Diabetes prevention in young babies - infant formula choice

[Dan Evans]

Hi,

I have been type 1 diabetic for 20+ years. Last year, my wife an I had our
first child, who is now 4 months old.

I am aware that my son will have a higher risk than average of developing
type 1 diabetes. But I obviously want to do all I can to prevent this from
happening. I have searched the web, and understand that breastfeeding is a
strong preventative factor. My wife will carry this on for as long as she
can, but it won't be long (2-3wks) before she has to stop since he's a big
baby and he's not getting enough nutrition from breastmilk alone.

So we want to introduce formula soon, and then soon after baby rice to start
weaning.

When I was searching, various sites/studies mentioned a link between cows
milk (in most formulas) acting as a risk factor. I'm obviously concerned
about this, and wondered if anyone has views on alternatives. One
alternative is presumably a soya based formula, but there have been other
scares with that. Another (as proposed by the http://trigr.epi.usf.edu/
study which I couldn't find the outcome of) is to use hydrolyzed formula.

Does anyone have any recommendations on what formula we should be using, or
any other practical preventative steps we can take? Is SMA LF (Lactose Free)
formula the same thing as hydrolyzed formula? What steps have other diabetic
parents taken?

Thanks for the help.

-- Dan Evans.
***@hotmail.com

[Willa Hunt]

Post by Dan Evans
I am aware that my son will have a higher risk than average of developing
type 1 diabetes. But I obviously want to do all I can to prevent this from
happening. I have searched the web, and understand that breastfeeding is a
strong preventative factor. My wife will carry this on for as long as she
can, but it won't be long (2-3wks) before she has to stop since he's a big
baby and he's not getting enough nutrition from breastmilk alone.
So we want to introduce formula soon, and then soon after baby rice to start
weaning.

Well... this is a very personal decision, and your wife naturally has
to be the main one to make it, since it's her life and boobies we're
talking about. But since you're concerned about health risks, continuing
with breastfeeding and postponing solids until at least 6 months is a
better plan, if she feels able to do it.

I'm afraid I don't have any real suggestions for formula. Both
milk-based and soy-based have potential allergenic problems. I'm not
sure anyone even knows what factor in breastmilk is protective, or
whether it's that some factor in formula is actually damaging.

[Penny Gaines]

Post by Dan Evans
Hi,
I have been type 1 diabetic for 20+ years. Last year, my wife an I had our
first child, who is now 4 months old.
I am aware that my son will have a higher risk than average of developing
type 1 diabetes. But I obviously want to do all I can to prevent this from
happening. I have searched the web, and understand that breastfeeding is a
strong preventative factor. My wife will carry this on for as long as she
can, but it won't be long (2-3wks) before she has to stop since he's a big
baby and he's not getting enough nutrition from breastmilk alone.

[snip]

Congratulations to your wife for breast-feeding for four months.

But what makes you say he's not getting enough nutrtition? If he's
growing he probably is getting the nutrition he needs.

Rather then changing to formula before adding solids, why doesn't she
continue with breastmilk, then see whether just adding solids is enough,
so your baby continues to get the benefits from breastfeeding.

FWIW, there is also a breastfeeding group, misc.kids.breastfeeding.
They might be able to help your wife carry on.

[Welches]

Post by Dan Evans
Hi,
I have been type 1 diabetic for 20+ years. Last year, my wife an I had our
first child, who is now 4 months old.
I am aware that my son will have a higher risk than average of developing
type 1 diabetes. But I obviously want to do all I can to prevent this from
happening. I have searched the web, and understand that breastfeeding is a
strong preventative factor. My wife will carry this on for as long as she
can, but it won't be long (2-3wks) before she has to stop since he's a big
baby and he's not getting enough nutrition from breastmilk alone.

Who says?
I haven't used formula in 3 children, one of whom was 95% centile at 5
months (when I introduced solids). I exclusively breastfed until 8 months
with #2 and 7 months with #3, neither of whom are tiny.
If you think he's ready then you may want to introduce solids. A little
amount of baby rice or a mashed up vegetables (sweet potatoes or carrots
mine appreciated most at first) is an appropriate first food. You can give a
little water to drink with it if you think they need it, but if you're
breastfeeding then it's not necessary.
If you wait until over 6 months then he may be able to go straight to finger
foods (even without teeth) which is what I've done. It is easier and they do
enjoy feeding themselves.
I really don't see the point in going for the soya formula. If they've a
problem with milk, then there's a high likelihood that they will react also
to soy milk. I've a feeling it's also higher sugar content too, which isn't
going to help any diabetic tendencies. The hypoallergenic formula is
absolutely disgusting I'm told, (some babies totally refuse it) and babies
that use it produce especially foul nappies too.
If you think cows milk is likely to be a problem you are far and away best
sticking with breast milk.
DEBBIE

Post by Dan Evans
So we want to introduce formula soon, and then soon after baby rice to
start weaning.
When I was searching, various sites/studies mentioned a link between cows
milk (in most formulas) acting as a risk factor. I'm obviously concerned
about this, and wondered if anyone has views on alternatives. One
alternative is presumably a soya based formula, but there have been other
scares with that. Another (as proposed by the http://trigr.epi.usf.edu/
study which I couldn't find the outcome of) is to use hydrolyzed formula.
Does anyone have any recommendations on what formula we should be using,
or any other practical preventative steps we can take? Is SMA LF (Lactose
Free) formula the same thing as hydrolyzed formula? What steps have other
diabetic parents taken?
Thanks for the help.
-- Dan Evans.

[Sarah Vaughan]

Post by Dan Evans
When I was searching, various sites/studies mentioned a link between cows
milk (in most formulas) acting as a risk factor. I'm obviously concerned
about this, and wondered if anyone has views on alternatives. One
alternative is presumably a soya based formula, but there have been other
scares with that. Another (as proposed by the http://trigr.epi.usf.edu/
study which I couldn't find the outcome of) is to use hydrolyzed formula.

The website says the study was recruiting babies up to the end of 2006.
Since it'll take years for most of the diabetes cases to start showing
up, it'll be a long time before the data are in on that study, alas. In
the meantime, we don't really have any evidence as to whether hydrolysed
formula is better or not. In the absence of data, I think it's
debatable whether it's worth paying an arm and a leg for the hydrolysed
stuff purely because it *might* theoretically have benefits. Your call,
obviously.

Post by Dan Evans
Does anyone have any recommendations on what formula we should be using, or
any other practical preventative steps we can take?

I agree with what others have said: the first step is to see whether
it's possible to stick to exclusive breastfeeding for longer. Could you
specify why you think your son needs more nutrition than he's getting
from breastmilk? (If it's just that he's a big baby, then that's not a
sign that he needs more - on the contrary, I'd say that's an excellent
sign that he's getting plenty of nutrition! If you have other reasons,
tell us and we can give you advice - sometimes parents mistake normal
behaviour for signs their baby needs more food when in fact he doesn't.)
If and when continuing exclusive breastfeeding really isn't an option,
I would start solids that don't contain any milk, and try and use
formula only if you're really sure that breastmilk *and* solids aren't
sufficient to do the trick (and, if that does happen, use it as a
supplement for breastmilk rather than a replacement).

Post by Dan Evans
Is SMA LF (Lactose Free)
formula the same thing as hydrolyzed formula?

No. Lactose is milk sugar, whereas it's the protein that you want to avoid.

BTW, you've crossposted this to a lot of groups - can you tell us which
one you're reading the answers from, so that I can trim any further
follow-ups down to that one and the one I'm reading from?


All the best,

Sarah

[Dan Evans]

Many thanks for all the helpful replies.

My wife (Emma) is going to try to continue breastfeeding for a bit longer,
but I can't see it lasting that long to be honest. Up to now, she has been
pumping breastmilk (~250ml) first thing in the morning, which we have been
giving to Charlie (baby) last thing at night (11pm ish). This has meant he
sleeps through the night. (The rest of the time he gets milk from breast
direct).

In the last month, Emma's AM supply has dropped to ~150ml pumped in AM,
which has meant that Emma is also now pumping in the evening to try to get
enough for the night feed. Charlie is not getting as much at night as he
wants and he is waking earlier than he did. It's managable for now (6:45-7am
waking rather than 8-8:30 previously) but we're not sure for how much
longer.

We're going to go and have a chat with our GP about best options. (Who
helpfully is also a diabetes specalist at local hospital). I imagine we'll
end up introducing one bottle of formula at night (it seems that there isn't
a consensus if normal/soya is most beneficial in the diabetes prevention
stakes?) and pump breastmilk to mix with baby rice some time in the day. Or
perhaps 50:50 formula-pumped breastmilk at night, with 50:50 formula-pumped
breastmilk+baby rice daytime?.... We're still trying to work out what will
be best.....

Am copying in misc.kids.breastfeeding as Penny Gaines helpfully suggested.
Am looking at replies in all the groups I posted to, but particularly
misc.health.diabetes (I spent many a hour posting on that group in years
ago, but less so recently)...

Thanks again.

-- Dan
dd_dd75 at hotmail.com

Post by Sarah Vaughan

Post by Dan Evans
When I was searching, various sites/studies mentioned a link between cows
milk (in most formulas) acting as a risk factor. I'm obviously concerned
about this, and wondered if anyone has views on alternatives. One
alternative is presumably a soya based formula, but there have been other
scares with that. Another (as proposed by the http://trigr.epi.usf.edu/
study which I couldn't find the outcome of) is to use hydrolyzed formula.

The website says the study was recruiting babies up to the end of 2006.
Since it'll take years for most of the diabetes cases to start showing up,
it'll be a long time before the data are in on that study, alas. In the
meantime, we don't really have any evidence as to whether hydrolysed
formula is better or not. In the absence of data, I think it's debatable
whether it's worth paying an arm and a leg for the hydrolysed stuff purely
because it *might* theoretically have benefits. Your call, obviously.

Post by Dan Evans
Does anyone have any recommendations on what formula we should be using,
or any other practical preventative steps we can take?

I agree with what others have said: the first step is to see whether it's
possible to stick to exclusive breastfeeding for longer. Could you
specify why you think your son needs more nutrition than he's getting from
breastmilk? (If it's just that he's a big baby, then that's not a sign
that he needs more - on the contrary, I'd say that's an excellent sign
that he's getting plenty of nutrition! If you have other reasons, tell us
and we can give you advice - sometimes parents mistake normal behaviour
for signs their baby needs more food when in fact he doesn't.) If and when
continuing exclusive breastfeeding really isn't an option, I would start
solids that don't contain any milk, and try and use formula only if you're
really sure that breastmilk *and* solids aren't sufficient to do the trick
(and, if that does happen, use it as a supplement for breastmilk rather
than a replacement).

Post by Dan Evans
Is SMA LF (Lactose Free) formula the same thing as hydrolyzed formula?

No. Lactose is milk sugar, whereas it's the protein that you want to avoid.
BTW, you've crossposted this to a lot of groups - can you tell us which
one you're reading the answers from, so that I can trim any further
follow-ups down to that one and the one I'm reading from?
All the best,
Sarah
--
http://www.goodenoughmummy.typepad.com
"That which can be destroyed by the truth, should be" - P. C. Hodgell

-------

original post (for benefit of misc.kids.breastfeeding now cced in)

Post by Sarah Vaughan
Hi,
I have been type 1 diabetic for 20+ years. Last year, my wife an I had our
first child, who is now 4 months old.
I am aware that my son will have a higher risk than average of developing
type 1 diabetes. But I obviously want to do all I can to prevent this from
happening. I have searched the web, and understand that breastfeeding is a
strong preventative factor. My wife will carry this on for as long as she
can, but it won't be long (2-3wks) before she has to stop since he's a big
baby and he's not getting enough nutrition from breastmilk alone.
So we want to introduce formula soon, and then soon after baby rice to start
weaning.
When I was searching, various sites/studies mentioned a link between cows
milk (in most formulas) acting as a risk factor. I'm obviously concerned
about this, and wondered if anyone has views on alternatives. One
alternative is presumably a soya based formula, but there have been other
scares with that. Another (as proposed by the http://trigr.epi.usf.edu/
study which I couldn't find the outcome of) is to use hydrolyzed formula.
Does anyone have any recommendations on what formula we should be using, or
any other practical preventative steps we can take? Is SMA LF (Lactose Free)
formula the same thing as hydrolyzed formula? What steps have other diabetic
parents taken?
Thanks for the help.
-- Dan Evans.

[W. Baker]

In alt.support.diabetes Dan Evans <***@hotmail.com> wrote:
: Many thanks for all the helpful replies.

: My wife (Emma) is going to try to continue breastfeeding for a bit longer,
: but I can't see it lasting that long to be honest. Up to now, she has been
: pumping breastmilk (~250ml) first thing in the morning, which we have been
: giving to Charlie (baby) last thing at night (11pm ish). This has meant he
: sleeps through the night. (The rest of the time he gets milk from breast
: direct).

: In the last month, Emma's AM supply has dropped to ~150ml pumped in AM,
: which has meant that Emma is also now pumping in the evening to try to get
: enough for the night feed. Charlie is not getting as much at night as he
: wants and he is waking earlier than he did. It's managable for now (6:45-7am
: waking rather than 8-8:30 previously) but we're not sure for how much
: longer.

: We're going to go and have a chat with our GP about best options. (Who
: helpfully is also a diabetes specalist at local hospital). I imagine we'll
: end up introducing one bottle of formula at night (it seems that there isn't
: a consensus if normal/soya is most beneficial in the diabetes prevention
: stakes?) and pump breastmilk to mix with baby rice some time in the day. Or
: perhaps 50:50 formula-pumped breastmilk at night, with 50:50 formula-pumped
: breastmilk+baby rice daytime?.... We're still trying to work out what will
: be best.....

: Am copying in misc.kids.breastfeeding as Penny Gaines helpfully suggested.
: Am looking at replies in all the groups I posted to, but particularly
: misc.health.diabetes (I spent many a hour posting on that group in years
: ago, but less so recently)...

: Thanks again.

: -- Dan
: dd_dd75 at hotmail.com

i am a n old fogey here, as my youngest will be 40 this
april! I also didn't breastfeed, as Jon was sick and had to stay inthe
hospital for an extra week, and hospitals were not friendly to
breastfeeding in those days. Jon was, however, a big eater(drinker),
consuming up to 12 oz of Similac at a feeding and onto 3 feeds a day by 2
months. To get him through the night at this fairly young age, and with
the advice of my pediatrician, we introduced mashed banana (no milk in
that) in the evening. It worked once he got to accept this funny way of
eating from a tiny spoon, not a nipple.

I would suggest something like that rather than stopping the breastfeeding
which has helped him grow so well until now.

Wendy

[Beth Kevles]

Hi --

Another thing to consider is that your baby is going through a growth
spurt. When that happens, they are hungrier and nurse more frequently.
It can last for several days, up to a week, and can be frustrating for
mom. However, what the baby is doing is nursing frequently to help mom
increase her milk supply. If mom responds by letting the baby nurse
whenever he wants, even at night, then her supply will increase more
rapidly and the two can get back to a normal routine. In other words,
consider ditching the nighttime bottle. Do continue pumping in the AM
if she wants (useful for baby sitters or emergencies) but don't feed it;
freeze it instead.

If your wife can hold out for just a bit longer then it will be time to
start introducing solids and the nursing will be much easier. And if
she can continue nursing past the introduction of solids, she may find
it easy to continue nursing for the first full year or beyond.

Milk vs. formula is only one factor among many in parenting. If it's
making her miserable to nurse, and especially if that's contributing to
depression or to resentment of the baby, then starting solids early
might be a good idea.

For formulas, I don't know if the milk-based hypoallergenic formulas are
implicated in diabetes. The milk proteins are modified, which makes
them more digestable by infants who are milk-intolerant (although
they're not safe for infants with true cow's milk allergy). Soy
formulas have their own advantages and disadvantages. And remember,
you're learning about cow's milk and the statistical baby. You've got a
REAL baby in front of you, not a statistical one. Do what you think is
best for the entire baby, not just his insulin!

Congratulations on his arrival,
--Beth Kevles
***@gmail.PUT-THE-COM-HERE
http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

NOTE: No email is read at my MIT address. Use the GMAIL one if you would
like me to reply.

[Welches]

<snip>
You might be interested in
http://news.bbc.co.uk/1/hi/health/7290423.stm

Vitamin D 'cuts risk of diabetes'


Giving young children vitamin D supplements may reduce their risk of
developing type 1 diabetes later in life, research suggests.


Check with your doctor before doing it though.
Debbie