Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence

Pereira, Patrícia F.; Alfenas, Rita de Cássia G.; Araújo, Raquel Maria A.

doi:10.1016/j.jpedp.2013.02.010

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Abstract

Objective

The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children.

Sources

Non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes).

Data synthesis

The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects.

Conclusion

Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes.

Keywords:

Breastfeeding

Blood glucose

Type 1 diabetes mellitus

Type 2 diabetes mellitus

Resumo

Objetivo

Realizar uma análise crítica da literatura para avaliar a influência da amamen- tação no risco de desenvolvimento de diabetes mellitus.

Fonte dos dados

Revisão não sistemática nas bases de dados SciELO, LILACS, MEDLINE, Scopuse BVS, selecionando-se 52 referências mais relevantes. Especificamente sobre o tema, foram analisadas 21 (sendo 9 para diabetes tipo 1 e 12 para diabetes tipo 2).

Síntese dos dados

A duração, a exclusividade do aleitamento materno e uso precoce do leite de vaca têm sido apresentados como fatores de risco para o desenvolvimento de diabetes. Acredita-se que o leite humano contenha substâncias que promovem a maturação do sistema imunológico protegendo contra o diabetes tipo 1. Além disso, ele possui substâncias bioativas, que promovem o equilíbrio energético e a saciedade, prevenindo o ganho de peso excessivo da criança e protegendo, consequentemente, contra o aparecimento do diabetes tipo 2. Apesar dos benefícios anteriormente citados não terem sido constatados por alguns pesquisadores, a imprecisão no relato dos hábitos dietéticos da infância e a presença de fatores interferentes têm sido responsabilizadas pela falta de identificação dos efeitos benéficos.

Conclusão

Diante das evidências científicas pautadas em grande parte dos estudos, acredita-se que a ausência da amamentação seja um possível fator de risco modificável para diabetes tipo 1 e tipo 2. Estratégias que visem à promoção e ao suporte ao aleita- mento materno devem ser adotadas por profissionais de saúde devidamente treinados como forma de prevenir a manifestação da doença.

Palavras-chave:

Aleitamento materno

Glicemia

Diabetes mellitus tipo 1

Diabetes mellitus tipo 2

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Como citar este artigo: Pereira PF, Alfenas RC, Araújo RM. Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence. J Pediatr (Rio J). 2014;90:7-15.

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