Karachi: Pakistan may be heading towards a new phase of its diabetes crisis, with experts warning that early life feeding practices, particularly the growing reliance on formula milk, are contributing to the emergence of type 2 diabetes among adolescents.
Pediatricians and child specialists say they are increasingly encountering teenagers with type 2 diabetes, a condition historically seen in adults, raising concerns about a dangerous shift in the country’s disease profile. They link this trend primarily to the lack of breastfeeding in infancy, which they describe as a critical but overlooked factor in long term metabolic health.
“We are now seeing adolescents and teenagers with type 2 diabetes in Pakistan, which is extremely unusual globally,” said Prof. Jamal Raza, Executive Director of the Sindh Institute of Child Health and Neonatology. “The absence of breastfeeding in early life is one of the most important contributors, as it increases the risk of obesity and diabetes later in life.”
Pakistan already has around 35 million adults living with diabetes, one of the highest burdens in the world. Health experts warn that if children begin developing the disease earlier, complications such as heart disease, kidney failure and stroke will also appear earlier, placing additional strain on families and the healthcare system.
Prof. Jamal Raza said children who are not breastfed face a 33 to 40 percent higher risk of developing type 2 diabetes later in life. Evidence from international research also supports this link, showing that individuals who were breastfed have significantly lower chances of developing diabetes compared to those who were not .
He explained that mother’s milk is biologically designed to meet an infant’s needs and helps regulate metabolism from the earliest stages of life. “It is a complete and protective diet that reduces the risk of obesity, which is a major driver of diabetes,” he said.
In contrast, formula feeding has been associated with faster weight gain and higher rates of childhood obesity. Experts say this early metabolic imbalance can set the stage for insulin resistance and diabetes during adolescence.
Children deprived of breastfeeding are also more vulnerable to infections, allergies and gastrointestinal illnesses, which further affect their overall health and development.
Prof. Raza stressed that infants should be exclusively breastfed for the first six months of life, without any additional food or water. He said this period is crucial for metabolic programming and long term disease prevention.
Global health expert Prof. Zulfiqar Bhutta has also highlighted that the need for formula milk is extremely limited, with only a small number of infants requiring it due to unavoidable medical or social circumstances. For the vast majority, breastfeeding remains the safest and most beneficial option.
Leading diabetologist Prof. Abdul Basit has previously warned that the roots of Pakistan’s diabetes epidemic are being laid early in life, with poor feeding practices contributing to a steady rise in cases.
Experts say the problem is being compounded by sedentary lifestyles, increasing screen time and widespread consumption of ultra processed foods among children, all of which accelerate weight gain and metabolic disorders.
They warn that unless breastfeeding is actively promoted and childhood lifestyles are improved, Pakistan could see a surge in early onset diabetes, turning a preventable risk into a long term public health burden.
“This is a preventable crisis,” Prof. Raza said. “If we protect breastfeeding, we can protect future generations from diabetes.”
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