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Prepregnancy diabetes predicts curtailed breastfeeding among black mothers
Black women with diabetes diagnosed before pregnancy were less likely to initiate breastfeeding and ceased breastfeeding earlier when compared with black women without diabetes, according to findings published in Breastfeeding Medicine.
Black women have nearly twice the age-adjusted diabetes prevalence when compared with white women in the United States and also have a lower breastfeeding initiation rate when compared with the overall U.S. population, Julie R. Palmer, ScD, MPH, of the Slone Epidemiology Center at Boston University, and colleagues wrote in the study background.
“When compared with women of other races with [prepregnancy diabetes], it is unclear whether black women with [prepregnancy diabetes] successfully initiate breastfeeding more or less often,” Palmer and colleagues wrote.
Researchers analyzed data from 3,404 primiparous women with births between 1995 and 2009, participating in the prospective Black Women’s Health Study (median age at enrollment, 38 years). Prepregnancy diabetes was defined as type 1 or type 2 diabetes reported before pregnancy (n = 85); lactation duration was ascertained in 2011. Researchers inspected Kaplan-Meier curves, log-rank tests and Cox proportional hazard models to assess the relationship between prepregnancy diabetes and time to breastfeeding cessation occurring up to 24 months.
Within the cohort, 22% of women reported breastfeeding for at least 12 months, and 6.7% reported breastfeeding at 2 years. Women with prepregnancy diabetes initiated breastfeeding at a lower rate vs. those without prepregnancy diabetes (60% vs. 81.5%) and were less likely to be breastfeeding at 3 months (47% vs. 69.2%), 6 months (22.4% vs. 52.5%) and 12 months (9.4% vs. 28.6%) when compared with mothers without diabetes, according to researchers. Women with prepregnancy diabetes were also more likely to have hypertension, a family history of diabetes and obesity, according to researchers.
After adjustments for age, BMI at age 18 years, prepregnancy BMI, metabolic factors and health behaviors, researchers found that women with prepregnancy diabetes were 1.5 times more likely to cease breastfeeding vs. women without diabetes (95% CI, 1.1-2). In models testing for effect measure modification, researchers found that the association of prepregnancy diabetes with breastfeeding cessation was different among women with hypertension (HR = 3.6; 95% CI, 2-6.4) vs. women without hypertension (HR = 0.5; 95% CI, 0.8-9.4).
“As the prevalence of type 2 diabetes is about twice as high in U.S. black women as compared with white women, these associations may contribute to racial disparities in breastfeeding,” the researchers wrote. “Our results underscore the importance of targeted breastfeeding support, particularly among women with diabetes.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.