Skip to main content
Log in

Early infant feeding and type 1 diabetes

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Background

Infant feeding practices, particularly the type of milk feeding, have been associated with the development of type 1 diabetes.

Aim of the study

We studied the relationship between early infant feeding (during the first year of life) and diabetes in a large population-based cohort.

Methods

In 1994–1995, 6,209 healthy full-term newborns participated in a study examining the effect of supplementary feeding, on development of allergy to cow’s milk, in maternity hospitals. All supplements in the maternity hospitals were known. Mothers recorded the feeding of infants prospectively at home. In August 2006, from a nationwide diabetes registry, 45 children from our cohort were listed as having type 1 diabetes.

Results

The distribution of cases was similar in the randomized feeding groups: 9/1,789 in the group that received adapted cow’s milk-based formula; 12/1,737 in those who received extensively hydrolyzed formula; 16/1,859 in those who received banked human milk; and 8 among those 824 exclusively breast-fed in the hospital. When children who had received cow’s milk-based formula in the maternity hospital were compared with those without such exposure, less number of children in the former group had diabetes by age 8 (P = 0.026), but by the end of the follow-up (11.5 years) the difference disappeared (P = 0.16). Length of breast-feeding and introduction of cereals and other solid foods were similar among those developing type 1 diabetes and those remaining healthy, while early regular daily feeding with cow’s milk-based formula tended to associate with lower risk for type 1 diabetes (OR 0.66; 95% confidence interval 0.38–1.13; P = 0.08).

Conclusions

In an extended, secondary analysis of a population-based cohort, very early exposure to cow’s milk is not a risk factor for type 1 diabetes; it may in fact diminish its appearance before age 8.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

CM:

Cow’s milk

References

  1. Akerblom HK, Virtanen SM, Ilonen J, Savilahti E, Vaarala O, Reunanen A, Teramo K, Hämäläinen AM, Paronen J, Riikjarv MA, Ormisson A, Ludvigsson J, Dosch HM, Hakulinen T, Knip M (2005) Dietary manipulation of beta cell autoimmunity in infants at increased risk of type 1 diabetes: a pilot study. Diabetologia 48:829–837

    Article  CAS  Google Scholar 

  2. Bach JF (2002) The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 347:911–920

    Article  Google Scholar 

  3. Borch-Johnsen K, Joner G, Nadrup-Paulsen T, Christy M, Zachau-Christiansen B, Kastrup K, Nerup J (1984) Relation between breast-feeding and incidence rates of insulin-dependent diabetes mellituls. Lancet 2:1083–1086

    Article  CAS  Google Scholar 

  4. Daneman D (2006) Type 1 diabetes. Lancet 367:847–858

    Article  CAS  Google Scholar 

  5. Gerstein HC (1994) Cow’s milk exposure and type I diabetes mellitus. a critical overview of the clinical literature. Diabetes Care 17:13–19

    Article  CAS  Google Scholar 

  6. Harjutsalo V, Sjöberg L, Tuomilehto J (2008) Time trends in the incidence of type 1 diabetes in Finnish children: a cohort study. Lancet 371:1777–1782

    Article  Google Scholar 

  7. Hasunen K, Ryynänen S (2006) Infant feeding in Finland 2005. Reports of the Ministry of Social Affairs and Health, vol 19, pp 1–70

  8. Hoffjan S, Nicolae D, Ostrovnaya I, Roberg K, Evans M, Mirel DB, Steiner L, Walker K, Shult P, Gangnon RE, Gern JE, Martinez FD, Lemanske RF, Ober C (2005) Gene–environment interaction effects on the development of immune responses in the 1st year of life. Am J Hum Genet 76:696–704

    Article  CAS  Google Scholar 

  9. Hummel M, Fuchtenbusch M, Schenker M, Ziegler AG (2000) No major association of breast-feeding, vaccinations, and childhood viral diseases with early islet autoimmunity in the German BABYDIAB Study. Diabetes Care 23:969–974

    Article  CAS  Google Scholar 

  10. Hyttinen V, Kaprio J, Kinnunen L, Koskenvuo M, Tuomilehto J (2003) Genetic liability of type 1 diabetes and the onset age among 22,650 young Finnish twin pairs: a nationwide follow-up study. Diabetes 52:1052–1055

    Article  CAS  Google Scholar 

  11. Janatuinen EK, Kemppainen TA, Julkunen RJ, Kosma VM, Mäki M, Heikkinen M, Uusitupa MI (2002) No harm from five year ingestion of oats in coeliac disease. Gut 50:332–335

    Article  CAS  Google Scholar 

  12. Kimpimäki T, Erkkola M, Korhonen S, Kupila A, Virtanen SM, Ilonen J, Simell O, Knip M (2001) Short-term exclusive breast-feeding predisposes young children with increased genetic risk of type I diabetes to progressive beta-cell autoimmunity. Diabetologia 44:63–69

    Article  Google Scholar 

  13. Lefebvre DE, Powell KL, Strom A, Scott FW (2006) Dietary proteins as environmental modifiers of type 1 diabetes mellitus. Annu Rev Nutr 26:175–202

    Article  CAS  Google Scholar 

  14. Mathis D, Vence L, Benoist C (2001) Beta-cell death during progression to diabetes. Nature 414:792–798

    Article  CAS  Google Scholar 

  15. Menezes Jda S, Mucida DS, Cara DC, Alvarez-Leite JI, Russo M, Vaz NM, de Faria AM (2003) Stimulation by food proteins plays a critical role in the maturation of the immune system. Int Immunol 15:447–455

    Article  Google Scholar 

  16. Mowat AM (2003) Anatomical basis of tolerance and immunity to intestinal antigens. Nat Rev Immunol 3:331–341

    Article  CAS  Google Scholar 

  17. Norris JM, Beaty B, Klingensmith G (1996) Lack of association between early exposure to cow′s milk protein and beta-cell autoimmunity. JAMA 276:609–614

    Article  CAS  Google Scholar 

  18. Norris JM, Barriga K, Klingensmith G, Hoffman M, Eisenbarth GS, Erlich HA, Rewers M (2003) Timing of initial cereal exposure in infancy and risk of islet autoimmunity. JAMA 290:1713–1720

    Article  CAS  Google Scholar 

  19. Rakoff-Nahoum S, Paglino J, Eslami-Varzaneh F, Edberg S, Medzhitov R (2004) Recognition of commensal microflora by toll-like receptors is required for intestinal homeostasis. Cell 118:229–241

    Article  CAS  Google Scholar 

  20. Saarinen KM, Juntunen-Backman K, Järvenpää AL, Kuitunen P, Lope L, Renlund M, Siivola M, Savilahti E (1999) Supplementary feeding in maternity hospitals and the risk of cow’s milk allergy: a prospective study of 6,209 infants. J Allergy Clin Immunol 104:457–461

    Article  CAS  Google Scholar 

  21. Saukkonen T, Virtanen SM, Karppinen M, Reijonen H, Ilonen J, Räsänen L, Åkerblom HK, Savilahti E (1998) Significance of cow’s milk protein antibodies as risk factor for childhood IDDM: interactions with dietary cow’s milk intake and HLA-DQB1 genotype: Childhood Diabetes in Finland Study Group. Diabetologia 41:72–78

    Article  CAS  Google Scholar 

  22. Siltanen M, Kajosaari M, Poussa T, Saarinen KM, Savilahti E (2003) A dual long-term effect of breast-feeding on atopy in relation to heredity in children at 4 years of age. Allergy 58:524–530

    Article  CAS  Google Scholar 

  23. Simpson A, John SL, Jury F, Niven R, Woodcock A, Ollier WE, Custovic A (2006) Endotoxin exposure, CD14, and allergic disease: an interaction between genes and the environment. Am J Respir Crit Care Med 174:386–392

    Article  CAS  Google Scholar 

  24. Tuomilehto J, Virtala E, Karvonen M, Lounamaa R, Pitkäniemi J, Reunanen A, Tuomilehto-Wolf E, Toivanen L (1995) Increase in incidence of insulin-dependent diabetes mellitus among children in Finland. Int J Epidemiol 24:984–992

    Article  CAS  Google Scholar 

  25. Virtanen SM, Räsänen L, Ylönen K, Aro A, Clayton D, Langholz B, Pitkäniemi J, Savilahti E, Lounamaa R, Tuomilehto J, Åkerblom HK (1993) Early introduction of dairy products is associated with increased risk of insulin-dependent diabetes mellitus in Finnish children. Diabetes 42:1786–1790

    Article  CAS  Google Scholar 

  26. Virtanen SM, Kenward MG, Erkkola M, Kautiainen S, Kronberg-Kippila C, Hakulinen T, Ahonen S, Uusitalo L, Niinisto S, Veijola R, Simell O, Ilonen J, Knip M (2006) Age at introduction of new foods and advanced beta cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes. Diabetologia 49:1512–1521

    Article  CAS  Google Scholar 

  27. Wahlberg J, Vaarala O, Ludvigsson J (2006) Dietary risk factors for the emergence of type 1 diabetes-related autoantibodies in 21/2-year-old Swedish children. Br J Nutr 95:603–608

    Article  CAS  Google Scholar 

  28. Ziegler AG, Schmid S, Huber D, Hummel M, Bonifacio E (2003) Early infant feeding and risk of developing type 1 diabetes-associated autoantibodies. JAMA 290:1721–1728

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We thank Professor Seppo Sarna for his advice on survival analysis. Fund support was from the Sigrid Juselius Foundation and State Special Funds for Research at the University Central Hospital, Helsinki (EVO).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Erkki Savilahti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Savilahti, E., Saarinen, K.M. Early infant feeding and type 1 diabetes. Eur J Nutr 48, 243–249 (2009). https://doi.org/10.1007/s00394-009-0008-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-009-0008-z

Keywords

Navigation