Lactation Consultation by an International Board Certified Lactation Consultant Improves Breastfeeding Rates for Mothers With Gestational Diabetes Mellitus

Abstract

Background

In patients with gestational diabetes, breastfeeding decreases the lifetime risk of Type 2 diabetes by half. Lactation consultation has been shown to increase breastfeeding rates in the general population but has not been assessed in a gestational diabetes population.

Research Aims

To determine if (1) a postpartum International Board Certified Lactation Consultant (IBCLC) consultation during delivery hospitalization improved inclusive (any) or exclusive breastfeeding rates at hospital discharge and 3 months postpartum in participants with GDM; and if (2) obstetrical providers’ acknowledgement of maternal feeding preference affected the rates of IBCLC consultation for patients.

Methods

This was a retrospective, comparative, secondary analysis of a prospective cohort (N = 517) study of women gestational diabetes. Participants who received a IBCLC consultation (n = 386; 74.5%) were compared to those who did not (n = 131; 25.5%). Baseline demographics, antepartum characteristics, neonatal information, mode of infant feeding at hospital discharge and 3 months postpartum, and IBCLC consultation during postpartum hospitalization were measured.

Results

After adjusting for baseline differences, participants who received an IBCLC consultation were more likely to report any breastfeeding at postpartum discharge (aOR 4.87; 95% CI [2.67, 8.86]) and at 3 months postpartum (aOR 5.39; 95% CI [2.61, 11.16]) compared to participants who did not. However, there was no difference in exclusive breastfeeding rates between those who did and did not receive IBCLC consultation.

Conclusion

Inpatient IBCLC consultation during the immediate postpartum period was associated with improved rates of any breastfeeding in participants with GDM.

Keywords

breastfeeding breastfeeding rates exclusive breastfeeding International Board Certified Lactation Consultant lactation lactation education postpartum care predominant breastfeeding

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References

American College of Obstetricians and Gynecologists . (2017). Committee opinion no 700: Methods for estimating the due date. Obstetrics & Gynecology, 129(5), e150–e154.doi:10.1097/AOG.0000000000002046

28426621

Bower

J. K.

Butler

B. N.

Bose-Brill

Kue

Wassel

C. L

. (2019). Racial/ethnic differences in diabetes screening and hyperglycemia among US women after gestational diabetes. Preventing Chronic Disease, 16, E145.doi:10.5888/pcd16.190144

31651379

Buchanan

T. A.

Xiang

A. H.

Kjos

S. L.

Trigo

Lee

W. P.

Peters

R. K

. (1999). Antepartum predictors of the development of type 2 diabetes in Latino women 11-26 months after pregnancies complicated by gestational diabetes. Diabetes, 48(12), 2430–2436.doi:10.2337/diabetes.48.12.2430

10580433

Centers for Disease Control and Prevention . (2000). Growth charts: United States. http://www.cdc.gov/growthcharts/

Colaizy

T. T.

Morriss

F. H

. (2008). Positive effect of NICU admission on breastfeeding of preterm US infants in 2000 to 2003. Journal of Perinatology, 28(7), 505–510.doi:10.1038/jp.2008.32

18368060

Correa

Bardenheier

Elixhauser

Geiss

L. S.

Gregg

. (2015). Trends in prevalence of diabetes among delivery hospitalizations, United States, 1993–2009. Maternal and Child Health Journal, 19(3), 635–642.doi:10.1007/s10995-014-1553-5

24996952

Demirci

J. R.

Bogen

D. L.

Holland

Tarr

J. A.

Rubio

Nemecek

Chang

J. C

. (2013). Characteristics of breastfeeding discussions at the initial prenatal visit. Obstetrics & Gynecology, 122(6), 1263–1270.doi:10.1097/01.AOG.0000435453.93732.a6

24201684

DeSisto

C. L.

Kim

S. Y.

Sharma

A. J

. (2014). Prevalence estimates of gestational diabetes mellitus in the United States, pregnancy risk assessment monitoring system (PRAMS), 2007-2010. Preventing Chronic Disease, 11, E104.doi:10.5888/pcd11.130415

24945238

Doughty

K. N.

Ronnenberg

A. G.

Reeves

K. W.

Qian

Sibeko

. (2018). Barriers to exclusive breastfeeding among women with gestational diabetes mellitus in the United States. Journal of Obstetric, Gynecologic & Neonatal Nursing, 47(3), 301–315.doi:10.1016/j.jogn.2018.02.005

29510090

10.

Ferrara

Hedderson

M. M.

Albright

C. L.

Ehrlich

S. F.

Quesenberry

C. P.

Peng

Feng

Ching

Crites

. (2011). A pregnancy and postpartum lifestyle intervention in women with gestational diabetes mellitus reduces diabetes risk factors: A feasibility randomized control trial. Diabetes Care, 34(7), 1519–1525.doi:10.2337/dc10-2221

21540430

11.

Gunderson

E. P

Hurston

S. R

Ning

J. C

Crites

Walton

Dewey

K. G

Azevedo

R. A

Young

Fox

Elmasian

C. C

Salvador

Lum

Sternfeld

Quesenberry

C. P

Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy Investigators . (2015). Lactation and progression to type 2 diabetes mellitus after gestational diabetes mellitus: A prospective cohort study. Annals of Internal Medicine, 163(12), 889–898.doi:10.7326/M15-0807

26595611

12.

Kjos

S. L.

Peters

R. K.

Xiang

Henry

O. A.

Montoro

Buchanan

T. A

. (1995). Predicting future diabetes in Latino women with gestational diabetes. Utility of early postpartum glucose tolerance testing. Diabetes, 44(5), 586–591.doi:10.2337/diab.44.5.586

7729620

13.

Ley

S. H.

Chavarro

J. E.

Bao

Hinkle

S. N.

Wander

P. L.

Rich-Edwards

Olsen

Vaag

Damm

Grunnet

L. G.

Mills

J. L.

F. B.

Zhang

. (2020). Lactation duration and long-term risk for incident type 2 diabetes in women with a history of gestational diabetes mellitus. Diabetes Care, 43(4), 793–798.doi:10.2337/dc19-2237

32041900

14.

Cheng

Wang

Chen

Ming

W.-K.

Wang

. (2020). Incidence rate of type 2 diabetes mellitus after gestational diabetes mellitus: A systematic review and meta-analysis of 170,139 women. Journal of Diabetes Research, 2020, 1–12.doi:10.1155/2020/3076463

32405502

15.

Martens

P. J.

Shafer

L. A.

Dean

H. J.

Sellers

E. A. C.

Yamamoto

Ludwig

Heaman

Phillips-Beck

Prior

H. J.

Morris

McGavock

Dart

A. B.

Shen

G. X

. (2016). Breastfeeding initiation associated with reduced incidence of diabetes in mothers and offspring. Obstetrics & Gynecology, 128(5), 1095–1104.doi:10.1097/AOG.0000000000001689

27741196

16.

Oza-Frank

Moreland

J. J.

McNamara

Geraghty

S. R.

Keim

S. A

. (2016). Early lactation and infant feeding practices differ by maternal gestational diabetes history. Journal of Human Lactation, 32(4), 658–665.doi:10.1177/0890334416663196

27550377

17.

Patel

. (2016). The effectiveness of lactation consultants and lactation counselors on breastfeeding outcomes. Journal of Human Lactation, 32(3), 530–541.doi:10.1177/0890334415618668

26644419

18.

Riddle

S. W.

Nommsen-Rivers

L. A

. (2016). A case control study of diabetes during pregnancy and low milk supply. Breastfeeding Medicine, 11(2), 80–85.doi:10.1089/bfm.2015.0120

26859784

19.

Stuebe

A. M.

Bonuck

Adatorwovor

Schwartz

T. A.

Berry

D. C

. (2016). A cluster randomized trial of tailored breastfeeding support for women with gestational diabetes. Breastfeeding Medicine, 11(10), 504–513.doi:10.1089/bfm.2016.0069

27782758

20.

Stuebe

A. M.

Rich-Edwards

J. W.

Willett

W. C.

Manson

J. E.

Michels

K. B

. (2005). Duration of lactation and incidence of type 2 diabetes. JAMA, 294(20), 2601–2610.doi:10.1001/jama.294.20.2601

16304074

21.

Werner

E. F.

Has

Kanno

Sullivan

Clark

M. A

. (2019). Barriers to postpartum glucose testing in women with gestational diabetes mellitus. American Journal of Perinatology, 36(2), 212–218.doi:10.1055/s-0038-1667290

30060291

22.

Ziegler

A.-G.

Wallner

Kaiser

Rossbauer

Harsunen

M. H.

Lachmann

Maier

Winkler

Hummel

. (2012). Long-term protective effect of lactation on the development of type 2 diabetes in women with recent gestational diabetes mellitus. Diabetes, 61(12), 3167–3171.doi:10.2337/db12-0393

23069624