Breastfeeding-an option to prevent adverse fetal programming?

Background: The prevalence of obesity during childhood and adolescence is significantly increased in children of mothers with gestational diabetes (GDM) and/or preconceptional obesity. Aim: We examined whether breastfeeding was associated with prevention of the risk of childhood obesity in offspring of mothers with gestational diabetes and/or obesity. Materials andmethods: A search of current literature on the topic was conducted. Results: In offspring of mothers with GDM, exclusive or any breastfeeding was associated with a lower risk of childhood overweight or obesity. However, the protective effect was attenuated in most studies after adjustment for maternal obesity. Possible mechanisms underlying a protective effect of breastfeeding include differences in energy or protein intake, deoxyribose nucleic acid (DNA) methylation, and/or gut microbiome between breastfed and nonbreastfed children. Women with GDM breastfeed less frequently and for shorter duration compared with women without diabetes. Some intervention studies to promote breastfeeding behavior in women with GDM and/ or obesity have been conducted and indicate that perinatal education/ support interventions for affected women may improve breastfeeding behavior. Conclusion: Mothers with GDM and/or obesity should be supported through perinatal education or counseling to breastfeed their infants according to World Health Organization (WHO) recommendations.