Long-term breast-feeding in women with type 1 diabetes
Long-term breast-feeding in women with type 1 diabetes
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DOI：
10.2337/diacare.29.04.06.dc05-1103
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发表时间：
2006-04-01
期刊：
影响因子：
16.2
通讯作者：
Mathiesen, E
中科院分区：
文献类型：
--
作者：
Stage, E;Norg책rd, H;Mathiesen, E
目的：由于新生儿发病率和母亲血糖值波动，糖尿病妇女的母乳喂养可能更加困难。研究了长期母乳喂养的频率和成功母乳喂养的可能预测因素。研究设计和方法：在分娩后5天和4个月，使用半结构化问卷对120名连续患有1型糖尿病的妇女进行了关于母乳喂养的访谈。从医疗记录中收集临床数据。结果：分娩后5天，86%的妇女母乳喂养。分娩4个月后，55名（54%）妇女完全母乳喂养，14名（14%）部分母乳喂养，33名（32%）不母乳喂养，而背景人群（NS）的这一比例分别为50、26和24%。4个月纯母乳喂养的母亲具有母乳喂养经验、较高的教育水平和阴道分娩的特点，其中不吸烟的比例较高，而与糖尿病相关的参数如白人阶级、糖尿病持续时间、HbA（1c）和受孕时胰岛素剂量没有关联。与其余的后代相比，母乳喂养的后代的出生体重和胎龄明显更高，静脉注射葡萄糖的次数也更少。4个月时纯母乳喂养的独立预测因素是既往母乳喂养经验（优势比为6.3 [95% CI 2.4-17]）和较高教育水平（优势比为7.1[2.4-21]）。停止母乳喂养主要是由于常见的护理问题，如感知母乳供应，与母亲糖尿病状况无关。结论：大多数1型糖尿病妇女开始母乳喂养，4个月时母乳喂养的患病率与背景人群相当。4个月纯母乳喂养的独立预测因素是有过母乳喂养经验和较高的教育水平。
OBJECTIVE - Breast-feeding may be more difficult in women with diabetes because of neonatal morbidity and fluctuating maternal blood glucose values. The frequency of long-term breast-feeding and the possible predictors for successful breast-feeding were investigated.RESEARCH DESIGN AND METHODS - one hundred two consecutive women with type I diabetes were interviewed about breast-feeding using a semistructured questionnaire 5 days and 4 months after delivery. Clinical data were collected from the medical records.RESULTS - Five days after delivery, 86% of the women were breast-feeding. Four months after delivery, 55 (54%) women were exclusively, 14 (14%) were partly, and 33 (32%) were not breast-feeding compared with 50, 26, and 24% in the background population (NS). Mothers exclusively breast-feeding at 4 months were characterized by previous experience With breast-feeding, a higher educational level, and vaginal delivery and included a high proportion of nonsmokers, whereas there were no associations with diabetes-related parameters such as white classes, duration of diabetes, HbA(1c) and insulin dose at conception. Breast-fed offspring had a significantly higher birth weight and gestational age and were less often receiving glucose intravenously compared with the remaining offspring. Independent predictors of exclusive breast-feeding at 4 months were previous experience with breast-feeding (odds ratio 6.3 [95% CI 2.4-17]) and higher educational level (7.1 [2.4-21]). Cessation of breast-feeding was mainly due to common nursing problems, such as perceived milk supply, and not related to maternal diabetes status.CONCLUSIONS - The majority of the women with type I diabetes initiated breast-feeding, and the prevalence of breast-feeding at 4 months was comparable to that in the background Population. Independent predictors of exclusive breast-feeding at 4 months were previous experience with breast-feeding and higher educational level.