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February 27, 2004

Genetics and Heredity, Other

Question from Los Angeles, California, USA:

My husband has type 1 diabetes, as do his mother and grandmother. We have a four month old daughter. I'm exclusively breast feeding now, but when the baby had some jaundice, the pediatrician said to give her formula, Enfamil. She took half formula, half breast milk for a couple of weeks and after that she took formula once in a while. I didn't know I had to avoid it in order to prevent the risk of diabetes. Now, I'm getting concerned that I have spoiled the benefits of breast feeding by exposing her too soon to cow's milk proteins, even if I'm breast feeding exclusively now. Is it true?


You need not be overly concerned. As you must already know autoimmune, or type IA diabetes, is partly a result of genetic disposition and partly an effect of some environmental factor which nobody yet understands. A good many years ago now, a group in Finland, a country that has a very high incidence of this form of diabetes, reported that the development of insulin dependance seemed to be related to early exposure to cow’s milk. This appeared to be a responsibly conducted study and many others followed, some of which supported the early findings and some of which did not. But, the final conclusion in a rather large and recent study, was that early exposure to cow’s milk was not a predisposing factor for clinical diabetes. We still, though, have a very poor idea of what these environmental factors might be. A maternal rubella infection during pregnancy certainly seems to be one and the Norwegians have made a case for insufficient vitamin D during pregnancy. More recently, it has been shown that the first introduction of cereals before the fourth month of life, or after the sixth, may also be a factor. With such a strong family history, you might think to talk to the doctor about antibody tests when your daughter is older or, even for what is called HLA typing, to see if she is even susceptible.