Catherine Buck, M.D. – 2026

One in five pregnancies are affected by high blood sugar (type 1, type 2, or gestational diabetes), a diagnosis which increases a child’s risk of developing obesity and metabolic conditions. How a baby grows after birth may change that risk: gaining weight too quickly may increase risk, while a small, “slow-down” may be protective. This group also has differences in nutrition including less breastfeeding. Up to half need care in the neonatal intensive care unit because they cannot take enough milk by mouth.

Because research is limited, feeding recommendations are extrapolated from studies of premature infants, even though most of these babies are more mature. Our early findings suggest that the feeding amounts clinicians prescribe for some infants born to women with high blood sugar may not match what babies otherwise naturally take in, raising concern that pushing higher volumes could go against the child’s own signals and lead to excess early growth. Our hypothesis is that feeding difficulties in babies born to women with high blood sugar may be the child’s natural way of protecting itself by slowing early growth, and that changing early feeding goals in this group may ultimately reduce later health risks.

We will conduct a randomized study of 30 babies born after 34 weeks of pregnancy to mothers with high blood sugar. Babies will be assigned to either lower, biology-based or the higher, usual-care starting feeding volumes. We will measure whether the lower approach is feasible and safe. In these infants, we will also study markers of feeding ability beyond the ability to take a specific amount of feeding by mouth, including expression of genes in saliva that relate to appetite and detailed assessments of how a baby feeds. This work is directly relevant to child health because it targets the early-life roots of obesity, which affects more than 20% of U.S. children.