title: Early Lactation and Infant Feeding Practices Differ by Maternal Gestational Diabetes History.
abstract: BACKGROUND
  Detailed data on lactation practices by gestational diabetes mellitus (GDM) history are lacking, precluding potential explanations and targets for interventions to improve lactation intensity and duration and, ultimately, long-term maternal and child health.
  
  
  OBJECTIVE
  This study aimed to examine breastfeeding practices through 12 months postpartum by GDM history.
  
  
  METHODS
  Women who delivered a singleton, liveborn infant at The Ohio State University Wexner Medical Center (Columbus, OH), in 2011 completed a postal questionnaire to assess lactation and infant feeding practices and difficulties. Bivariate and multivariate associations between GDM history and lactation and infant feeding practices were examined.
  
  
  RESULTS
  The sample included 432 women (62% response rate), including 7.9% who had GDM during the index pregnancy. Women with GDM initiated breastfeeding (at-the-breast or pumping) as often as women without any diabetes but were more likely to report introduction of formula within the first 2 days of life (79.4% vs 53.8%, P < .01; adjusted odds ratio: 3.48; 95% confidence interval, 1.47-8.26). Women with GDM initiated pumping 4 days earlier than women without diabetes ( P < .05), which was confirmed in adjusted analyses. There was no difference in the proportion of women reporting breastfeeding difficulty (odds ratio: 2.08; 95% confidence interval, 0.78-5.52). However, there was a trend toward women with GDM reporting more formula feeding and less at-the-breast feeding as strategies to address difficulty compared with women without diabetes.
  
  
  CONCLUSIONS
  Additional research is needed to understand why women with GDM engage in different early lactation and infant feeding practices, and how best to promote and sustain breastfeeding among these women.
authors.affiliation: 1 The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.|2 The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Reena
authors.initials: R
authors.lastname: Oza-Frank
authors.affiliation: 1 The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Moreland
authors.affiliation: 1 The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: McNamara
authors.affiliation: 3 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Sheela R
authors.initials: SR
authors.lastname: Geraghty
authors.affiliation: 1 The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.|2 The Ohio State University College of Medicine, Columbus, OH, USA.|4 The Ohio State University College of Public Health, Columbus, OH, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Keim
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration / Q000706:statistics & numerical data; D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000523:psychology*; D004522:Educational Status; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D007774:Lactation / Q000523:psychology; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D009820:Ohio; D011247:Pregnancy; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires
keywords: breastfeeding; breastfeeding and diabetes; diabetes; infant and child nutrition; infant feeding; infant feeding behavior