Factors associated with breastfeeding at discharge differ by maternal diabetes type

To investigate the factors associated with breastfeeding initiation in mothers with gestational and prepregnancy diabetes mellitus vs those without diabetes.

Ohio Vital Statistics birth certificate data from 2006 to 2011 on all singleton births to women resident in Ohio aged 16-44 years were used to determine the factors associated with breastfeeding initiation by diabetes status. Logistic regression models stratified by diabetes status were used to analyse the association of breastfeeding with characteristics of the mother and infant.

Among the 792 730 infants born in Ohio between 2006 and 2011 used in the analysis, 5.3% were born to mothers with gestational diabetes and 0.8% to mothers with prepregnancy diabetes. Although some associations of breastfeeding initiation with maternal and infant characteristics were similar across all diabetes statuses, they differed by maternal prepregnancy weight, age and race, prenatal care, county type and infant's gestational age. Unlike mothers without diabetes, overweight mothers with gestational diabetes were equally likely to breastfeed compared with those of normal weight (odds ratio 0.95; 95% CI 0.87, 1.03) and mothers in rural (odds ratio 1.0; 95% CI 0.9, 1.1) and metropolitan counties (OR 1.1; 95% CI 1.0, 1.1) were equally likely to breastfeed compared with those in suburban counties. Although significantly associated with breastfeeding initiation among mothers without diabetes, the mother's prepregnancy weight status and age, county type and prenatal care were not found to be significant factors among mothers with prepregnancy diabetes.

Further research is needed to understand how these factors influence the initiation of breastfeeding decisions made by mothers.