Routine Postpartum Colostrum Expression and Breastfeeding Outcomes in Women With Diabetes: A Feasibility Trial

Women with diabetes have an increased risk of delayed Lactogenesis II, and their infants are at higher risk of hypoglycemia and formula supplementation.

To assess the feasibility and acceptability of routine postpartum colostrum expression for women with diabetes, and its influence on exclusive breastfeeding.

A non-randomized feasibility clinical study was conducted from birth to 30 days postpartum involving women with DM, including those with GDM, from a maternity in São Paulo, Brazil in 2021-2022.We aimed to identify challenges related to participant acceptance, adherence to the intervention, retention, and the rates of exclusive breastfeeding, in preparation for a full randomized controlled trial (N = 30). The intervention consisted of providing participants with education on the postpartum colostrum expression as a routine practice and offering the expressed milk to their infant after breastfeeds sessions.

We analyzed data from all 30 participants, with 13 in the intervention group and 17 in the control group. More women in the intervention group (12/13, 92%) exclusively breastfed at hospital stay compared with those in the control group (8/17, 47%; p = 0.017). Women in the intervention group reported increased confidence in breastfeeding. Despite barriers like challenges with expression techniques, concerns about milk volume, and labor fatigue, participants found the intervention acceptable.

Postpartum colostrum expression was feasible and acceptable, and may influence exclusive breastfeeding rates among women with diabetes, supporting further research in a larger trial.