TY - JOUR
T1 - A Cluster Randomized Trial of Tailored Breastfeeding Support for Women with Gestational Diabetes
AU - Stuebe, Alison M.
AU - Bonuck, Karen
AU - Adatorwovor, Reuben
AU - Schwartz, Todd A.
AU - Berry, Diane C.
N1 - Publisher Copyright:
© 2016, Mary Ann Liebert, Inc.
PY - 2016/12
Y1 - 2016/12
N2 - Background: Women with gestational diabetes mellitus (GDM) and their infants are at increased risk of developing metabolic disease; however, longer breastfeeding is associated with a reduction in these risks. We tested an intervention to increase breastfeeding duration among women with GDM. Materials and Methods: We conducted a cluster randomized trial to determine the efficacy of a breastfeeding education and support program for women with GDM. Women were enrolled between 22 and 36 weeks of pregnancy and cluster randomized to an experimental lifestyle intervention or wait-list control group. Breastfeeding duration and intensity were prespecified secondary outcomes of the trial. Duration of exclusive and any breastfeeding was assessed at 6 weeks and at 4, 7, and 10 months postpartum. We quantified differences in breastfeeding rates using Kaplan-Meier estimates, log-rank tests, and Cox regression models. Results: We enrolled 100 women, of whom 52% were African American, 31% non-Hispanic white, 11% Hispanic, 9% American Indian or Alaskan Native, 2% Asian, 2% other, and 4% more than one race. In models accounting for within-cluster correlation and adjusted for study site, breastfeeding intention, and African American race, women allocated to the intervention group were less likely to stop breastfeeding (adjusted hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.21-0.74) or to introduce formula (adjusted HR 0.50, 95% CI 0.34-0.72). Conclusion: Our results suggest that targeted breastfeeding education for women with GDM is feasible and efficacious.
AB - Background: Women with gestational diabetes mellitus (GDM) and their infants are at increased risk of developing metabolic disease; however, longer breastfeeding is associated with a reduction in these risks. We tested an intervention to increase breastfeeding duration among women with GDM. Materials and Methods: We conducted a cluster randomized trial to determine the efficacy of a breastfeeding education and support program for women with GDM. Women were enrolled between 22 and 36 weeks of pregnancy and cluster randomized to an experimental lifestyle intervention or wait-list control group. Breastfeeding duration and intensity were prespecified secondary outcomes of the trial. Duration of exclusive and any breastfeeding was assessed at 6 weeks and at 4, 7, and 10 months postpartum. We quantified differences in breastfeeding rates using Kaplan-Meier estimates, log-rank tests, and Cox regression models. Results: We enrolled 100 women, of whom 52% were African American, 31% non-Hispanic white, 11% Hispanic, 9% American Indian or Alaskan Native, 2% Asian, 2% other, and 4% more than one race. In models accounting for within-cluster correlation and adjusted for study site, breastfeeding intention, and African American race, women allocated to the intervention group were less likely to stop breastfeeding (adjusted hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.21-0.74) or to introduce formula (adjusted HR 0.50, 95% CI 0.34-0.72). Conclusion: Our results suggest that targeted breastfeeding education for women with GDM is feasible and efficacious.
KW - Breastfeeding
KW - gestational diabetes
KW - lactation
UR - http://www.scopus.com/inward/record.url?scp=85003634505&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85003634505&partnerID=8YFLogxK
U2 - 10.1089/bfm.2016.0069
DO - 10.1089/bfm.2016.0069
M3 - Article
C2 - 27782758
AN - SCOPUS:85003634505
SN - 1556-8253
VL - 11
SP - 504
EP - 513
JO - Breastfeeding Medicine
JF - Breastfeeding Medicine
IS - 10
ER -