New evidence on the benefits of breastfeeding in protecting against diabetes was presented at this year’s World Diabetes Congress in Vancouver, Canada, with a study showing that breastfeeding protects Canadian women and their children (including First Nations Canadians) from developing type 2 diabetes (T2D).
The prevalence of diabetes has increased rapidly in Canada, especially among people of First Nation (FN) descent. Previous studies have indicated that exclusive or partial breastfeeding may reduce the risk of T2D in mothers or offspring. The impact of breastfeeding initiation on the development of subsequent diabetes among mothers and offspring has not been determined in a large-scale database study. So Garry Shen, MD, PhD, of the University of Manitoba, and his team investigated the impact of breastfeeding initiation on subsequent diabetes among FN and non-FN mothers and their offspring in Manitoba between 1987 and 2011.
The researchers studied 334,553 deliveries during the 24-year period in Manitoba province (60,088 FN births and 274,465 non-FN births). The main exposure, breastfeeding initiation at discharge, was obtained from hospital abstracts. Computer modelling was used to explore the association between breastfeeding initiation and the risk of subsequent incident diabetes in mothers (n=180,107) and their offspring (n=250,392). Diabetes was determined from hospital International Classification of Disease (ICD) codes.
Breastfeeding initiation was recorded in 56% of FN mothers and 83% of non-FN mothers. Breastfeeding initiation was associated with a 14% reduced risk of diabetes among FN mothers and a 23% reduced risk among non-FN mothers.
A protective effect of breastfeeding initiation was also observed for T2D among offspring of the above mothers during up to 24 years of follow-up, reducing the risk of diabetes by 18%. Different from mothers, FN status did not significantly affect association between breastfeeding and incident diabetes; therefore the analyses across FN and non-FN offspring were pooled together. This 18% risk reduction represents the reduction in risk to all children of both ethnicities. The protective effects of breastfeeding initiation among mothers and offspring were independent of FN status, gestational diabetes, gestational hypertension, family income, location of residence, age of mothers at birth, parity and the birthweight of offspring.
The authors say: “Breastfeeding initiation was associated with a reduced risk of subsequently developing diabetes among women and their offspring. Breastfeeding initiation should be promoted in general population, especially for FN mothers who have lower rates of breastfeeding initiation.”
In Manitoba, Shen and colleagues are promoting breastfeeding in urban and rural or remote FN communities in Manitoba using web and social media-based approaches. Several groups of Canadian researchers in other provinces are also promoting breastfeeding in various ethnic groups.
Shen’s team has developed a multi-disciplinary group including endocrinologists, paediatricians, obstetricians, nutritionists, and epidemiologists—and partnered with provincial and FN health authorities. They recently developed a prenatal care and breastfeeding website aiming to promote breastfeeding of mothers including rural-living FN women in the province. The website is linked with Facebook and provides services for self-registration, on-line chat, video and audio-educations tools. Shen and colleagues have made several visits to participating FN communities and developed close partnership relationships with these communities and health care workers based there.
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