Abstract
ObjectiveTo compare exclusive breastfeeding (BF) and BF initiation among 185 women with Type 1 and 212 women with Type 2 pregestational diabetes who intended exclusive or partial BF and delivered at ≥34 weeks of gestation.MethodsRetrospective cohort study. At discharge, exclusive BF is direct BF or BF complemented with expressed breast milk. BF initiation is defined by exclusive or partial BF.ResultsType 1 and Type 2 groups were similar in prior BF experience (69 vs 67%) but were different in intention to BF exclusively (92 vs 78%) and partially (8 vs 22%). Women in the Type 1 group were younger (median age 30 vs 33y), likely to be primiparous (47 vs 25%), have a lower median BMI (32 vs 36 kg/m2) and deliver by primary cesarean (37 vs 26%). Infants born to Type 1 women were more likely to be admitted to the NICU (44 vs 18%) and to have hypoglycemia (59 vs 41%). At discharge, exclusive BF among Type 1 was higher (34 vs 23%), partial BF was similar (47 vs 46%) while FF (formula feeding) was lower (19 vs 31%) than in the Type 2 group. BF initiation occurred in 81% of Type 1 and 69% of Type 2 women.ConclusionIntention to BF exclusively was higher in Type 1 women compared to Type 2. At discharge, exclusive BF and BF initiation were lower and FF higher in the Type 2 group highlighting the need for different strategies if lactation in this special population is to be improved.
Highlights
Pregestational diabetes mellitus (Type 1 and Type 2) affects 1–1.5% of all pregnant women and may lead to adverse maternal and neonatal outcomes [1]
Other investigators noted an increase in pregestational diabetes as well as preeclampsia, chronic hypertension and obesity among women hospitalized for delivery in the US from 2005 through 2014 [2]
The study population consisted of 185 women with Type 1 and 212 women with Type 2 pregestational diabetes who intended to BF
Summary
Pregestational diabetes mellitus (Type 1 and Type 2) affects 1–1.5% of all pregnant women and may lead to adverse maternal and neonatal outcomes [1]. Other investigators noted an increase in pregestational diabetes as well as preeclampsia, chronic hypertension and obesity among women hospitalized for delivery in the US from 2005 through 2014 [2]. Investigators in California observed an alarming rise in the prevalence of Type 1 and Type 2 diabetes as well as racial/ethnic. A collaborative study confirmed that the duration of exclusive and overall BF was shorter in Type 1 than in non-diabetic women [6]. Herskin et al compared 105 Type 1 with 44 Type 2 dyads and reported different BF rates at hospital discharge (76 vs 45%) and at 4 months postpartum (49 vs 23%) [7].
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