Pregnant Diabetics May Have Trouble Breastfeeding

New mothers with diabetes who experience difficulty with lactation may have maternal glucose intolerance.

Recent research published in the journalBreastfeeding Medicineinvestigated the association between maternal diabetes and low breast milk supply.

For the study, researchers from the Center for Breastfeeding Medicine at Cincinnati Children’s Hospital reviewed electronic health records of 641 women who had visited the center between June 2011 and May 2013. All of the women had given birth within the previous 90 days and expressed a desire to breastfeed their children.

The study authors found that 15% of women with low milk supply issues had diabetes during their pregnancy, and just over 6% of mothers who had lactation problems unrelated to milk supply had maternal diabetes.

In light of these results, the researchers concluded, “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.”

Their study is thought to be the first of its kind, and they noted that there are few evidence-based strategies to help mothers increase their breast milk supply.

Nevertheless, retail clinicians can communicate these findings to new or expectant mothers with diabetes or prediabetes. Mothers should be encouraged to properly manage their condition to help combat the risk of low milk supply and breastfeeding inability.

The potential for low milk supply is just another reason retail clinicians should watch for prediabetes in women.Recent researchhas also suggested that women who are obese and diabetic prior to becoming pregnant are more likely to have a baby with autism.

Contemporary ClinicBoard Member Kristene Diggins, FAANP, CNE, NEA-BC, DNP, DCC, MBA, corporate senior educator at MinuteClinic,previously saidthat one of the dynamic trends in diabetes management within the retail clinic setting involves making more of an effort to follow diabetic patients closely.

“The convenient care clinician has an opportunity to act and act quickly,” she explained. “This patient may not be seeing any other health care provider, and [clinicians] can work with the pharmacist in that setting to make sure that things happen.”

Beyond pharmacologic interventions, nurse practitioners (NPs) and physician assistants (PAs) working in retail clinics can encourage behavioral changes to help patientslose weight.

For instance, NPs and PAs can suggest a healthier diet that incorporates more whole grains, vegetables, lean proteins, and fruit. They can also suggest that patients join a weight-loss program like Jenny Craig or Weight Watchers and conduct daily weigh-ins to track progress.

Prediabetes is also on the rise, according to the American Diabetes Association (ADA). Considering that 86 million Americans aged 20 years and older had prediabetes in 2012, retail clinicians have their work cut out to help identify and treat these patients, especially women who are planning to have children.

Early intervention can help patients avoid developing diabetes in the first place. Retail clinicians should advise patients that they can help lower their risk for developing type 2 diabetes by 58% if they lose 7% of their body weight and exercise moderately 30 minutes a day, 5 times per week, according to the ADA.