Breastfeeding predicts the risk of childhood obesity in a multi-ethnic cohort of women with diabetes

Objective. To determine whether breastfeeding reduced the risk of childhood obesity in the infants of a multi-ethnic cohort of women with pregestational diabetes. Methods. In this retrospective cohort study, women with pregestational diabetes were mailed a questionnaire about breastfeeding and current height and weight of mothers and infants. Predictors of obesity (weight for age > 85 percentile) were assessed among offspring of index pregnancies, using univariate and multivariable logistic regression. Results. Of 125 women, 81 (65%%) had type 1 diabetes and 44 (35%%) had type 2 diabetes. The mean age of offspring was 4.5 years. On univariate analysis, significant predictors of obesity in offspring were type 2 diabetes (odds ratio, OR 2.4, 95%% confidence interval, CI 0.99--5.72); maternal body mass index (BMI) > 25 (OR 4.4, 95%% CI 1.4--19.4); and any breastfeeding (OR 0.22, 95%% CI 0.07--0.72). After multivariable adjustment, breastfeeding (OR 0.20, 95%% CI 0.06--0.69) and having an overweight/obese mother (OR 3.49, 95%% CI 1.03--16.2) remained independently associated with childhood obesity. Conclusion. Breastfeeding significantly decreased the likelihood of obesity in offspring of mothers with pregestational diabetes, independent of maternal BMI and diabetes type. Women with diabetes should be encouraged to breastfeed, given the increased risk of obesity in their children.