title: Differences in breast-feeding initiation and continuation by maternal diabetes status.
abstract: OBJECTIVE
  To examine (i) the prevalence of and associations between breast-feeding initiation and continuation by maternal diabetes status and (ii) the reasons for not initiating and/or continuing breast-feeding by maternal diabetes status.
  
  
  METHODS
  Secondary data analyses of a population-based cross-sectional study were conducting using data from the US Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS), 2009-2011. Multivariable logistic regression was used to investigate the associations between breast-feeding initiation and continuation by diabetes status.
  
  
  METHODS
  Thirty states and New York City, USA.
  
  
  METHODS
  Mothers of recently live-born infants, selected by birth certificate sampling.
  
  
  RESULTS
  Among 72755 women, 8.8 % had gestational diabetes mellitus (GDM) and 1.7 % had pregestational diabetes mellitus (PDM). Breast-feeding initiation was similar among GDM and no diabetes mellitus (NDM) women (80.8 % v. 82.2 %, respectively, P=0.2), but continuation was lower among GDM (65.7 % v. 68.8 %, respectively, P=0.01). PDM women had lower initiation and continuation compared with NDM (78.2 %, P=0.03 and 60.4 %, P<0.01, respectively). In adjusted analyses, current smoking status was a significant effect modifier for initiation, but not for continuation.
  
  
  CONCLUSIONS
  Differences in breast-feeding initiation and continuation prevalence by maternal diabetes status may reflect differences in prenatal education, indicating the need for increased efforts among PDM women. Additionally, non-smoking women with PDM or GDM would benefit from additional breast-feeding education.
authors.affiliation: 1Center for Perinatal Research,Research Institute at Nationwide Children's Hospital,Department of Pediatrics,The Ohio State University,700 Children's Drive,Research Building 3,Columbus,OH 43205,USA.
authors.forename: Reena
authors.initials: R
authors.lastname: Oza-Frank
authors.affiliation: 2School of Nursing,West Virginia University,Morgantown,WV,USA.
authors.forename: Ilana
authors.initials: I
authors.lastname: Chertok
authors.affiliation: 3College of Public Health,The Ohio State University,Columbus,OH,USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Bartley
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D002487:Centers for Disease Control and Prevention, U.S.; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000523:psychology*; D007231:Infant, Newborn; D008019:Life Style; D015999:Multivariate Analysis; D011247:Pregnancy; D018570:Risk Assessment / Q000706:statistics & numerical data*; D012907:Smoking; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
keywords: Pregnancy