University of North Carolina, USA
Posters & Accepted Abstracts: J Nurs Care
Women with gestational diabetes mellitus (GDM) have lower rates of breastfeeding compared to women without diabetes. One of the factors associated with lower breastfeeding rates is delayed lactogenesis II, the transition to increased milk production. Research suggests that women with GDM experience higher rates of delayed lactogenesis II. Increased colostrum lactose levels indicate lactogenesis II, although the effect of GDM on lactose levels has not been published. The aim of the study is to examine lactose levels in colostrum of women with and without GDM. A prospective case-control study examining differences in colostral metabolites of postpartum women, 19 with GDM and 29 without GDM, was conducted using enzymatic methods. Results of the composition analysis revealed significantly higher concentrations of lactose at 72 hours postpartum in colostral samples of women without GDM compared to women with GDM (p=0.043). Glucose and citrate levels were significantly higher in the colostral samples of women without GDM. Differences in colostral concentrations of lactose, glucose, and citrate between women with and without GDM suggests that delayed lactogenesis II in women with GDM may be physiological, supporting previous findings of maternal perception of delayed lactogenesis II. Validation of maternal self-report with biochemical research strengthens the findings and helps explain the biological mechanism of action. Healthcare providers should encourage early and frequent breastfeeding among women with GDM, with early pumping for women who are unable to directly breastfeed their infants in the early postpartum period, to facilitate transition to lactogenesis II and promote breastfeeding among this at-risk population.
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