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December 11, 1996

Association of Exposure to Cow's Milk Protein and β-Cell Autoimmunity-Reply

Author Affiliations

University of Colorado Health Science Center Denver

JAMA. 1996;276(22):1800. doi:10.1001/jama.1996.03540220024015

In Reply.  —We concur with Drs Holmes and Johnston and Ms Spear that breast-feeding should be encouraged for almost all mothers. Currently, there is no evidence that breast-feeding increases IDDM risk, although it has been shown to have numerous advantages over formula feeding.We are aware of only 6 independent case-control studies examining exposure to cow's milk formula and diabetes,1-3 and 2 of these studies found no association. Moreover, all of these studies were subject to both selection bias and recall bias.1 The unique design of our study eliminated recall bias by collecting exposure data before disease status was known and selection bias by drawing both our cases and controls from the same cohort. These are methodological strengths that should not be ignored when comparisons are made with previous research.Follow-up data on our patients with BCA were not available when the article was written, but we now have data