Reduce Your Child’s Risk of Diabetes by Avoiding Cow Milk Formula

nomilkBovine Serum Albumin (BSA- cow milk protein) has been found to trigger diabetes in genetically vulnerable mice and thought to be a mechanism where our own immune systems attack our own islets of Langerhan cells in the pancreas, causing insulin dependent diabetes mellitus (IDDM).  Serum antibodies against BSA have been found to be elevated in children with IDDM.  The amino acid sequence of BSA is similar to that of human pancreatic B-cells, which could explain how antibodies made against cow milk protein (BSA) could attack one’s own pancreas and trigger diabetes. Studies show less diabetes by delaying cow milk protein introduction with greater risk if cow milk formula is introduced before 4 months age and even greater risk if introduced the first week of life. Exclusive breast feeding for the first 4 months is associated with significantly less diabetes.

Gut permeability to large molecules is greatest at birth, and decreases significantly each week of life, making it important to exclusively breast feed for 2-  months if at all possible, and the benefits continue for those who can breast feed for up to a year or longer. These studies make a case for doing everything possible to avoid formula in the early weeks of life when these non-human proteins, like BSA, can be absorbed and interact with the infant’s immune system setting them up for future risk of diabetes, other auto-immune disorders, and allergies. 

I know I am guilty as a physician for excessive worry about weight loss the first week of life, and jaundice (hyperbilirubenemia) which is aggravated by poor weight gain that first week of life. Hyperbilirubenemia (high bilirubin), if allowed to remain high for too long (a couple weeks or more), can result in permanent brain damage (kernicterus). Jaundice should not be ignored, however the quick response to supplement with formula may not be the best idea, if giving mom and baby another day or two would allow breast milk to come in adequately and enable that infant to avoid formula. 

One study showed that liquid formula did NOT trigger antibodies to BSA and thus did not cause diabetes.  It was thought that the heat treatment of the liquid formula likely destroyed the BSA.  This might suggest that if one must supplement with formula early on, use liquid formula. Initially I would also highly recommend using liquid formula that is in glass bottles rather than the plastic containers. 

Take Home message: Breast is best, and giving only breast milk for as long as you can but at least for the first 4 months, will greatly reduce your baby’s chance of getting insulin-dependent diabetes. Other studies have implicated BSA in other autoimmune processes like autoimmune thyroiditis, and we know that gut permeability issues are involved in celiac disease. Healthy patients without these disorders do not have antibodies against BSA. Nothing could be more important than maintaining your infants gut integrity, and nothing is better at doing that than exclusive breast feeding.  Probiotics are another important tool, especially for those who must use formula.


Increased levels of bovine serum albumin antibodies in patients with type 1 diabetes and celiac disease-related antibodies. Read the study here…

The predictive significance of autoantibodies in organ-specific autoimmune diseases. Read the study here…

Infant formula ingestion is associated with the development of diabetes in the BB/Wor rat. Read the study here…


Dr. Paul


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