My husband has Type 1 diabetes and our 2 children are 7 and 4 years old. They do not have diabetes as of yet. I’d like to know the very latest status on the theoretical risk between cows’ milk in early childhood. I’ve also heard that high milk consumption in childhood (past the first year of life) still can put them at risk. To be extra safe should we limit milk? They have been on cows’ milk formula since three months old, and it’s on our kitchen table three times a day! I would never have pushed milk if I knew then what I know now. (I have only recently heard about this.)

Shortly after it was shown that by far the most common form of diabetes in Caucasian children was due to a disorder of the immune system, it was realised from studies of the unaffected twin in identical twins that there was both a genetic and an environmental component to the genesis of the disorder. By a form of genetic typing called HLA typing, it is now possible to show who is most at risk and who is protected. Since this is an expensive process and not readily available except in special laboratories, most families are comfortable with the generalisation that about 5% of the first degree relatives of a case will develop diabetes. The figure is a little lower if it is a mother or a sibling that is affected and a little higher if it is the father. The environmental factor however has been more elusive; but, for some years now, investigators, especially in Toronto, in Finland and in New Zealand have been making a case that the early ingestion of cow’s milk is important. It must be said, however, that other studies of these environmental factors, notably a large US study called DAISY (Diabetes and AutoImmune Syndromes in Youth) have so far not confirmed this.

At the end of last year, in a Journal called Diabetologia a report by Elliott and others showed that there was indeed a significant correlation not so much between the amount of milk drunk; but with the presence of A1 and B beta caseins in the milk. These are herd-specific proteins in dairy cattle somewhat in the same way that there are specific blood groups in man. It is not known yet how great the exposure has to be to trigger insulin dependence.

So what are the options for your two children? You could have them tested for antibodies in the CANENDIT study on nicotinamide or in the US study of insulin (tel 1-800-425-8361) or by Quest Diagnostics in California. You could try to find milk with A2 beta casein; but commercial dairies and formula makers tend to purchase milk in bulk over a wide area that varies with the season. You could also ask their doctor about HLA typing. However, since both of them seem to have been exposed to cows’ milk already for several years, and since milk is an important nutritional source in childhood, especially for vitamin D and calcium, I would not make any changes in their diet.

DOB