May 27, 2001
Research: Causes and Prevention
Question from New Brunswick, New Jersey, USA:
A family member is very worried about her infant daughter developing type 1 diabetes because of the severity of her brother-in-law’s case (he was diagnosed at 18 months). She has only breast fed her seven month old, and on the recommendation of her pediatrician, has avoided feeding cow’s milk formula because of a possible increased risk. Her baby doesn’t tolerate soy. I would think though that if the mother herself doesn’t avoid cow’s milk and products of the milk, that there is still substantial risk of these beta casein proteins being transmitted via the breast milk, in the same way that mothers of infants with severe cows mild allergy may breast feed, but often must eschew any cow’s milk product themselves also. Also, her doctor wants to test the baby for some antibody when the baby is about nine months or so old so, to see if it’s “safe” to start feeding cow’s milk. What test could possibly determine that?
Your family friend seems to be concerned at two levels about the risk of autoimmune diabetes in her infant daughter.
In the first place, a brother-in-law is not a first degree relative so that the baby’s chance of developing type 1A (autoimmune) diabetes before the age of twenty is not significantly different from the community as a whole which is around 3 per 1000.
The second issue, that of early cow’s milk exposure is still ‘non-proven’. Careful work in Finland has suggested this link, but the effect has not been confirmed in other major studies like DAISY (Diabetes and AutoImmune Syndromes in Youth) in the U.S. In any case, there is some indication that the link, where it does exist, is not to all beta caseins, but only to milks that contain A1 or A1+B beta casein. A New Zealand group is going to manufacture an infant formula that lacks this antigen. In the light of all existing evidence I do not think that the mother needs to discontinue the use of milk products.