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Breastfeed Med. 2016 Dec;11:504-513. Epub 2016 Oct 26.

A Cluster Randomized Trial of Tailored Breastfeeding Support for Women with Gestational Diabetes.

Author information

  • 11 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine , Chapel Hill, North Carolina.
  • 22 Department of Maternal and Child Health, Carolina Global Breastfeeding Institute , Gillings School of Global Public Health, Chapel Hill, North Carolina.
  • 33 Department of Family and Social Medicine, Albert Einstein College of Medicine , Bronx, New York.
  • 44 Department of Biostatistics, Gillings School of Global Public Health , Chapel Hill, North Carolina.
  • 55 School of Nursing, University of North Carolina , Chapel Hill, North Carolina.

Abstract

BACKGROUND:

Women with gestational diabetes mellitus (GDM) and their infants are at increased risk of developing metabolic disease; however, longer breastfeeding is associated with a reduction in these risks. We tested an intervention to increase breastfeeding duration among women with GDM.

MATERIALS AND METHODS:

We conducted a cluster randomized trial to determine the efficacy of a breastfeeding education and support program for women with GDM. Women were enrolled between 22 and 36 weeks of pregnancy and cluster randomized to an experimental lifestyle intervention or wait-list control group. Breastfeeding duration and intensity were prespecified secondary outcomes of the trial. Duration of exclusive and any breastfeeding was assessed at 6 weeks and at 4, 7, and 10 months postpartum. We quantified differences in breastfeeding rates using Kaplan-Meier estimates, log-rank tests, and Cox regression models.

RESULTS:

We enrolled 100 women, of whom 52% were African American, 31% non-Hispanic white, 11% Hispanic, 9% American Indian or Alaskan Native, 2% Asian, 2% other, and 4% more than one race. In models accounting for within-cluster correlation and adjusted for study site, breastfeeding intention, and African American race, women allocated to the intervention group were less likely to stop breastfeeding (adjusted hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.21-0.74) or to introduce formula (adjusted HR 0.50, 95% CI 0.34-0.72).

CONCLUSION:

Our results suggest that targeted breastfeeding education for women with GDM is feasible and efficacious.

CLINICAL TRIALS REGISTRATION:

http://clinicaltrials.gov/ct2/show/NCT01809431.

KEYWORDS:

breastfeeding; gestational diabetes; lactation

PMID:
27782758
PMCID:
PMC5165668
[Available on 2017-12-01]
DOI:
10.1089/bfm.2016.0069
[PubMed - in process]
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