The Effect of Gestational Diabetes on Human Milk Macronutrients Content

Background: Little is known about the effect of gestational-diabetes (GD) upon macronutrients content of human-milk (HM).

Aim: To study macronutrients (fat, lactose, protein) and caloric content in HM from women with GD compared to women with no-GD.

Methods: Sixty-two lactating mothers (31 with GD, 31 without GD) were recruited. Diagnosis of GD was made by using a 100-gram Glucose-Tolerance-Test. After manual expression, each mother contributed 3 samples of HM (during first 72 hours after labor (colostrum), after 7-days (transitional-HM) and at 14-days post-partum (mature-HM). Immediately following expression, samples were stored at -20°C until thawed and analyzed using infrared transmission spectroscopy HM analyzer.

Results: Sixteen women (52%) in the GD group were treated by diet alone (48%) while 15 (48%) by pharmacotherapy. The non-GD and GD groups did not differ in terms of maternal age, maternal pre pregnancy weight, height, diet and weight gain during pregnancy, gestational age and infant birthweight. A total of 186 HM milk samples were collected. Macronutrients content in colostrum and transitional milk did not differ between the 2 groups. Fat and energy contents in mature HM were higher in the non-GD samples than in the GD samples (p=0.07 and p<0.02, respectively). There were no differences in macronutrients content of samples of mother with diet-treated-GD compared to mother with pharmacotherapy-treated-GD.

Conclusions: Fat and energy content of mature milk obtained from mothers with GD is lower compared to that of milk from mothers without GD. The mechanism and biological significance of our findings is yet to be determined.