Poster Topical Area: Maternal, Perinatal and Pediatric Nutrition
Location: Hall D
Poster Board Number: 313
Objectives: The USDA and HHS initiated the Pregnancy and Birth to 24 Months project to examine important public health topics for these populations with systematic reviews (SRs). The purpose of this SR is to examine the relationship between human milk feeding and type 1 diabetes (T1D) and type 2 diabetes (T2D) in offspring.
Methods: A SR team identified articles in PubMed, Cochrane, Embase, and CINAHL with a date range of 01/1980-03/2016 that met a priori inclusion criteria. After dual-screening the search results, extracting data from the included studies, and assessing their risk of bias, the SR team synthesized the evidence, drew conclusion statements, and graded the strength of the evidence.
Results: Thirty-eight articles examined the duration of any human milk feeding, 18 examined the duration of exclusive human milk feeding, 21 examined never vs ever feeding human milk, and none examined the intensity, proportion, or amount of human milk fed to mixed-fed infants. Moderate evidence suggests that, among infants fed some amount of human milk, a shorter vs longer duration of any or exclusive human milk feeding is associated with a higher relative risk of T1D. Limited evidence suggests that never vs ever being fed human milk is also associated with a higher relative risk of T1D. Limited but consistent evidence suggests that never vs ever being fed human milk is associated with a higher relative risk of early-onset T2D; however, no conclusions can be drawn regarding the relationships between other human milk-feeding practices and T2D.
Conclusions: There is evidence of a relationship between the durations of any and exclusive human milk feeding and T1D, and never vs ever feeding human milk and T1D and early-onset T2D, most of which is observational. Future research should address the gaps in literature, and researchers should clearly define their independent variables, collect data using validated methods, and more consistently address critical confounders.
Center for Nutrition Policy and Promotion, Food and Nutrition Service, USDA, Alexandria, VA and the Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, US Department of Health and Human Services, Rockville, MD.