The association of early life infant feeding with obesity prevalence and metabolic changes among offspring of mothers with gestational diabetes mellitus

Childhood obesity has become a serious health concern in the U.S., especially among Hispanic children. Offspring born to mothers with gestational diabetes (GDM) are more likely to develop obesity, type 1 diabetes (T1D), type 2 diabetes (T2D), and other metabolic diseases later in life. Many studies have shown that increased breastfeeding (BF) duration is linked to a lower prevalence of childhood overweight and obesity, diabetes, and the Metabolic Syndrome (MetS). In addition, early exposure to sugar sweetened beverages (SSBs) is linked to increased obesity in youth. However, few studies have examined how infant feeding impacts growth and obesity prevalence in offspring of mothers with GDM. Preliminary findings from the SWIFT cohort by Gunderson et al. showed that greater BF intensity and duration throughout the first 12 months of life was protective against ponderal growth and weight gain among children of mothers with GDM. To date, no study has examined how early life feeding in an exclusive GDM population impacts overweight and obesity, prediabetes, and MetS prevalence in children 1 to 19 years of age. Therefore, the overall goal of this analyses was to examine how early life feeding (i.e., BF duration and introduction to SSBs) impacts obesity, prediabetes, and MetS prevalence in offspring (1-19 years of age) of mothers with GDM. The current research aims were from three different datasets all conducted in California: 1) Using a longitudinal study with over 300 Hispanic children (8-19 y) with overweight or obesity, where early life feeding was collected retrospectively, the effects of BF duration on MetS and prediabetes in offspring from mothers with and without GDM was assessed. 2) Using the LAC WIC 2014 survey with over 4,000 mothers with children (1-5 y), where early life infant feeding was collected retrospectively, the effects of exclusive BF and early introduction to SSBs on obesity prevalence in children born to mothers with and without GDM was assessed. 3) Using an ongoing prospective cohort of 1,035 postpartum women diagnosed with GDM during pregnancy, where the association of BF duration and intensity and early introduction to SSBs and fruit juice during the first year of life with subsequent overweight and obesity in children (2-5 y) was assessed.