Breastfeeding Rates in Pre-gestational Diabetes – Where Do We Stand? - Endo Annual 2022 The 50th Annual Meeting of The Israel Endocrine Society

Tal Schiller ¹ Tali Gassner ¹ Yael Winter Shafran ² Hilla Knobler ¹ Taiba Zornitzki ¹ Ronit Harris ³ Alena Kirzhner ^1,4

¹Department of Diabetes, Endocrinology and Metabolism, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
²Obstetric and Gynecology Department, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
³Department of Statistical, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
⁴Department of Medicine, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel

Background:
Data suggests that women with pre gestational diabetes mellitus (PGDM) tend to breastfeed less compared to women without diabetes. We aimed to evaluate any or exclusive breastfeeding (BF) rates at three and six months in PGDM and whether targeted counseling at the end of pregnancy can impact breastfeeding rates and duration.

Methods:
Fifty-two women with PGDM were cluster randomized between 32-36 weeks gestation, either to frontal instruction (FI) with a BF counselor or elaborated written information on BF with diabetes (non-frontal instruction, NFI). 38 women without diabetes giving birth at our center served as controls. All women filled a questionnaire regarding BF duration and intensity before instruction, and at three and six months after birth.

Results:
Twenty-six women completed the questionnaire in each group. 63% had type 1 diabetes and the rest had type 2 diabetes. Women in the NFI were younger (31±5 vs 35±5 years) and more likely to have higher education. Past BF rates were similar and almost all women in our cohort intended to breastfeed. At three- and six-months postpartum, any BF rates were around 60% and 30%, respectively. Approximately half of those breastfed exclusively in each group. No difference was noted between FI and NFI.

Conclusions:
BF rates in PGDM were comparable to those of women without diabetes. Mode of instruction did not confer a difference in BF rates or duration. Although results are encouraging continuous education and support are required.