Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2023; 14(5): 617-631
Published online May 15, 2023. doi: 10.4239/wjd.v14.i5.617
Cardiometabolic effects of breastfeeding on infants of diabetic mothers
Reem Elbeltagi, Mohammed Al-Beltagi, Nermin Kamal Saeed, Adel Salah Bediwy
Reem Elbeltagi, Department of Medicine, Irish Royal College of Surgeon, Busaiteen 15503, Bahrain
Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Egypt
Mohammed Al-Beltagi, Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 12, Bahrain
Nermin Kamal Saeed, Department of Microbiology, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Bahrain
Adel Salah Bediwy, Department of Chest Diseases, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
Adel Salah Bediwy, Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
Author contributions: Elbeltagi R, Al-Biltagi M, Saeed NK, and Bediwy AS collected the data, wrote and revised the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
PRISMA 2009 Checklist statement: The manuscript was prepared and revised according to the PRISMA 2009 Checklist statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MBChB, MD, MSc, PhD, Academic Editor, Chairman, Consultant Physician-Scientist, Professor, Researcher, Department of Pediatrics, Faculty of Medicine, Tanta University, Al Bahr Street, Tanta 31511, Egypt. mbelrem@hotmail.com
Received: December 19, 2022
Peer-review started: December 19, 2022
First decision: February 28, 2023
Revised: March 1, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: May 15, 2023
Processing time: 146 Days and 17 Hours
Abstract
BACKGROUND

Breast milk is the best and principal nutritional source for neonates and infants. It may protect infants against many metabolic diseases, predominantly obesity and type 2 diabetes. Diabetes mellitus (DM) is a chronic metabolic and microvascular disease that affects all the body systems and all ages from intrauterine life to late adulthood. Breastfeeding protects against infant mortality and diseases, such as necrotizing enterocolitis, diarrhoea, respiratory infections, viral and bacterial infection, eczema, allergic rhinitis, asthma, food allergies, malocclusion, dental caries, Crohn's disease, and ulcerative colitis. It also protects against obesity and insulin resistance and increases intelligence and mental development. Gestational diabetes has short and long-term impacts on infants of diabetic mothers (IDM). Breast milk composition changes in mothers with gestational diabetes.

AIM

To investigate the beneficial or detrimental effects of breastfeeding on the cardiometabolic health of IDM and their mothers.

METHODS

We performed a database search on different engines and a thorough literature review and included 121 research published in English between January 2000 and December 15, 2022, in this review.

RESULTS

Most of the literature agreed on the beneficial effects of breast milk for both the mother and the infant in the short and long terms. Breastfeeding protects mothers with gestational diabetes against obesity and type 2 DM. Despite some evidence of the protective effects of breastfeeding on IDM in the short and long term, the evidence is not strong enough due to the presence of many confounding factors and a lack of sufficient studies.

CONCLUSION

We need more comprehensive research to prove these effects. Despite many obstacles that may enface mothers with gestational diabetes to start and maintain breastfeeding, every effort should be made to encourage them to breastfeed.

Keywords: Breast milk; Breastfeeding; Gestational diabetes mellitus; Cardiometabolic effects; Infants of diabetic mothers; Obesity

Core Tip: Breast milk is the ideal nutritional source for all neonates. It protects against many cardiometabolic disorders for babies and their mothers in the presence or absence of gestational diabetes. It protects against overweight, obesity, insulin resistance, prediabetes, diabetes, and metabolic syndrome in offspring regardless of gestational diabetes status. Therefore, it prevents significant risk factors predisposing to cardiovascular diseases during childhood and adulthood. Every effort should be made to encourage breastfeeding.