Association of Exposure to Cow's Milk Protein and β-Cell Autoimmunity

Abstract

To the Editor. —Recent discussions about the possible association between early infant diets and IDDM, including the Editorial by Drs Schatz and Maclaren, 1 have focused on the possible role of cow's milk. The possibility that the protective nature of breast-feeding may be the explanation for reported differences in incidence of diabetes between breast-fed infants and those artificially fed has received little attention. Although Norris et al 2 did not find such an association among children who have a familial risk of diabetes, this does not exclude a small protective effect of breast-feeding in the population of children without familial risk. As the authors acknowledge, it is likely that several factors play a role in the etiology of IDDM. One plausible explanation for the reported protection against IDDM is that breast-feeding has been found to protect infants from infection with enteroviruses such as coxsackievirus B. 3 This protection results from direct neutralization of