Pregnant women diagnosed with gestational diabetes may produce breast milk with unique properties that could positively influence infant growth and development, according to a new study.
The research, published in JAMA Network Open on Thursday, suggests that breast milk from mothers with gestational diabetes contains distinct metabolites found in higher concentrations that correlate with infant growth patterns, including potential effects on body composition and length.
Gestational diabetes (GD), a condition characterized by high blood sugar levels during pregnancy, affects more than 8 percent of expectant mothers in the United States and has been linked to various health risks for both mother and baby.
Dr. Kecia Gaither, a double board-certified physician in OB-GYN and maternal–fetal medicine and director of perinatal services for NYC Health + Hospitals/Lincoln, told The Epoch Times that rates of the condition have been rising globally for several reasons.
These include higher rates of obesity, sedentary lifestyles, and women choosing to have children at older ages, often prioritizing other life choices, such as establishing their careers. She explained that advanced maternal age (over 35 years) is associated with a higher risk of both gestational and pre-gestational diabetes.
Gaither also noted demographic changes in the U.S. population as a contributing factor. “Certain ethnic groups, such as Latinx, Indigenous people, and African Americans, are at a higher risk of developing both types of diabetes,” she said.
Effects of GD on Breast Milk
For this study, researchers investigated how GD influences the composition of human milk and its potential effects on infant growth.
Researchers analyzed data collected from 348 mother–infant pairs enrolled in the ongoing Mothers and Infants LinKed (MILK) for Healthy Growth Study and the Maternal Milk, Metabolism, and Microbiome Study between October 2014 and August 2019. The study participation sites were in Minnesota and Oklahoma.
The mothers, aged between 21 and 45 years at the time of delivery, had a pre-pregnancy body mass index (BMI) ranging from 18.5 to 45. All participants had healthy pregnancies, delivered full-term infants, intended to breastfeed for three or more months, and had adequate social support.
Among the participants, 53 mothers with an average age of 34 years were diagnosed with GD, while the non-GD group averaged 30.7 years.
Milk samples were collected from the mothers one month after giving birth, and researchers measured various infant growth metrics, including the baby’s weight relative to length and overall body composition.
The study found that mothers with GD experienced notable changes in nine out of 458 metabolites tested in their milk.
Specifically, three metabolites—2-hydroxybutyric acid, stearoylcarnitine, and phenylacetic acid—were linked to growth in babies.
2-Hydroxybutyric acid, which is significantly more prevalent in the breast milk of women with GD, was linked with no change in body fat in babies within the first three months. Stearoylcarnitine, which is reduced in the breast milk of mothers with GD, was linked to rapid weight gain in babies. Furthermore, phenylacetic acid, which was also reduced in the breast milk of mothers with GD, was linked to a child’s change in length as they age.
These findings suggest that human milk composition altered by GD could influence an infant’s growth patterns.
Health Risks of Gestational Diabetes
GD carries significant health risks for the baby, and “that’s why during pregnancy, we’re actually much more aggressive in treating the diabetes because it not only helps the mother but also helps the baby,” Dr. Adi Davidov, an assistant professor in obstetrics and gynecology and associate chair of the Department of Obstetrics and Gynecology at Staten Island University Hospital/Northwell Health in New York, told The Epoch Times.
“A baby can die in utero due to uncontrolled gestational diabetes,” Davidov noted. Another risk is that the baby can become very large, a condition called fetal macrosomia, potentially leading to birth injuries during delivery, he added.
Also, uncontrolled diabetes, especially earlier in pregnancy, can cause congenital anomalies, chiefly heart disease linked to heart defects, Davidov said.
Low blood sugar (hypoglycemia) is another risk to babies born to mothers with GD.
“There’s a lot of things that can go wrong with women that have gestational diabetes. And that’s why we take this disease so seriously,” Davidov said.
More Research Needed
Despite the findings, the study authors caution that previous research regarding the relationship between GD and breastfeeding’s effects on infant growth and health has yielded mixed results. Some studies suggest that infants breastfed by mothers with GD may develop insulin and weight issues later in life.
It is unknown how an infant’s body processes these metabolites and whether metabolite levels are causally linked to the observed patterns of growth and body composition, the researchers wrote.
They added that as this study only “identified candidate metabolites potentially involved in the relationship between GD and infant growth, further work is needed to better understand their role in infant health.”