Type-1 and breast-feeding

I have a friend who had gestational diabetes which subsequently turned out to be LADA. She’s breast-feeding her baby. The concern is about antibodies being present in breast-milk. Does the presence of her autoantibodies in her milk harm the baby? Are there any studies done on this?

She had LADA while being pregnant. It has not turned from gestational into LADA I would say. So she has already exchanged the antibodies with her child through the placenta. To pass the antibodies with the milk seems unlikely to me. So thumbs up for breast feeding.

I don’t know the answer to your specific question. However, I do know that breastfeeding helps to prevent diabetes. The longer, the better.

Agreed. They likely discovered her LADA while doing regular 24-28 week gestational diabetes glucose screening.

The benefits of breastfeeding far outweigh the risks anyway. They even tell smokers to breastfeed now (if they continued to smoke throughout the pregnancy). There are always circumstances where people cannot or should not attempt breastfeeding, but fear of LADA antibodies should not be one of them!

I’m a type 1 who is about to give birth in 2 weeks and I plan to try to breastfeed.

Actually, if you read “Diabetes Rising” there is much more thinking that baby formula is what really puts you at risk for t1. Please breast feed your baby for at least six months and even longer if you can. There appears to be a statistically significant risk of t1 attached to the early use of cows milk and wheat in baby formula.

Breast feeding confers antibody protection but does not infect a baby with autoimmune conditions of any kind. Not LADA, not Graves, not Lupus or anything else. Besides a large number of women with gestational diabetes test positive for antibodies (like 10%).

Nope. As the others have said, breastfeeding is far healthier for baby & for the mom, too.

Correct me if I’m wrong, but I think the antibodies would be destroyed by digestive enzymes/acids. This is the same reason that insulin can’t be taken orally…

Also wonder what the statistics would be for the # of type 1’s who were breastfed. My son (diagnosed 9 mos ago) was breastfed for 13 mos and only given the proper foods introduced at the right times. It isn’t much conselation to do things right and still have children with health issues, but maybe at least less guilt although I can still come up with ways to have guilt without trying too hard.

I was a breast fed baby & T1 with no family history. Would be really interesting to know the stats.

Actually antibodies do pass through breastmilk… that’s the primary way it offers such a protective “passive immunity” to babies who are breastfed.

That said, I was breastfed until 18 months, and I still got T1… my kids were all breastfed and none of them have D (so far)… clearly there is more involved.

Don’t say “try” - say you will :slight_smile: Positive attitude can go a long way towards forming a successful nursing relationship, especially with your first.

Make sure you are prepared to be faced with a barrage of nurses and other staff wanting you to give your baby bottles… or whisk them off to the NICU because it’s “policy” - none of it truly is. Room in with your baby, and if they need supplementation, use a SNS (Supplemental Nursing System)… most hospitals will have those available if you ask, but it’s extremely unlikely that anyone will bring it up unless you request it.

Oh, the only reason I said “try” is because I’m tired of people telling me “oh, well, you never know” in regard to EVERYTHING. I told a friend I was going to breastfeed and she played the whole “some women aren’t able to / it’s harder than you think” game and I couldn’t convince her I’m prepared to do it. So now I just state my intentions in a more general way and pretend I have an open mind. :wink:

As far as bottles after delivery, I’m delivering via c-section and understand that the baby will be whisked away whether I like it or not. I have declared to the doc that I don’t want to deal with nipple confusion and prefer no bottle if possible, but I also want her potential BG issues treated immediately and that means she may need glucose water. I’m patient enough to deal with the consequences and confident enough that she’ll still be able to figure out nursing - even if I don’t see her until after I’m out of the OR.

Breastfeeding is the way to go. There are very few absolute contraindications to breastfeeding - infections like hepatitis or HIV, use of chemotherapeutic agents or radioactive agents, some potent IV antibiotics. Antibodies are passed in the breast milk that confer passive immunity to the baby - for example, if Mom gets HINI vaccine, she’ll pass those antibodies on to her baby and baby will be protected against HINI. But autoantibodies are directed against the MOTHER’s tissue, and won’t affect the baby’s unique tissue at all. I am an OB doc who has type 1. Please tell your friend to breastfeed for as long as she can. It really is the best for baby.

Thank you, all, for your replies. I directed my friend to read this discussion and she’s very encouraged by all the posts telling her that her baby will not get T1 because of her autoantibodies.

My wife was diagnosed with gestational diabetes during her first pregnancy and I specifically asked about breastfeeding. The answer was a resounding “No, it does not affect the baby in any negative way” and she encouraged her to breastfeed if she wanted/could.
Hope this helps even though my wife wasn’t LADA.

A hallmark paper on cow’s milk and t1 is http://content.nejm.org/cgi/content/abstract/327/5/302, it showed a clear connection between cows milk antibodies and the occurence of T1. The study looked at 142 children with diabetes and 79 healthy children. All of the T1 kids had antibodies to cows milk, while only 2.5% of the healthy children had the antibodies. There is a whole chapter in the book I mentioned on the so called “Cows Milk Hypothesis.” I would not say that the evidence necessarily “proves” the connection, and it surely won’t explain all of juvenile t1, but it is enough of a demonstrated risk that every doctor should be counseling expectant mothers on on the risk.

To anyone reading this who is thinking about breastfeeding, or has tried in the past and not had success, I would encourage you to contact La Leche League. http://www.llli.org/ They are so helpful for anyone struggling with breastfeeding. If you can go to a meeting while pregnant, it can be especially helpful. Even if there isn’t a group close to you, all of the leaders offer phone support. If there is a group close to you and you end up needing more help than they can give, they can usually recommend a good lactation consultant in your area. Not all lactation consultants are equally helpful, so it’s important to find a good one. And I’m happy to help in any way that I can! I’ve been breastfeeding for a long time.