Breastfeeding and growth during infancy among offspring of mothers with gestational diabetes mellitus: a prospective cohort study.

Abstract

Breastfeeding (BF) may protect against obesity and type 2 diabetes mellitus in children exposed to maternal diabetes in utero, but its effects on infant growth among this high-risk group have rarely been evaluated. The objective of this study was to evaluate BF intensity and duration in relation to infant growth from birth through 12months among offspring of mothers with gestational diabetes mellitus (GDM). Prospective cohort of 464 GDM mother-infant dyads (28% White, 36% Hispanic, 26% Asian, 8% Black, 2% other). Weight and length measured at birth, 6-9weeks, 6months and 12months. Categorized as intensive BF or formula feeding (FF) groups at 6-9weeks (study baseline), and intensity from birth through 12months as Group 1: consistent exclusive/mostly FF, Group 2: transition from BF to FF within 3-9months and Group 3: consistent exclusive/mostly BF. Multivariable mixed linear regression models estimated adjusted mean (95% confidence interval) change in z-scores; weight-for-length (WLZ), weight-for-age and length-for-age. Compared with intensive BF at 6-9weeks, FF showed greater increases in WLZ-scores from 6 to 9weeks to 6months [+0.38 (0.13 to 0.62) vs. +0.02 (-0.15 to 0.19); p=0.02] and birth to 12months [+1.11 (0.87 to 1.34) vs. +0.53 (0.37 to 0.69); p<0.001]. For 12-month intensity and duration, Groups 2 and 3 had smaller WLZ-score increases than Group 1 from 6 to 9weeks to 6months [-0.05 (-0.27 to 0.18) and +0.07 (-0.19 to 0.23) vs. +0.40 (0.15 to 0.64); p=0.01 and 0.07], and birth to 12months [+0.60 (0.39 to 0.82) and +0.59 (0.33 to 0.85) vs. +0.97 (0.75 to 1.19); p<0.05]. Among offspring of mothers with GDM, high intensity BF from birth through 1year is associated with slower infant ponderal growth and lower weight gain.