Abstract
BackgroundBreastfeeding is associated with reduced risk of becoming overweight or obese later in life. Breastfed babies grow more slowly during infancy than formula-fed babies. Among offspring exposed in utero to maternal glucose intolerance, prospective data on growth during infancy have been unavailable. Thus, scientific evidence is insufficient to conclude that breastfeeding reduces the risk of obesity among the offspring of diabetic mothers (ODM).To address this gap, we devised the Study of Women, Infant Feeding and Type 2 Diabetes after GDM Pregnancy and Growth of their Offspring, also known as the SWIFT Offspring Study. This prospective, longitudinal study recruited mother-infant pairs from the SWIFT Study, a prospective study of women with recent gestational diabetes mellitus (GDM). The goal of the SWIFT Offspring Study is to determine whether breastfeeding intensity and duration, compared with formula feeding, are related to slower growth of GDM offspring during the first year life. This article details the study design, participant eligibility, data collection, and methodologies. We also describe the baseline characteristics of the GDM mother-infant pairs.MethodsThe study enrolled 466 mother-infant pairs among GDM deliveries in northern California from 2009–2011. Participants attended three in-person study exams at 6–9 weeks, 6 months and 12 months after delivery for infant anthropometry (head circumference, body weight, length, abdominal circumference and skinfold thicknesses), as well as maternal anthropometry (body weight, waist circumference and percent body fat). Mothers also completed questionnaires on health and lifestyle behaviors, including infant diet, sleep and temperament. Breastfeeding intensity and duration were assessed via several sources (diaries, telephone interviews, monthly mailings and in-person exams) from birth through the first year of life. Pregnancy course, clinical perinatal and newborn outcomes were obtained from health plan electronic medical records. Infant saliva samples were collected and stored for genetics studies.DiscussionThis large, racially and ethnically diverse cohort of GDM offspring will enable evaluation of the relationship of infant feeding to growth during infancy independent of perinatal characteristics, sociodemographics and other risk factors. The longitudinal design provides the first quantitative measures of breastfeeding intensity and duration among GDM offspring during early life.
Highlights
Breastfeeding is associated with reduced risk of becoming overweight or obese later in life
To address these gaps in knowledge, we implemented the Study of Women (SWIFT) Offspring study, a prospective study of growth during infancy among gestational diabetes mellitus (GDM) offspring that evaluates the associations with breastfeeding intensity based on quantitative methods independent of the intrauterine environment, perinatal outcomes and postnatal behaviors related to serial growth measures from birth through one year of age
Current scientific evidence is mixed regarding the benefits of breastfeeding on future health outcomes for ODM
Summary
Study participants and setting The SWIFT Offspring Study cohort is an observational study of 466 mother-infant pairs recruited from among women with recent GDM who were participants in the SWIFT Study [77]. Sample size and power analysis Minimum detectable differences in means (either at exam or change between exams) of a continuous variable (e.g., change in weight-for-age z-score, skinfold thickness, waist girth) are expressed in standard deviation units, in analyses of offspring and mothers at 6–9 weeks (offspring only, Aim 1), at 6 months and at 12 months (Table 2). These estimates are based on the standard t-test for differences in means, in a comparison of breastfeeding (66.7 %) vs none/minimal (33.3 %).
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