Prior breastfeeding experience and infant feeding at discharge among women with pregestational diabetes mellitus

Cordero, L.*, Stenger, M.R., Blaney, S.D., Finneran, M.M., Nankervis, C.A. | JNPM 2020;

Abstract. 

OBJECTIVE: To compare multiparous women with pregestational diabetes mellitus (PGDM) with and without prior breastfeeding (BF) experience and to ascertain their infants’ feeding type during hospitalization and at discharge.

METHODS: A retrospective cohort study of 304 women with PGDM who delivered at ≥34 weeks gestational age (GA). Prior BF experience and infant feeding preference was declared prenatally. At discharge, BF was defined as exclusive or partial.

RESULTS: BF experience and no experience groups were similar in diabetes type 1 and 2, race and number of pregnancies. Women with no experience had more spontaneous abortions (35 vs 27%), fewer term deliveries (51 vs 61%) and living children (median 1 vs 2). In the current pregnancy, mode of delivery: vaginal (36 & 37%), cesarean (64 & 63%), birthweight (3592 & 3515 g), GA (38 & 37 w), NICU admission (14 & 11%) and hypoglycemia (44 & 43%) were similar. Women with experience intended to BF (79 vs 46%), their infants’ first feeding was BF (64 vs 36%) and had lactation consults (96 vs 63%) more often than those without experience. At discharge, women with BF experience were different in rate of exclusive BF (33 vs 11%), partial BF (48 vs 25%) and formula feeding (19 vs 64%).

CONCLUSION: Prior BF experience leads to better BF initiation rates while the absence of BF experience adds a risk for BF initiation failure. A detailed BF history could provide insight into obstacles that lead to unsuccessful BF experiences and may help define appropriate preventive or corrective strategies.

 

*Corresponding Author: 

Leandro Cordero, MD, Professor Emeritus, The Ohio State University Wexner Medical Center Department of Pediatrics, N118 Doan Hall, 410W. 10th Avenue, Columbus, Ohio 43210-1228. Tel.: +1 614.293.8660; Fax: +1 614.293.7676; E-mail: leandro.cordero@osumc.edu.