Daijiworld Media Network - New Delhi
New Delhi, Nov 1: Higher body mass index (BMI), rather than Type 2 diabetes alone, may be associated with lower breastfeeding rates among women with the condition, according to a prospective controlled study. The findings highlight the importance of considering maternal weight and other contributing factors when assessing breastfeeding outcomes.
Researchers compared breastfeeding patterns among women with Type 2 diabetes and two groups of women without diabetes. The comparison included women matched for age, parity and BMI, as well as a separate group of women with normal BMI.
Four-month breastfeeding data were available for 29 women with Type 2 diabetes, 29 BMI-matched controls and 28 women in the normal-BMI control group.
The findings showed that exclusive breastfeeding rates were 24 per cent among women with diabetes, compared with 38 per cent in the BMI-matched control group and 64 per cent among women with normal BMI.
The rates of any breastfeeding were 55 per cent among women with diabetes, 54 per cent among BMI-matched controls and 82 per cent among women with normal BMI.
Importantly, researchers found no statistically significant difference in either exclusive or any breastfeeding between women with Type 2 diabetes and those in the BMI-matched control group. However, breastfeeding rates were significantly lower among women with diabetes compared with those in the normal-BMI group.
The findings suggest that higher BMI may be an important factor associated with reduced breastfeeding rates, rather than diabetes itself being the sole explanation.
The study also found that women with Type 2 diabetes breastfed less frequently during the first 24 hours after childbirth. Their newborns were also more likely to receive formula milk while in hospital.
Neonatal hypoglycaemia, a condition characterised by low blood sugar levels in newborns, was identified as the most common reason for introducing formula feeding for infants in the diabetes group.
However, researchers cautioned that the study had certain limitations. The relatively small sample size restricted the scope for comprehensive statistical adjustments, while its observational design meant that a direct causal relationship between higher BMI and reduced breastfeeding could not be established.
The researchers also emphasised that the absence of a statistically significant difference between women with diabetes and BMI-matched controls does not necessarily establish that diabetes has no independent influence on breastfeeding outcomes. Larger studies involving more participants may help identify differences that the present study was not sufficiently powered to detect.
The findings have important implications for maternity care and diabetes management teams. They highlight the need to identify individual breastfeeding challenges throughout pregnancy, hospital admission and the months following childbirth.
Medical professionals also need to consider the circumstances surrounding early formula supplementation. When formula is medically required to manage neonatal hypoglycaemia, it should not automatically be viewed as a failure of breastfeeding support.
Instead, healthcare teams should ensure that necessary medical treatment and the mother's breastfeeding preferences are addressed together.
The researchers said larger studies are needed to distinguish the individual contributions of BMI, metabolic health, newborn care and other social and medical factors. Such research could also help identify effective support strategies to improve breastfeeding continuation among women with diabetes who wish to breastfeed.