Women who breastfed for six months or more across all births had a 47 per cent reduction in their risk of developing type 2 diabetes compared to those who did not breastfeed at all.
Women who breastfed for six months or less had a 25 per cent reduction in diabetes risk, according to the study published in the journal JAMA Internal Medicine.
"We found a very strong association between breastfeeding duration and lower risk of developing diabetes, even after accounting for all possible confounding risk factors," said Erica P Gunderson, senior research scientist with the Kaiser Permanente, a health care company in the US.
The findings add to a growing body of evidence that breastfeeding has protective effects for both mothers and their offspring, including lowering a mother's risk of breast and ovarian cancer.
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The long-term benefits of breastfeeding on lower diabetes risk were similar for black women and white women, and women with and without gestational diabetes.
"The incidence of diabetes decreased in a graded manner as breastfeeding duration increased, regardless of race, gestational diabetes, lifestyle behaviours, body size, and other metabolic risk factors measured before pregnancy, implying the possibility that the underlying mechanism may be biological," Gunderson said.
Several plausible biological mechanisms are possible for the protective effects of breastfeeding, including the influence of lactation-associated hormones on the pancreatic cells that control blood insulin levels and thereby impact blood sugar.
Over the next 30 years, each woman had at least one live birth and was routinely screened for diabetes under the CARDIA protocol, which included diagnostic screening criteria for diabetes.
Participants also reported lifestyle behaviours (such as diet and physical activity) and the total amount of time they breastfed their children.
"We were able to follow women specifically during the childbearing period and screen them regularly for diabetes before and after pregnancies," Gunderson said.
Researchers were also able to account for pre-pregnancy metabolic risk, including obesity and fasting glucose and insulin, lifestyle behaviours, family history of diabetes, and perinatal outcomes.