18 and 22 The divergence in the results of these studies may reflect the existence of biases and confounding factors. Therefore, a critical review of studies published on the subject was conducted in order to clarify the influence of breastfeeding on the risk of T1DM and T2DM development. This analysis also aimed to identify possible dietary strategies that can be implemented to prevent

disease onset. A literature review was performed after research in the following electronic databases: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences (LILACS), Medical Literature Analysis and Retrieval buy Navitoclax System Online (MEDLINE), SciVerse Scopus (Scopus), and the Virtual Health Library (VHL). The search prioritized studies published in the last ten years on the subject. However, studies considered important and used as reference in the most recent articles were searched for additional review material. The following key words and their corresponding Portuguese words were used in the search: breastfeeding (aleitamento materno), breast milk (leite do peito), lactating (lactação); early infant feeding (alimentação na infância); complementary feeding (alimentação complementar), diabetes mellitus (diabetes mellitus), type 1 diabetes (diabetes tipo 1), and type 2 diabetes (diabetes tipo 2). RGFP966 clinical trial Using the term “breast-feeding”,

29,069 published studies were identified. However, by including the terms “diabetes”, a total of 52 articles were retrieved. Megestrol Acetate Of these, 21 were analyzed (nine for T1DM and 12 for T2DM). The remaining articles were discarded, as they did not specifically address the issue.

Borch-Johnsen et al., in 1984, were the first to observe that breastfeeding appeared to have a protective effect against T1DM, preventing or delaying the onset of this disease. It is proposed that the presence of antimicrobials and anti-inflammatory agents, as well as substances that promote the maturation of the immune system in human milk exert a protective effect against T1DM.23 In animals prone to diabetes, offering prolonged and exclusive breastfeeding protected them against autoimmune diabetes, whereas intake of solid foods completely abolished this protective effect. It was found that breastfeeding is correlated with high levels of T-cells and low levels of inflammatory cytokines such as interferon-γ, interleukin-4, and interleukin-10.24 Epidemiological studies in humans also indicate the existence of a similar association.25, 26, 27 and 28 The results of these studies suggest that proper nutrition during the first months of life prevents the manifestation of the disease. However, these positive effects were not identified by some authors.13 and 29 It appears that early exposure to cow’s milk increases the chance of acquiring T1DM when compared to exclusive breastfeeding up to at least four months after birth.