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Breastfeeding and Diabetes Mellitus/Thyroid Disease

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In spite of the increasing importance on breast feeding, the breast feeding rates are lower in nursing mother with chronic disease such as obesity, diabetes, and thyroid disease. It has been suggested that early exposure to cow’s milk proteins may be induced diabetes in humans with genetic susceptibility. The children of women with diabetes in pregnancy are at particularly high risk of developing obesity and diabetes in the future. Numerous researches showed that breastfeeding has a protective effect against obesity, type 1 and type 2 diabetes. Hyper/hypothyroidism should be carefully treated to prevent adverse effects on the mother, fetus and neonate during pregnancy and lactation. Prophylthiouracil is only recommended as the drug of choice in hyperthyroidism during the first trimester of pregnancy, but it should be changed to methimazole (MMI) thereafter because of its serious hepatotoxicity. Also MMI is the first drug of choice in either mother or child during lactation. The dose of thyroid hormone for treatment of maternal hypothyroidism transfer to breast milk is too small to influence on thyroid hormone levels in neonates. Appropriate education and counseling about health benefits of breastfeeding should be available to patients with diabetes and thyroid disease.

Abstract

In spite of the increasing importance on breast feeding, the breast feeding rates are lower in nursing mother with chronic disease such as obesity, diabetes, and thyroid disease. It has been suggested that early exposure to cow’s milk proteins may be induced diabetes in humans with genetic susceptibility. The children of women with diabetes in pregnancy are at particularly high risk of developing obesity and diabetes in the future. Numerous researches showed that breastfeeding has a protective effect against obesity, type 1 and type 2 diabetes. Hyper/hypothyroidism should be carefully treated to prevent adverse effects on the mother, fetus and neonate during pregnancy and lactation. Prophylthiouracil is only recommended as the drug of choice in hyperthyroidism during the first trimester of pregnancy, but it should be changed to methimazole (MMI) thereafter because of its serious hepatotoxicity. Also MMI is the first drug of choice in either mother or child during lactation. The dose of thyroid hormone for treatment of maternal hypothyroidism transfer to breast milk is too small to influence on thyroid hormone levels in neonates. Appropriate education and counseling about health benefits of breastfeeding should be available to patients with diabetes and thyroid disease.

참고문헌 (56)

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