Detailed data on lactation practices by gestational diabetes mellitus (GDM) history are lacking, precluding potential explanations and targets for interventions to improve lactation intensity and duration and, ultimately, long-term maternal and child health.
Objective:
This study aimed to examine breastfeeding practices through 12 months postpartum by GDM history.
Methods:
Women who delivered a singleton, liveborn infant at The Ohio State University Wexner Medical Center (Columbus, OH), in 2011 completed a postal questionnaire to assess lactation and infant feeding practices and difficulties. Bivariate and multivariate associations between GDM history and lactation and infant feeding practices were examined.
Results:
The sample included 432 women (62% response rate), including 7.9% who had GDM during the index pregnancy. Women with GDM initiated breastfeeding (at-the-breast or pumping) as often as women without any diabetes but were more likely to report introduction of formula within the first 2 days of life (79.4% vs 53.8%, P < .01; adjusted odds ratio: 3.48; 95% confidence interval, 1.47-8.26). Women with GDM initiated pumping 4 days earlier than women without diabetes (P < .05), which was confirmed in adjusted analyses. There was no difference in the proportion of women reporting breastfeeding difficulty (odds ratio: 2.08; 95% confidence interval, 0.78-5.52). However, there was a trend toward women with GDM reporting more formula feeding and less at-the-breast feeding as strategies to address difficulty compared with women without diabetes.
Conclusion:
Additional research is needed to understand why women with GDM engage in different early lactation and infant feeding practices, and how best to promote and sustain breastfeeding among these women.
American Diabetes Association. Standards of medical care in diabetes—2015. Diabetes Care. 2015;38(suppl 1):S1-S93.
2.
BellamyLCasasJPHingoraniADWilliamsD. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773-1779.
3.
Chouinard-CastonguaySWeisnagelSJTchernofARobitailleJ. Relationship between lactation duration and insulin and glucose response among women with prior gestational diabetes. Eur J Endocrinol. 2013;168(4):515-523.
4.
TroutKKAverbuchTBarowskiM. Promoting breastfeeding among obese women and women with gestational diabetes mellitus. Curr Diab Rep. 2011;11(1):7-12.
5.
BorgonoCARetnakaranR. Higher breastfeeding intensity associated with improved postpartum glucose metabolism in women with recent gestational diabetes. Evid Based Med. 2012;17(6):e7.
6.
GundersonEPJacobsDRJrChiangV. Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: a 20-year prospective study in CARDIA (Coronary Artery Risk Development in Young Adults). Diabetes. 2010;59(2):495-504.
7.
GundersonEPHurstonSRNingX. Lactation and progression to type 2 diabetes mellitus after gestational diabetes mellitus: a prospective cohort study. Ann Intern Med. 2015;163(12):889-898.
8.
ChertokIRRazIShohamIHaddadHWiznitzerA. Effects of early breastfeeding on neonatal glucose levels of term infants born to women with gestational diabetes. J Hum Nutr Diet. 2009;22(2):166-169.
9.
Mayer-DavisEJRifas-ShimanSLZhouLHuFBColditzGAGillmanMW. Breast-feeding and risk for childhood obesity: does maternal diabetes or obesity status matter?Diabetes Care. 2006;29(10):2231-2237.
10.
CrumeTLOgdenLGMayer-DavisEJ. The impact of neonatal breast-feeding on growth trajectories of youth exposed and unexposed to diabetes in utero: the EPOCH Study. Int J Obes. 2012;36(4):529-534.
11.
Oza-FrankRChertokIBartleyA. Differences in breast-feeding initiation and continuation by maternal diabetes status. Public Health Nutr. 2015;18(4):727-735.
12.
KachoriaROza-FrankR. Differences in breastfeeding initiation by maternal diabetes status and race, Ohio 2006-2011. Matern Child Health J. 2014;18(9):2226-2235.
13.
HaileZTOza-FrankRAzulay ChertokIRPassenN. Association between history of gestational diabetes and exclusive breastfeeding at hospital discharge. J Hum Lact. 2016;32(3):NP36-NP43.
14.
HornellAHofvanderYKylbergE. Solids and formula: association with pattern and duration of breastfeeding. Pediatrics. 2001;107(3):E38.
15.
FlahermanVJAbyJBurgosAELeeKACabanaMDNewmanTB. Effect of early limited formula on duration and exclusivity of breastfeeding in at-risk infants: an RCT. Pediatrics. 2013;131(6):1059-1065.
16.
MortonJHallJYWongRJThairuLBenitzWERhineWD. Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. J Perinatol. 2009;29(11):757-764.
17.
KentJCPrimeDKGarbinCP. Principles for maintaining or increasing breast milk production. J Obstet Gynecol Neonatal Nurs. 2012;41(1):114-121.
18.
KeimSAMcNamaraKADillonCE. Breastmilk sharing: awareness and participation among women in the Moms2Moms Study. Breastfeed Med. 2014;9(8):398-406.
19.
BrysonCLIoannouGNRulyakSJCritchlowC. Association between gestational diabetes and pregnancy-induced hypertension. Am J Epidemiol. 2003;158(12):1148-1153.
20.
KachoriaROza-FrankR. Factors associated with breastfeeding at discharge differ by maternal diabetes type. Diabet Med. 2014;31(10):1222-1229.
21.
CallenJPinelliJ. A review of the literature examining the benefits and challenges, incidence and duration, and barriers to breastfeeding in preterm infants. Adv Neonatal Care. 2005;5(2):72-88.
22.
BerkowitzGSRomanSHLapinskiRHAlvarezM. Maternal characteristics, neonatal outcome, and the time of diagnosis of gestational diabetes. Am J Obstet Gynecol. 1992;167(4, pt 1):976-982.
23.
BerkowitzGSLapinskiRHWeinRLeeD. Race/ethnicity and other risk factors for gestational diabetes. Am J Epidemiol. 1992;135(9):965-973.
24.
HeckKEBravemanPCubbinCChavezGFKielyJL. Socioeconomic status and breastfeeding initiation among California mothers. Public Health Rep. 2006;121(1):51-59.
25.
KitsantasPGaffneyKFKornidesML. Prepregnancy body mass index, socioeconomic status, race/ethnicity and breastfeeding practices. J Perinat Med. 2012;40(1):77-83.
26.
Oza-FrankRBartleyA. Exclusive breastfeeding rates lowest among women with gestational diabetes. In: American Diabetes Association 74th Scientific Sessions. Vol 63. San Francisco, CA; 2014.
EidelmanAISchanlerRJJohnstonM. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):E827-E841.
29.
FarrarDDuleyLLawlorDA. Different strategies for diagnosing gestational diabetes to improve maternal and infant health. Cochrane Database Syst Rev. 2011;(10):CD007122.
30.
KimC. Gestational diabetes: risks, management, and treatment options. Int J Womens Health. 2010;2:339-351.
31.
MatiasSLDeweyKGQuesenberryCPJrGundersonEP. Maternal prepregnancy obesity and insulin treatment during pregnancy are independently associated with delayed lactogenesis in women with recent gestational diabetes mellitus. Am J Clin Nutr. 2014;99(1):115-121.
32.
RiddleSWNommsen-RiversLA. A case control study of diabetes during pregnancy and low milk supply. Breastfeed Med. 2016;11(2):80-85.
33.
ChantryCJDeweyKGPeersonJMWagnerEANommsen-RiversLA. In-hospital formula use increases early breastfeeding cessation among first-time mothers intending to exclusively breastfeed. J Pediatr. 2014;164(6):1339-1345.
34.
BassJL. In-hospital formula use and early breastfeeding cessation: association not causation. J Pediatr. 2015;166(1):209.
35.
KorhonenKLehtonenL. Unnecessary and necessary in-hospital formula supplementation. J Pediatr. 2014;165(4):877.
36.
WinNNBinnsCWZhaoYScottJAOddyWH. Breastfeeding duration in mothers who express breast milk: a cohort study. Int Breastfeed J. 2006;1:28.
37.
FeliceJPCassanoPARasmussenKM. Pumping human milk in the early postpartum period: its impact on long-term practices for feeding at the breast and exclusively feeding human milk in a longitudinal survey cohort. Am J Clin Nutr. 2016;103(5):1267-1277.
38.
TeamVRyanK. Expressed breast milk as commodity: disembodied motherhood and involved fatherhood. 2014:221-235.
39.
ChapmanDJ. New insights into the risk of feeding infants by bottle. J Hum Lact. 2012;28(4):455-456.
40.
JansenJde WeerthCRiksen-WalravenM. Breastfeeding and the mother–infant relationship—a review. Dev Rev. 2008;28(4):503-521.
41.
TorloniMRBetranAPHortaBL. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev. 2009;10(2):194-203.
42.
BrownellEHowardCRLawrenceRADozierAM. Delayed onset lactogenesis II predicts the cessation of any or exclusive breastfeeding. J Pediatr. 2012;161(4):608-614.
43.
RasmussenKMHilsonJAKjolhedeCL. Obesity may impair lactogenesis II. J Nutr. 2001;131(11):3009s-3011s.
44.
LiRFeinSBGrummer-StrawnLM. Do infants fed from bottles lack self-regulation of milk intake compared with directly breastfed infants?Pediatrics. 2010;125(6):e1386-e1393.
45.
NilssonCCarlssonALandin-OlssonM. Increased risk for overweight among Swedish children born to mothers with gestational diabetes mellitus. Pediatr Diabetes. 2014;15(1):57-66.
46.
DeSistoCLKimSYSharmaAJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007-2010. Prev Chronic Dis. 2014;11.
47.
TaylorJSKacmarJENothnagleMLawrenceRA. A systematic review of the literature associating breastfeeding with type 2 diabetes and gestational diabetes. J Am Coll Nutr. 2005;24(5):320-326.
