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July 11, 2002

Research: Causes and Prevention

Question from Syracuse, New York, USA:

My six year old has had type 1 diabetes since 15 months of age (and also celiac disease since age four), my three year old does not have diabetes, there is no other family history of type 1 diabetes. I am due with my third child in a few weeks, and I plan to nurse the baby exclusively for the first month, then to supplement nursing with formula the second month, and then to discontinue nursing the third month when I return to work. Do you believe it is worthwhile to use a formula that does not contain not cow's milk? I see there is a formula designed for infants with allergies that is not milk based. I know you've been asked this question before, but I wonder if your opinion on the matter has changed based on more recent articles and studies that have been published. Specifically, I just read about an experimental study where newborns will be separated into two groups -- milk based formula and non-milk formula, to determine if there really is a correlation with cow's milk and type 1 diabetes. Other than the added cost of the special formula, I don't expect it could hurt to have the baby on special formula.

Answer:

This is a difficult question to answer with any assurance because the evidence is conflicting. The early studies, which were carefully done came from Finland where the incidence of type 1A (autoimmune) diabetes is more than double what it is in this country. However, other studies in Europe and North America really didn’t confirm this, the latest explanation being that it was only milk from particular herds that genetically produced an alpha1 beta casein in their milk that provided the environmental trigger in genetically susceptible infants.

Even though the chance of the next baby developing diabetes is less than 1:20, the cow’s milk story is still of concern to parents, and recently there have been a few studies that have been promoting soy formula with a gluten free diet later. Our own experience in this clinic is that neither course is justified at present.

DOB