medwireNews: Results from the CARDIA study support previous reports that sticking with breastfeeding for longer could reduce women’s future diabetes risk, even for those without gestational diabetes.
There was a clear relationship between breastfeeding duration and diabetes rates during 30 years of follow-up, report Erica Gunderson (Kaiser Permanente Northern California, Oakland, USA) and co-researchers in JAMA Internal Medicine.
Among 1083 women without gestational diabetes, diabetes rates were 7.5 per 1000 person–years among those who did not breastfeed, compared with 5.5, 3.4, and 2.7 per 1000 person–years among those who breastfed for up to 6 months, between 6 and 12 months, and for 12 months or more, respectively.
This trend was also evident among the 155 women who had gestational diabetes, with corresponding rates of 31.1, 16.7, 12.1, and 10.3 per 1000 person–years.
The researchers comment that the only large prospective study to previously address this relationship was conducted exclusively in women with gestational diabetes. Other large studies reporting a relationship in women without gestational diabetes were based on women’s recall of breastfeeding duration a long time after the event and self-report of diabetes, whereas women in the CARDIA cohort were assessed for lactation and had glucose levels tested up to seven times during follow-up.
The community-based CARDIA study cohort is composed of equal numbers of Black and White people. Although nearly three-quarters of diabetes cases occurred in Black women, the association between breastfeeding duration and diabetes risk was statistically significant after accounting for race, as well as other variables including age, baseline BMI and fasting glucose, family history of diabetes, and changes in physical activity and diet over time.
Notably, the association remained significant even after the team accounted for changes in the women’s weight during follow-up, with diabetes risk reduced by 25%, 48%, and 47% for women who breastfed for up to 6 months, between 6 and 12 months, and for 12 months or more, respectively, versus those who did not breastfeed.
Gunderson and team stress that it is “imperative to improve breastfeeding practices to interrupt the transgenerational transmission of obesity-related diseases.”
They say their results “may have implications for social policies to extend paid maternity leave to achieve higher intensity and longer duration of breastfeeding,” noting that such costs could be offset by a later reduction in healthcare costs.
And they add: “Breastfeeding offers numerous other health benefits to both mother and child, including reduction in childhood infectious diseases, asthma and type 2 diabetes, as well as lower risk of breast and ovarian cancer in women.”
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