In-hospital breast feeding rates among women with gestational diabetes and pregestational Type 2 diabetes in South Auckland

Aim: To describe the uptake of breast feeding in mothers with either Type 2 diabetes or gestational diabetes (GDM) in a hospital serving a multiethnic community in South Auckland, New Zealand. Research design and methods: A retrospective study of all women attending the Diabetes in Pregnancy clinic over a 4-year period was undertaken: 30 women had Type 2 diabetes and 373 GDM. Results: Compared with mothers with GDM, mothers with Type 2 diabetes were less likely to breast feed in any way as the first feed (41.4% vs. 68.0%, P = 0.011) or at discharge (69.0% vs. 84.0%, P = 0.039). In the combined group, there were no differences in uptake of breast feeding by ethnicity, age, parity, body mass index, smoking or antenatal glycaemia, use of insulin or presence of hypertension. Breast feeding on discharge was associated with a higher APGAR score, breast feeding as the first feed (78.2% vs. 19.4%, P < 0.001) and lower rates of delivery by Caesarean section (17.0% vs. 31.8%, P = 0.006). Logistic regression showed breast feeding as the first feed, the major determinant for breast feeding on discharge. Conclusions: Factors delaying breast feeding as the first feed are the major determinant of breast feeding on discharge. Strategies to increase breast feeding as the first feed among women with Type 2 diabetes, and those having a Caesarean section, may be useful in increasing the uptake of breast feeding in the longer term.