Abstract
Aim: Previous data from our Kaulsdorf Cohort Study (KCS) suggest that early neonatal ingestion (1st week) of breast milk from diabetic mothers (diabetic breast milk, DBM) may increase the risk of being overweight and delay speech development in offspring of diabetic mothers (ODM). Late neonatal DBM ingestion (2nd–4th week), however, not independently influenced the risk of overweight. We investigated whether late neonatal DBM ingestion might independently influence neuro-development.
Methods: Achievement of developmental milestones according to late neonatal DBM intake was analyzed in 242 ODM.
Results: No impact of DBM ingestion on psychomotor parameters was observed. In contrast, it negatively influenced onset of speaking (no DBM: median 44.0 weeks, range 31.0–72.0; some DBM: 48.0, 24.0–100.0; DBM only: 52.0, 28.0–84.0; P=0.037) and halved the probability of reaching this milestone at any time point (hazard ratio: 0.53, 95% confidence interval: 0.31–0.91). However, adjustment for DBM volume ingested during the early neonatal period weakened the hazard ratio towards non-significance. In the fully adjusted model, the hazard ratio was halved, but insignificant.
Conclusions: Our results underscore that neonatal DBM ingestion, particularly during the first week of life, may delay speech development, an important indicator of cognitive development. Further studies are urgently recommended on consequences of breast-feeding for neurodevelopment in ODM.
References
1 Anderson JW, BM Johnstone, DT Remley: Breast-feeding and cognitive development: a meta-analysis. Am J Clin Nutr70 (1999) 525Search in Google Scholar
2 Auestad N, R Halter, RT Hall, M Blatter, ML Bogle, W Burks, JR Erickson, et al.: Growth and development in term infants fed long-chain polyunsaturated fatty acids: a double-masked, randomized, parallel, prospective, multivariate study. Pediatrics108 (2001) 372Search in Google Scholar
3 Bitman J, M Hamosh, P Hamosh, V Lutes, MC Neville, J Seacat, et al.: Milk composition and volume during the onset of lactation in a diabetic mother. Am J Clin Nutr50 (1989) 1364Search in Google Scholar
4 Buinauskiene J, D Baliutaviciene, R Zalinkevicius: Glucose tolerance of 2- to 5-year-old offspring of diabetic mothers. Pediatric Diabetes5 (2004) 143Search in Google Scholar
5 Butte NF, C Garza, R Burr, AS Goldman, K Kennedy, JL Kitzmiller: Milk composition of insulin-dependent diabetic women. J Pediatr Gastr Nutr6 (1987) 936Search in Google Scholar
6 Clark EV: How language acquisition builds on cognitive development. Trends Cogn Sci8 (2004) 47210.1016/j.tics.2004.08.012Search in Google Scholar
7 Dörner G, H Grychtolik: Long-lasting ill-effects of neonatal qualitative and/or quantitative dysnutrition in the human. Endokrinologie71 (1978) 81Search in Google Scholar
8 Frankenburg WK, AW Fandal, W Sciarillo, D Burgess: The newly abbreviated and revised Denver Developmental Screening Test. J Pediatr99 (1981) 995Search in Google Scholar
9 Grosvenor CE, MF Picciano, CR Baumrucker: Hormones and growth factors in milk. Endocr Rev14 (1992) 710Search in Google Scholar
10 Hod M, R Levy-Shiff, M Lerman, B Schindel, Z Ben-Rafael, J Bar: Developmental outcome of offspring of pregestational diabetic mothers. J Pediatr Endocr Met12 (1999) 867Search in Google Scholar
11 Jackson MB, CJ Lammi-Keefe, RG Jensen, SC Couch, AM Ferris: Total lipid and fatty acid composition of milk from women with and without insulin-dependent diabetes mellitus. Am J Clin Nutr60 (1994) 353Search in Google Scholar
12 Jovanovic-Peterson L, K Fuhrmann, K Hedden, L Walker, CM Peterson: Maternal milk and plasma glucose and insulin levels: studies in normal and diabetic subjects. J Am Coll Nutr8 (1989) 125Search in Google Scholar
13 Kerssen A, IM Evers, HW de Valk, GHA Visser: Effect of breast milk of diabetic mothers on bodyweight of the offspring in the first year of life. Eur J Clin Nutr58 (2004) 1429Search in Google Scholar
14 Kube DA, WM Wilson, MC Petersen, FB Palmer: CAT/CLAMS: Its use in detecting early childhood cognitive impairment. Pediatr Neurol32 (2000) 208Search in Google Scholar
15 Lucas A, R Morley, TJ Cole, G Lister, C Leeson-Payle: Breast milk and subsequent intelligence quotient in children born preterm. Lancet339 (1992) 261Search in Google Scholar
16 Mayer-Davis EJ, SL Rifas-Shiman, F Hu, GA Colditz, MW Gillman: Breast feeding and risk for childhood obesity: Does maternal diabetes or obesity status matter? Pediatr Res58 (2005) 1027 (abstract)Search in Google Scholar
17 Ornoy A, N Ratzon, C Greenbaum, A Wolf, M Dulitzky: School-age children born to diabetic mothers and to mothers with gestational diabetes exhibit a high rate of inattention and fine and gross motor impairment. J Pediatr Endocr Met14 (2001) 681Search in Google Scholar
18 Park CR: Cognitive effects of insulin in the central nervous system. Neurosci Biobehav Rev25 (2001) 31110.1016/S0149-7634(01)00016-1Search in Google Scholar
19 Pettitt DJ, WC Knowler: Long-term effects of the intrauterine environment, birth weight, and breast-feeding in Pima Indians. Diabetes Care21 (1998) B138Search in Google Scholar
20 Plagemann A: Perinatal programming and functional teratogenesis: Impact on body weight regulation and obesity. Physiol Behav86 (2005) 66110.1016/j.physbeh.2005.08.065Search in Google Scholar PubMed
21 Plagemann A, T Harder, K Franke, R Kohlhoff: Long-term impact of neonatal breast feeding on body weight and glucose tolerance in children of diabetic mothers. Diabetes Care25 (2002) 16Search in Google Scholar
22 Plagemann A, T Harder, R Kohlhoff, S Fahrenkrog, E Rodekamp, K Franke, et al.: Impact of early neonatal breast feeding on psychomotor and neuropsychological development in children of diabetic mothers. Diabetes Care28 (2005) 573Search in Google Scholar
23 Plagemann A, T Harder, E Rodekamp: Letter regarding article by Stettler et al.: “Weight gain in the first week of life and overweight in adulthood: a cohort study of European American subjects fed infant formula”. Circulation112 (2005) e11010.1161/CIRCULATIONAHA.105.564617Search in Google Scholar PubMed
24 Rizzo T, BE Metzger, WJ Burns, K Burns: Correlations between antepartum maternal metabolism and intelligence of offspring. N Engl J Med325 (1990) 911Search in Google Scholar
25 Rodekamp E, T Harder, R Kohlhoff, K Franke, JW Dudenhausen, A Plagemann: Long-term impact of breast-feeding on body weight and glucose tolerance in children of diabetic mothers: role of the late neonatal period and early infancy. Diabetes Care28 (2005) 1457Search in Google Scholar
26 Stettler N, VA Stallings, AB Troxel, J Zhao, R Schinnar, SE Nelson, et al.: Weight gain in the first week of life and overweight in adulthood: a cohort study of European American subjects fed infant formula. Circulation111 (2005) 1897Search in Google Scholar
27 Stubbs SM, JM Brudenell, DA Pyke, PJ Watkins, WA Stubbs, KG Alberti: Management of the pregnant diabetic: home or hospital, with or without glucose meters? Lancet1 (1980) 1122Search in Google Scholar
28 Temboury MC, A Otero, I Polanco, E Arribas: Influence of breast-feeding on the infant's intellectual development. J Pediatr Gastr Nutr18 (1994) 32Search in Google Scholar
29 Vohr BR, ST McGarvey, C Garcia Coll: Effects of maternal gestational diabetes and adiposity on neonatal adiposity and blood pressure. Diabetes Care18 (1995) 467Search in Google Scholar
©2006 by Walter de Gruyter Berlin New York