This article is more than 5 years old. Information may no longer be current.
Intensive, extended breastfeeding linked to reduced risk for type 2 diabetes after gestational diabetes
SAN FRANCISCO — Intensive and extended breastfeeding lowered a woman’s risk of developing type 2 diabetes after pregnancy in which they had gestational diabetes, according to a presenter at the American Diabetes Association’s 74th Scientific Sessions.
“Our findings show that lactation measures are inversely associated with incidence of diabetes in 2 years,” Erica Gunderson, PhD, MPH, MS, from the division of research, Kaiser Permanente Northern California, said during her presentation. “Lactation that tends toward high intensity at 6-9 weeks postpartum was associated with 40% to 60% lower risk of diabetes in women and longer duration was also of the same magnitude. Severity of glucose intolerance during pregnancy or any other lifestyle risk factors did not change the associations.
“In the Study of Women, Infant Feeding and Type 2 Diabetes after GDM pregnancy, or SWIFT, study, researchers conducted a prospective observational study from 2008 to 2014 that assembled a cohort of 1,010 women (age 20-45 years) with recent gestational diabetes to determine the impact of breastfeeding on development of type 2 diabetes in women.
The women did not have pre-existing diabetes or diabetes at 6 to 9 weeks postpartum, Gunderson said, and they were determined to be either in the intensive breastfeeding (<6 oz/day of formula) or intensive formula feeding (>17 oz/day) groups at enrollment.
The study consisted of three in-person exams at 6 to 9 weeks (baseline), 1 year and 2 years postpartum, all of which included 2-hour, 75 g oral glucose tolerance tests. In addition, the participants received 10 monthly mailings in the first year and three telephone interviews, one prenatal and two postpartum at 1 and 6 months. Within 2 years, there were 106 incident cases of diabetes (11%), Gunderson said.
After adjusting for pre-pregnancy BMI, race, prenatal 3-hour OGTT score and gestational diabetes treatment, women who exclusively breastfed at 6 to 9 weeks postpartum showed a 61% risk reduction in their 2-year diabetes incidence (relative hazard (RH)=0.39; 95% CI, 0.22-0.77) and those that breastfed at any frequency showed a nearly 40% reduction (mixed feeding RH=0.61; 95% CI, 0.34-1.08; mostly breastfeeding RH=0.66; 95% CI, 0.41-1.07); P-trend=.04.
Duration of lactation was also associated with reduced risk of incident diabetes in the 2-year study period, Gunderson showed. The women that breastfed for 2 months to 6 months reduced their risk by 30%; those that did so for 6 to 14 months reduced their risk by 42%; and those that breastfed for more than 14 months reduced their risk by 58% (RHs=0.70, 0.58, 0.42, respectively; P-trend=.05).
For More Information: Gunderson E. Abstract 357-OR. Presented at: American Diabetes Association’s 74th Scientific Sessions; June 13-17, 2014; San Francisco.
Disclosures: Gunderson reports no relevant financial relationships.