This systematic review was conducted as part of the U.S. Department of Agriculture and Department of Health and Human Services Pregnancy and Birth to 24 Months Project. The goal of this systematic review was to examine the following question: What is the relationship between feeding a lower versus higher intensity, proportion, or amount of human milk to mixed-fed infants and diabetes outcomes in offspring? This systematic review examines comparisons of mixed-fed infants fed different intensities, proportions, or amounts of human milk. was defined as feeding human milk and infant formula but not complementary foods or beverages such as cow’s milk. was defined as mother’s own milk provided at the breast (i.e., nursing) or expressed and fed fresh or after refrigeration or freezing. Donor milk (e.g., banked milk) was not examined in this review. was defined as commercially-prepared infant formula meeting FDA and/or Codex Alimentarius international food standards. was defined as foods and beverages other than human milk or infant formula provided to an infant or young child to provide nutrients and energy. This systematic review examines available evidence related to diabetes outcomes in offspring, including fasting glucose, HbA1C, glucose tolerance/insulin resistance, and the incidence and prevalence of prediabetes, type 1 diabetes, and type 2 diabetes.
There is insufficient evidence to determine whether or not there is a relationship between feeding a lower versus higher intensity, proportion, or amount of human milk to mixed-fed infants and diabetes outcomes in offspring. : Grade Not Assignable.
The systematic review was conducted by a team of staff from the Nutrition Evidence Systematic Review in collaboration with a Technical Expert Collaborative. A single literature search was conducted to identify literature for several related systematic reviews that examined infant milk-feeding practices and different outcomes. The search was conducted in CINAHL, Cochrane, Embase, and PubMed, and used a search date range of January 1980 to March 2016. A manual search was done to identify articles that may not have been included in the electronic databases searched. Articles were screened independently by 2 NESR analysts to determine which articles met predetermined criteria for inclusion. Data from the included article were extracted, risks of bias were assessed, and both were checked for accuracy. The body of evidence was qualitatively synthesized, a conclusion statement was developed, and the strength of the evidence (grade) was assessed using pre-established criteria including evaluation of the internal validity/risk of bias, adequacy, consistency, impact, and generalizability of available evidence.
This review includes 1 article, which was not enough evidence to draw any conclusions about the relationship between the intensity, proportion, or amount of human milk fed to infants who are fed both human milk and infant formula and diabetes outcomes in offspring.
