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Bedeutung des Stillens für diabetische Mütter und ihre Kinder

Importance of breastfeeding for diabetic mothers and their children

  • Leitthema
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Der Diabetologe Aims and scope

Zusammenfassung

Hintergrund

Ausschließliches Stillen bietet für Mutter und Kind unzählige kurz- und langfristige Vorteile. Dies scheint auch auf diabetische Mütter und deren Nachkommen zuzutreffen.

Auswirkungen des Stillens auf die Mutter

Diabetische Mütter, die stillen, weisen in den ersten 4 Monaten postpartal deutlich bessere metabolische Parameter, z. B. niedrige Blutlipidkonzentrationen, niedrigere Glukosewerte und eine höhere Insulinsensitivität, auf. In verschiedenen Studien wurde gezeigt, dass Frauen mit Gestationsdiabetes durch längeres Stillen ihr Langzeitrisiko für kardiometabolische Erkrankungen, insbesondere einen Diabetes mellitus Typ 2, reduzieren konnten.

Auswirkungen des Stillens auf das Kind

Auch die Nachkommen diabetischer Mütter scheinen vom Stillen zu profitieren. So entwickelten diese seltener eine postnatale Hypoglykämie und waren im späteren Leben weniger übergewichtig bzw. adipös. Letzteres scheint davon abhängig zu sein, dass über einen bestimmten Zeitraum weitergestillt wird, bis sich die Zusammensetzung der Muttermilch normalisiert hat.

Resümee

Aufgrund verschiedener Risikofaktoren und pathophysiologischer Mechanismen stillen diabetische Mütter insgesamt seltener und kürzer. Sie sollten deshalb rechtzeitig aufgeklärt und zu einem 4- bis 6-monatigen ausschließlichen Stillen ermuntert werden, um die mütterliche und kindliche Gesundheit kurz- und langfristig zu verbessern, präventiv auf die Entwicklung von kardiometabolischen Erkrankungen im späteren Leben einzuwirken und dadurch auch Gesundheitskosten zu sparen.

Abstract

Background

Exclusive breastfeeding provides optimal nutrition and health protection for mothers and their offspring.

Health benefits of breastfeeding for diabetic women

Diabetic mothers who breastfeed in the first 4 months postpartum have improved metabolic parameters, e.g., lower blood lipids, lower blood glucose, and greater insulin sensitivity. Studies have reported that longer duration of breastfeeding in women with a history of gestational diabetes may reduce long-term risks of cardiometabolic disease, including type 2 diabetes.

Health benefits of breastfeeding for children

Children of diabetic mothers may benefit from breastfeeding in that they have lower rates of hypoglycemia immediately after birth and lower rates of obesity in later life. It has been suggested that the latter benefits may only be observed if breastfeeding is continued beyond a certain period where breastmilk composition would have normalized over time.

Conclusion

Due to several risk factors and pathophysiological mechanisms, diabetic women are less likely and for a shorter duration to breastfeed. Therefore, diabetic women should be encouraged to breastfeed exclusively for at least 4–6 months to improve maternal and child morbidity, to prevent noncommunicable diseases in later life, and to decrease health care costs.

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Stupin, J.H. Bedeutung des Stillens für diabetische Mütter und ihre Kinder. Diabetologe 12, 13–21 (2016). https://doi.org/10.1007/s11428-015-0053-6

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