A Case‐Control Study of Diabetes during Pregnancy and Low Milk Supply

Abstract

Low milk supply is one of the most common reasons for stopping breastfeeding. Correlates of glucose intolerance are risk factors for delayed secretory activation, but it is not known if glucose intolerance is associated with persistent low milk supply. Our objective was to determine whether exposure to diabetes in pregnancy is greater among women with low milk supply as compared to women with latch problems in a Breastfeeding Medicine Clinic (BMC). We conducted a case‐control analysis of electronic medical records. We defined cases as low milk supply, but without latch or nipple problem; and controls as latch or nipple problem without low milk supply. We calculated odds of exposure to diabetes in cases versus controls in an unadjusted model and after adjusting for covariates (maternal and infant age, Cesarean delivery, preterm birth) and comorbidities (PCOS, hypothyroid or infertility). After excluding 74 with dual diagnoses, 14.9% of cases (26/175) versus 6.2% of controls (14/226) were exposed to diabetes (OR [95%CI], 2.6[1.3‐5.2]), a relation that remained robust after adjustment for covariates and comorbidities (AOR [95%CI], 2.4[1.2‐4.9]). Thus, women with low milk supply were significantly more likely to have been exposed to diabetes than those with latch or nipple problems. Identification of physiologic parameters that underlie the association between glucose intolerance and low milk supply is needed to enable more effective therapy options.