To the Editor.
—Recent discussions about the possible association between early infant diets and IDDM, including the Editorial by Drs Schatz and Maclaren,1 have focused on the possible role of cow's milk. The possibility that the protective nature of breast-feeding may be the explanation for reported differences in incidence of diabetes between breast-fed infants and those artificially fed has received little attention. Although Norris et al2 did not find such an association among children who have a familial risk of diabetes, this does not exclude a small protective effect of breast-feeding in the population of children without familial risk. As the authors acknowledge, it is likely that several factors play a role in the etiology of IDDM.One plausible explanation for the reported protection against IDDM is that breast-feeding has been found to protect infants from infection with enteroviruses such as coxsackievirus B.3 This protection results from direct neutralization of
Holmes W. Association of Exposure to Cow's Milk Protein and β-Cell Autoimmunity. JAMA. 1996;276(22):1800. doi:10.1001/jama.1996.03540220024014