Early Lactation and Infant Feeding Practices Differ by Maternal Gestational Diabetes History. (November 2016)

• Record Type: Journal Article
• Authors: Oza-Frank, Reena; Moreland, Jennifer J.; McNamara, Kelly; Geraghty, Sheela R.; Keim, Sarah A.
• Is Part Of: Journal of human lactation. Volume 32:Number 4(2016:Nov.)
• Page Start: 658
• Page End: 665
• Publication Date: 2016-11
• Subjects: breastfeeding -- breastfeeding and diabetes -- diabetes -- infant and child nutrition -- infant feeding -- infant feeding behavior; Breastfeeding -- Periodicals; Lactation -- Periodicals; 612.664
• DOI: 10.1177/0890334416663196
• Languages: English
• ISSNs: 0890-3344

Abstract

Background: 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.