Abstract
Breastfeeding rates remain extremely low in Greece and women with gestational diabetes mellitus and hypothyroidism may experience additional difficulties. The aim of the study was to investigate the effect of a structured individualized lactation educational intervention by a midwife on increasing breastfeeding rates in women with endocrine disorders and low-risk women compared to women receiving standard care, 24 months after delivery. Two-hundred women made up the study population. Half of them were experiencing endocrine pregnancy disorders and 100 women constituted the low-risk pregnancy standard care control group. Women who were breastfeeding exclusively were significantly higher in the midwifery intervention group with endocrine disorders, namely breastfeeding continued at four months (breastfeeding: 20% vs. 12%, exclusive breastfeeding: 50% vs. 26%, p = 0.0228), and at six months after childbirth (breastfeeding: 54% vs. 28%, exclusive breastfeeding: 32% vs. 12%, p = 0.0011), compared to the standard care control group with endocrine disorder. The low-risk midwifery intervention group breastfed at four months (22% vs. 14%, p = 0.0428) and at six months (52% vs. 26%, p = 0.0018) at higher rates compared to the standard care control group. In addition, exclusive breastfeeding was significantly higher in the low-risk midwifery intervention group at four months (46% vs. 20%, p = 0.0102) and six months (38% vs. 4%, p < 0.0001) compared to the standard care control group. This study was the first attempt of a structured midwifery breastfeeding education in Greece and its major contribution reflects a significant positive impact on breastfeeding rates in terms of duration and exclusivity in women with gestational endocrine disorders as well as in low-risk women, and could possibly be applied and instituted in everyday clinical practice to increase the low breastfeeding rates in Greece.
Highlights
The aim of the study was to examine the effect of a personalized prenatal and postnatal structured midwifery intervention programme on increasing breastfeeding rates and exclusive breastfeeding, especially in women with endocrine pregnancy disorders and low-risk pregnancies compared to women who received standard hospital care and no structured midwife intervention up to two years after childbirth
gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and appears to be a temporary condition that occurs in pregnancy, carrying long-term risk of type 2 diabetes development [52]
The results of that effort showed that individualized structured prenatal and postnatal breastfeeding education by a specialty midwife might lead to increased improved rates of duration of any type of breastfeeding and exclusive breastfeeding in women with gestational endocrine disorders and in low-risk
Summary
Introduction published maps and institutional affilLicensee MDPI, Basel, Switzerland.Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).It is well established that breastfeeding has benefits for infants, children, mothers, and public health [1,2,3]. Breastfeeding increases protection against childhood infections, decreases the likelihood for development of type II diabetes mellitus in children and adolescents/young women, as well as reduces the incidence risk of metabolic diseases in children, while exclusive breastfeeding may additionally even reduce the potential risk for future childhood obesity [1,4,5,6,7,8,9].Int. J. Environ. Res. Public Health 2021, 18, 11359. https://doi.org/10.3390/ijerph182111359 https://www.mdpi.com/journal/ijerph
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