I am 34 years old and have had type 2 diabetes for about two years. I had gestational diabetes with my daughter almost five years ago. I am currently pregnant and have an A1c of 4.7. My blood sugars have been very controlled by insulin injections throughout the pregnancy. If I choose not to breast feed my child, what are the chances he will develop type 1 diabetes as a child? Does breast feeding really make a difference in babies born to diabetic mothers? If I bottle feed, would he have the same chance of developing type 1 as any other baby?

Congratulations on great A1c levels while pregnant.

Your child does not have an increased risk of type 1 diabetes if you have type 2 diabetes. If you have a slower onset of type 1, however, and not type 2, that would change the risk possibilities, of course.

The research answer to your question about breast feeding suggests the following: breast feeding offers some protection against developing type 1 diabetes presumably by avoidance of cow’s milk antigens (probably proteins). It is also good for decreasing allergies and infections. So, the best advice about breast feeding is to do so exclusively for up to a year for every baby and every mother, if possible and a bit more important if one wants to decrease type 1 diabetes risks. There is no data beyond one year.

Also, it is important to consider avoiding gluten and wheat since there is some preliminary data that also suggests avoiding these food products also may be helpful in avoiding type 1 diabetes.

All mothers interested in breast feeding should be able to get support from pediatricians, family physicians, nurses and groups like La Leche League to be successful.

SB