus.edu.sg.|Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore. paeleeys@nus.edu.sg.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
mesh_terms: D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001942:Breast Feeding; D002657:Child Development; D002675:Child, Preschool; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005865:Gestational Age; D005951:Glucose Tolerance Test; D006801:Humans; D007223:Infant; D016014:Linear Models; D011939:Mental Recall; D008895:Milk, Human / Q000737:chemistry; D009035:Mothers; D015596:Nutrition Assessment; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain
chemical_list: D001786:Blood Glucose
keywords: Gestational diabetes; Infant milk feeding; Offspring growth