Breastfeeding a small for gestational age infant, complicated by maternal gestational diabetes: a case report
Alexandra D George1, Melvin C L Gay2, Mary E Wlodek3
1School of Molecular Sciences, The University of Western Australia, Crawley, Perth, Western Australia, 6009, Australia. alexandra.george@research.uwa.edu.au.
Insights
Maternal milk supply and composition can be negatively impacted by conditions like placental insufficiency and Gestational Diabetes Mellitus (GDM), affecting small for gestational age (SGA) infants. This highlights the need for careful monitoring of milk intake for SGA infants.
Area of Science:
- Neonatal nutrition
- Maternal-fetal medicine
- Pediatric endocrinology
Background:
- Small for gestational age (SGA) infants face long-term health risks, including metabolic and cardiovascular diseases.
- Pregnancy complications such as placental insufficiency and Gestational Diabetes Mellitus (GDM) can affect infant development.
- Previous research suggested maternal milk is typically unaffected in SGA cases.
Observation:
- An SGA infant was born to a mother with diagnosed placental insufficiency and GDM.
- The mother experienced a low milk supply.
- Maternal milk composition deviated from reference values, providing insufficient energy for the infant.
Findings:
- Maternal milk quantity and quality may be compromised in pregnancies complicated by SGA and/or GDM.
- Infant energy intake from breast milk was significantly below recommended levels at 3 months.
- This case challenges the notion that maternal milk is unaffected in SGA infants.
Implications:
- Compromised maternal milk in SGA/GDM cases necessitates targeted follow-up for infants.
- Early nutritional support is crucial to mitigate long-term disease risks for SGA infants.
- Understanding these impacts is vital for public health strategies concerning neonatal outcomes.
Background:
Small for gestational age (SGA) infants are those born small for their gestational age, with weight below the 10th percentile. Not only do SGA infants suffer growth issues after birth, they have elevated risk for the development of metabolic and cardiovascular diseases later in life. Current research has suggested that in cases of SGA infants, maternal milk and breastfeeding are not affected. The mother of an SGA infant was diagnosed with placental insufficiency and Gestational Diabetes Mellitus (GDM) during her pregnancy. The infant was born term, at 38 weeks 3 days, and SGA. The mother had a low milk supply and her milk composition differed from reference values such that the daily infant intake provided less than 50% of the required energy intake at 3 months.
Conclusion:
In cases of SGA and/or GDM, maternal milk quality and quantity may be compromised. This requires follow-up in order to reduce the disease risk for SGA infants and the corresponding public health implications.
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