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Hydrolyzed infant formula fails to protect against islet autoimmunity
Hydrolyzed cow’s milk-based infant formula did not reduce the risk for developing islet autoimmunity among infants at risk for developing type 1 diabetes, and may even increase the risk, according to findings published in Diabetes Care.
“Although the evidence for an association between early cow’s milk exposure or longer exclusive breast-feeding duration and type 1 diabetes risk is limited, various infant feeding policies suggest a type 1 diabetes protective effect by delayed introduction of cow’s milk,” Sandra Hummel, PhD, of the institute of diabetes research at the Helmholtz Zentrum München, Munich, and colleagues wrote. “As a result, health care professionals and mothers are uncertain regarding the choice of infant formula if breast-feeding is not possible or additional milk feeding is needed. This is of particular interest to mothers with type 1 diabetes, who experience difficulties with exclusive breast-feeding and have to introduce infant formula in the early postpartum period.”
Researchers performed The Environmental Determinants of Diabetes in the Young (TEDDY), an international prospective cohort study, on 8,506 children at an increased genetic risk for type 1 diabetes between September 2004 and February 2010. Hummel and colleagues measured the infants’ islet antigen-2 (IA-2), autoantibodies to insulin and glutamic acid decarboxylase (GAD65) to determine the presence of islet autoimmunity. Median follow-up was 8 years.
The researchers did not find a significant association between islet autoimmunity and feeding with hydrolyzed formula compared with nonhydrolyzed formula after adjusting for family type 1 diabetes history, human leukocyte antigen (HLA) genotype, breast-feeding for at least 3 months, seasonality of birth, sex, country or delivery mode (adjusted HR = 1.38; 95% CI, 0.95-2.01). Hummel and colleagues noted, however, that there was a significantly increased risk for islet autoimmunity among infants who received extensively hydrolyzed formula in the first 7 days (adjusted HR = 1.57; 95% CI, 1.04-2.38).
Hummel and colleagues wrote that 80.5% of infants who received extensively hydrolyzed formula were from Finland, which had a greater incidence of type 1 diabetes than other countries in the study.
“Consistent with findings from the TRIGR trial, our results provide evidence that introducing an extensively hydrolyzed formula as the first infant formula does not protect children with an HLA-conferred increased risk for type 1 diabetes from the development of islet autoimmunity and, specifically, of [insulin] autoantibodies,” the researchers wrote. “Rather, our findings indicate that early weaning to an extensively hydrolyzed cow’s milk-based formula is associated with an increased risk for islet autoimmunity.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.