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From Marylhurst, Oregon, USA:

My husband has had Type I since age 7 and we have a son who is now 5. In 1992 we learned of a 10-year research project which is exploring a possible link between early introduction to dairy products and Type 1 diabetes. We have now been dairy-free for 5 years, but are finding it hard to wait for the results of this study, however, we are afraid to introduce dairy just in case it proves valid.


It's your decision. Even if milk products do turn out to be a trigger, there are lots of others and it will be impossible to shield this child from them all, short of putting him in a plastic bubble.

I would be sure to see a dietitian if you're going to keep your son dairy-free. There are a number of nutrients in dairy products which are essential for a child's proper growth and development.


Additional Comment by Dr. Stuart Brink

We do not know the answer to the "research question about avoiding cow milk products in the first year of life" is a complicated one. Studies in Toronto and Helsinki among other sites have linked breast mild feeding to some protection against developing IDDM especially those of Hans Michael Dosch and colleagues in Toronto and Hans Akerblom in Helsinki. We have heard a great deal from both groups at recent ISPAD meetings with an intervention trial already underway in all of Finland to test the theory. There is also some experimental information about gut immune responsively that suggests the first year of life is the most important. However, there are also conflicting reports that refute these studies despite some interesting comparisons between bovine serum albumin, Coxsackie viral particles and beta cell protein components. At present, we do not know the answer and it would be extremely premature, in my own opinion, to advise anyone to actually totally avoid all cow milk proteins. Not only is this extremely difficult to do but also to sustain. Soy proteins have similar protein components so they do not provide an adequate source of nourishment for infants. Better to advise and encourage breast milk feeding for as long as possible since this poses may theoretical advantages not only to avoiding IDDM.

There is an excellent discussion of this aspect in the latest Annals of Medicine published (not the Annals of Internal Medicine) with Hans Akerblom and Mikael Knip as authors in a symposium that took place in Helsinki in January 1998. Unfortunately for the person requesting the information, they have probably already obtained any theoretical benefit and there is not much that can be done practically to prevent diabetes from developing in their child without immune intervention. Their pediatricians might be interested in sending serum for the Diabetes Prevention Trial to see if the youngster is islet cell antibody positive and then might be a candidate for the oral or injectable insulin prevention studies ongoing in the US - if they want to try something experimental.


Original posting 13 Jan 98
Additional comment added 7 Mar 1998


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