Breastfed Babies May Have a Lower Risk of Type 1 Diabetes

Around the world, rising numbers of children are developing the autoimmune disease type 1 diabetes. In the United States, there was a 1.9% increase in new cases of type 1 diabetes per year between 2002 and 2015, according to the Centers for Disease Control and Prevention (CDC). 

Sweden has the second-highest incidence of type 1 diabetes in children, with 40 children per 100,000 diagnosed each year. This prompted researchers at Karolinska Institutet in Solna to carry out a systematic review and meta-analysis of existing research on the role of diet in the development of the disease. 

The researchers found that some high-quality studies indicate that longer breastfeeding and later introduction to gluten, fruit, and cow's milk may reduce the risk of type 1 diabetes. They hope that their findings, published in the journal EBioMedicine, will lead to further research into possible preventive measures. 

"So far, we know that genetic predisposition is linked to the condition, but our knowledge is limited when it comes to environmental triggers and thus, no preventive strategies have been established,” says the study’s first author Anna-Maria Lampousi, a doctoral student at the Institute of Environmental Medicine at Karolinska Institutet.  

A Closer Look at the Study 

The researchers screened 5,935 articles published in medical journals up to October 2020. They identified 96 relevant studies, which provided results on diet and the risk of type 1 diabetes in children. 

Altogether, 26 dietary factors were evaluated, including breastfeeding, age of introduction to different foods, and childhood diet. The strongest research found an association between longer periods of breastfeeding and later introduction to gluten and a lower risk of type 1 diabetes.  

Babies who were breastfed for at least six to 12 months had a 61% lower risk of developing type 1 diabetes than other babies. And babies who were introduced to gluten at three to six months of age were 64% less likely to develop type 1 diabetes than those who were introduced to gluten earlier.

While the researchers didn’t investigate the mechanisms that may explain the associations, previous research has shown prolonged periods of breastfeeding to have generally positive effects on an infant’s immune system and gut health. Additionally, some experimental studies found that gluten may hinder the production of insulin, which helps control blood glucose levels.

“Our findings support that longer breastfeeding and later introduction to gluten, cow’s milk, and fruit may decrease the risk of developing type 1 diabetes,” says Lampousi. She adds that there are many dietary factors of potential interest, but the evidence is weak and more high quality studies are required. 

“On the positive side, the likelihood that an individual will develop type 1 diabetes is low, even if breastfeeding is not initiated or if gluten is introduced early,” Lampousi says. 

Breastfeeding Is Learned Behavior

Former labor and delivery nurse and certified lactation consultant Lindsey Shipley, RN, IBCLC, isn't surprised by association between breastfeeding and a lower risk of type 1 diabetes. "We know through previous research that breastfed babies have a lower incidence of lots of other illnesses like asthma, obesity, infectious disease, and diarrhea, among others. Breastfeeding also helps form the gut and prepare it for the processing of future foods." 

Breastfeeding may be the most natural way to feed a baby, but it doesn't come naturally to everyone. "It's a learned behavior for both mom and baby," Shipley says. "I've seen so many parents feel overwhelmed and unsure when it comes to breastfeeding, even though they wanted to do it."

Shipley suggests educating yourself as much as you can during pregnancy on how breastfeeding works, and then seeking help from a certified lactation consultant if there are any issues, like difficulty latching or unresolved pain. But she advises steering clear of things like lactation cookies and quick fixes. "Lean into education and support that can help you on your unique journey," she says.