Research Shows Women With Diabetes Are 'Less Likely To Breastfeed'

Dr. Enrique Jacome

Breastfeeding is considered beneficial for both mother and baby. Breast milk is believed to give infants the nutrients they need, while breastfeeding has been associated with a lower risk of breast and ovarian cancers. But new research suggests that women diagnosed with diabetes before or during pregnancy are less likely to initiate or continue breastfeeding their newborns, compared with women without diabetes.

The research team, led by Dr. Reena Oza-Frank of the Center for Perinatal Research at Nationwide Children's Hospital in Columbus, OH, recently published their findings in the journalPublic Health Nutrition.

Past research has indicated that infants born to women withdiabetes during pregnancy, known as gestational diabetes, are more likely to develop hypoglycemia (low blood sugar) immediately after birth, as well as type 2 diabetes or obesity later in life. But Dr. Oza-Frank says breastfeeding can help reduce such risks.

The team set out to see whether pre-pregnancy diabetes or gestational diabetes influence breastfeeding initiation or the overall duration a mother breastfeeds.

Women with pre-pregnancy or gestational diabetes 'need additional support'

For their study, the researchers looked at data from the 2009-2011 Pregnancy Risk Assessment Monitoring Program (PRAMS) - a surveillance project of the Centers for Disease Control and Prevention (CDC).

Of almost 73,000 women, the researchers identified 8.8% who had gestational diabetes and 1.7% who had pre-pregnancy diabetes.

In order to ensure that any differences in breastfeeding initiation or continuation could be attributed solely to diabetes, the team accounted for 16 influential factors, including age, income and ethnicity.

They found that women with gestational diabetes and those without diabetes were equally as likely to start breastfeeding. However, women with gestational diabetes were more likely to breastfeed for at least 2 months less than healthy women.

Women with pre-pregnancy diabetes were less likely to start breastfeeding than those with gestational diabetes or without diabetes, but those who did breastfeed continued to do so for approximately the same duration as women with gestational diabetes.

Commenting on the team's findings, Dr. Oza-Frank says:

"We found that women with pre-pregnancy diabetes had the lowest breastfeeding initiation and continuation rates. However, women with gestational diabetes also had low continuation rates.

This study indicates that women with pre-pregnancy diabetes need additional support both initiating and continuing breastfeeding, and women with gestational diabetes need additional support continuing breastfeeding."

Prenatal education for diabetic women could ease breastfeeding concerns

The researchers also found that 30% of women with pre-pregnancy diabetes said their illness and medication use deterred them from breastfeeding, indicating that diabetes and its treatment has a direct influence on women's breastfeeding decisions.

Many of the women with diabetes said they simply did not want to breastfeed or felt that they could not supply enough milk for their infants - reasons that were also cited among women without diabetes.

Dr. Oza-Frank says that women with pre-pregnancy or gestational diabetes could have their breastfeeding concerns put to rest by having prenatal education about how their illness may influence their infant's health and how breastfeeding may help reduce these risks.

"Breastfeeding intention is often the strongest predictor of breastfeeding initiation, and by establishing intent early in pregnancy, successful initiation is more likely," she adds. "Lactation consultants are an excellent resource and support for breastfeeding moms both immediately after delivery and beyond."

The researchers plan to further their research in this field by assessing exclusive breastfeeding rates for up to 6 months among women with pre-pregnancy and gestational diabetes. They also plan to look at the women's breastfeeding patterns in the first year of their infant's life, as well as the introduction of bottle-feeding and solid foods.

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