OBJECTIVE -Breast-feeding may be more difficult in women with diabetes because of neonatal morbidity and fluctuating maternal blood glucose values. The frequency of long-term breast-feeding and the possible predictors for successful breast-feeding were investigated.RESEARCH DESIGN AND METHODS -One hundred two consecutive women with type 1 diabetes were interviewed about breast-feeding using a semistructured questionnaire 5 days and 4 months after delivery. Clinical data were collected from the medical records.RESULTS -Five days after delivery, 86% of the women were breast-feeding. Four months after delivery, 55 (54%) women were exclusively, 14 (14%) were partly, and 33 (32%) were not breast-feeding compared with 50, 26, and 24% in the background population (NS). Mothers exclusively breast-feeding at 4 months were characterized by previous experience with breastfeeding, a higher educational level, and vaginal delivery and included a high proportion of nonsmokers, whereas there were no associations with diabetes-related parameters such as white classes, duration of diabetes, HbA 1c , and insulin dose at conception. Breast-fed offspring had a significantly higher birth weight and gestational age and were less often receiving glucose intravenously compared with the remaining offspring. Independent predictors of exclusive breastfeeding at 4 months were previous experience with breast-feeding (odds ratio 6.3 [95% CI 2.4 -17]) and higher educational level (7.1 [2.4 -21]). Cessation of breast-feeding was mainly due to common nursing problems, such as perceived milk supply, and not related to maternal diabetes status.CONCLUSIONS -The majority of the women with type 1 diabetes initiated breast-feeding, and the prevalence of breast-feeding at 4 months was comparable to that in the background population. Independent predictors of exclusive breast-feeding at 4 months were previous experience with breast-feeding and higher educational level.
Diabetes Care 29:771-774, 2006I n Denmark, as well as globally, exclusive breast-feeding is recommended for the first 4 -6 months of life (1,2). Health care workers are encouraged to play a role in promoting breast-feeding and providing mothers with the appropriate information and support (1). In women with diabetes, much attention is given during pregnancy to preventing morbidity for both mother and child (3), whereas less attention is paid to breastfeeding (4). Breast-feeding is suggested to prevent future diseases and may prevent future obesity (2,5). Breast-feeding probably protects against the development of both type 1 diabetes (6,7) and type 2 diabetes (8) in offspring. Therefore, it is of special importance to encourage women with diabetes to breast-feed for at least 4 -6 months and to prevent early exposure of their offspring to cow's milk. Breast-feeding in women with type 1 diabetes may be more difficult to establish and of shorter duration compared with the background population because of increased maternal and neonatal morbidity.Fluctuating maternal blood glucose values with...