Diabetes Linked to Low Breast Milk Supply

Diabetes in pregnant women may be associated with a lower supply of breast milk.

New research published in Breastfeeding Medicine examined the electronic medical records of women at a breastfeeding medicine clinic less than 90 days after giving birth. The women, who were all considered “highly motivated to breastfeed,” visited the breastfeeding center between June 1, 2011, and May 31, 2013.

The Cincinnati Children’s Hospital Medical Center researchers sought to determine whether a history of diabetes during pregnancy “as a marker of perinatal glucose intolerance” had an effect on milk supply.

A diagnosis of diabetes included type 1, type 2, and gestational. The women who were considered to have a low milk supply didn’t have latch or nipple problems. Meanwhile, the controls were women with latch or nipple problems but who didn’t have a low milk supply.

The researchers adjusted for factors such as cesarean delivery, preterm birth, polycystic ovary syndrome, hypothyroidism, and infertility.

The results showed that nearly 15% of the 175 women with low milk supply had a history of diabetes during pregnancy. In the control group, 6.2% of those with lactation problems but an adequate milk supply had a history of diabetes during pregnancy.

Next, the researchers expanded the study to include all low milk supply cases in one group and women with any diagnosis except low milk supply to serve as controls.

In this sensitivity analysis, again, nearly 15% of 249 cases from the first group, compared with 6.1% in the control group, had diabetes during pregnancy.

“Women diagnosed with low milk supply were significantly more likely to have had diabetes in pregnancy compared with women with latch or nipple problems and, more generally, compared with women with any other lactation difficulty,” the researchers concluded.

They called for more research on how maternal glucose intolerance could affect lactation.

“This study shows the importance of further research to determine how maternal glucose intolerance may impede lactation, so that targeted therapies may be developed to increase milk supply,” lead study author Sarah Riddle, MD, a pediatrician in the Center for Breastfeeding Medicine at Cincinnati Children’s, said in a press release. “There are limited evidence-based strategies for helping mothers to increase milk supply, and low milk supply is often cited as the reason for new mothers to stop breastfeeding earlier than planned.”

Previous research has shown that obesity is a risk factor for poor lactation outcomes, and insulin resistance is common among obese women.

To the researchers’ knowledge, this was the first study to examine whether diabetes could be a risk factor for low milk supply.

Pharmacists can help their breastfeeding patients by asking which medications they’re using, including OTC drugs and supplements, in order to make sure the therapies are safe for the baby.
In addition, pharmacists can make sure breastfeeding women who want to be on birth control are using a safe form.

The American Academy of Pediatrics advises that women should breastfeed for at least 12 months. For the first 6 months, babies should only consume breastmilk.