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Farahmand M, Rahmati M, Azizi F, Ramezani Tehrani F. Lactation duration and lifetime progression to metabolic syndrome in women according to their history of gestational diabetes: a prospective longitudinal community-based cohort study. J Transl Med 2023; 21:177. [PMID: 36879241 PMCID: PMC9987076 DOI: 10.1186/s12967-023-04005-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/16/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Despite the many signs of progress in pharmacotherapies, metabolic syndrome (MetS) is one of the main public-health burdens worldwide. Our study aimed to compare the effect of breastfeeding (BF) in women with and without gestational diabetes mellitus (GDM) on MetS incidence. METHODS Of females who participated in the Tehran Lipid and glucose study, women who met our inclusion criteria were selected. The Cox proportional hazards regression model, with adjustment of potential confounders, was done to evaluate the relationship between duration of BF and incident of MetS in women with a GDM history compared to non-GDM. RESULTS Out of 1176 women, there were 1001 non-GDM and 175 GDM. The median follow-up was 16.3 (11.9, 19.3) years. Results of the adjusted model illustrated that the total BF duration was negatively associated with MetS incidence risk (hazard ratio (HR) 0.98, 95% CI 0.98-0.99) in total participants indicating that per one-month increase of BF duration, the hazard of MetS reduced by 2%. The HR of MetS in Comparison between GDM and non-GDM women demonstrated significantly more reduced MetS incidence with a longer duration of exclusive BF (HR 0.93, 95% CI 0.88-0.98). CONCLUSIONS Our findings illustrated the protective effect of BF, especially exclusive BF, on MetS incidence risk. BF is more effective in reducing the risk of MetS among women with a history of GDM than among women without such a history.
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Affiliation(s)
- Maryam Farahmand
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rahmati
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Foudil-Bey I, Murphy MSQ, Dunn S, Keely EJ, El-Chaâr D. Evaluating antenatal breastmilk expression outcomes: a scoping review. Int Breastfeed J 2021; 16:25. [PMID: 33712049 PMCID: PMC7971107 DOI: 10.1186/s13006-021-00371-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/02/2021] [Indexed: 01/19/2023] Open
Abstract
Background Antenatal breastmilk expression (aBME) is recommended by some healthcare providers to improve lactation, breastfeeding, and newborn outcomes, particularly for women with diabetes as they face unique challenges with breastfeeding. However, there is limited evidence of the potential harms and benefits of this practice. Our objective was to conduct a scoping review to map the literature describing maternal and newborn outcomes of aBME. Methods We searched Medline, Embase, CINAHL, Cochrane Database of Systematic Reviews, British Library E-Theses Online Services (EThOS) database, OpenGrey, and Clinical trials.gov from inception to January 2020. Studies in English that reported on the effect of aBME on maternal and newborn outcomes, and the experiences of women who have engaged in the practice were included for screening. Titles, abstracts, and full-text articles were screened by two independent reviewers. A critical appraisal and clinical consultation were conducted. Key findings were extracted and summarized. Results We screened 659 studies and 20 met the inclusion criteria. The majority of included studies (n = 11, 55.0%) were published after 2015, and seven (35.0%) originated from Australia. Ten (50.0%) studies provided data on high-risk obstetrical populations, including those with diabetes (n = 8), overweight or obesity (n = 1), and preeclampsia (n = 1). Commonly reported outcomes included breastfeeding status at discharge or follow-up, mode of delivery, newborn blood glucose, and time to establishing full lactation. Maternal experiences were related to challenges with aBME, confidence and mastery, perceived impact, security and altruism, learning and resources, and physical symptoms as a result of aBME. The critical appraisal demonstrated limited high-quality evidence surrounding aBME. Conclusions Our findings demonstrate increasing interest in the safety, efficacy, and acceptability of aBME. Existing studies are heterogenous with variable research questions, outcomes, study designs, and methodology. The recommendations made in this review can be used to help inform future studies evaluating aBME. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-021-00371-7.
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Affiliation(s)
- Imane Foudil-Bey
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Malia S Q Murphy
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Sandra Dunn
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Erin J Keely
- Division of Endocrinology and Metabolism, Department of Medicine, University of Ottawa, Ottawa, Canada.,Diabetes, Obesity, Metabolism and Endocrinology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Foustanellas Endocrine & Diabetes Centre, The Ottawa Hospital, Ottawa, Canada
| | - Darine El-Chaâr
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada. .,Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada. .,Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, General Campus, CPCR, Box 241, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
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Ringholm L, Stougaard EB, Nørgaard SK, Damm P, Mathiesen ER. Diabetes Management During Breastfeeding in Women with Type 1 Diabetes. Curr Diab Rep 2020; 20:34. [PMID: 32562097 DOI: 10.1007/s11892-020-01315-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW To provide an update on glycemic management of type 1 diabetes during breastfeeding with focus on diet and insulin treatment to prevent hypoglycemia, ketoacidosis, and weight retention. Recommendations for insulin pump settings are given. RECENT FINDINGS Women with type 1 diabetes are encouraged to breastfeed. Hypoglycemia is a concern in the breastfeeding period among women with type 1 diabetes, and ketoacidosis may also occur. The usual goals for glucose values for persons with diabetes also apply during breastfeeding. The recommended minimum daily carbohydrate intake is 210 g during breastfeeding, and this may contribute to prevention of hypoglycemia and ketoacidosis while aiming for gradual weight loss. Insulin requirements are 21% lower during breastfeeding than before pregnancy. Diabetes management in breastfeeding women with type 1 diabetes includes the same goals for glucose values as in other persons with diabetes, sufficient carbohydrate intake, and adequate reduction in insulin dose.
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Affiliation(s)
- Lene Ringholm
- Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
- Department of Endocrinology PE7562, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
- Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, DK-2820, Gentofte, Denmark.
| | | | - Sidse Kjærhus Nørgaard
- Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
- Department of Endocrinology PE7562, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
- Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R Mathiesen
- Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
- Department of Endocrinology PE7562, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Foudil-Bey I, Murphy MS, Keely EJ, El-Chaâr D. Maternal and newborn outcomes of antenatal breastmilk expression: a scoping review protocol. BMJ Open 2020; 10:e033101. [PMID: 32404385 PMCID: PMC7228481 DOI: 10.1136/bmjopen-2019-033101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 02/25/2020] [Accepted: 04/07/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Mothers with diabetes face unique challenges associated with breastfeeding initiation and maintenance. Antenatal breastmilk expression (BME) may be suggested to mothers, including mothers with diabetes, to improve breastfeeding, maternal, and infant outcomes postpartum. However, there have been few evaluations of the potential harms and benefits of this practice. The objective of our scoping review will be to broadly examine the literature describing maternal and infant outcomes of antenatal BME. METHODS AND ANALYSIS This scoping review will address the research question: 'Among women who engaged in antenatal BME, what maternal and infant outcomes have been evaluated?' A search of published and unpublished studies available in English will be conducted in February 2020 using the following databases: Medline (OVID), Embase (OVID), CINAHL (EBSCOHost), and Cochrane Database of Systematic Reviews (OVID). A search of the British Library E-Theses Online Services (EThOS) database and OpenGrey will be conducted to identify relevant grey literature. This scoping review will use a five-step framework to guide the selection, extraction, and analysis of eligible studies. Clinical consultation will be included as a sixth step to our methodology. Literature reporting on the effect of antenatal BME on maternal and infant outcomes, breastfeeding initiation and duration, and the experiences of women who have engaged in the practice will be considered. The data will be summarised with attention paid to high-risk obstetrical populations such as women with diabetes. Our results will be reported as outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. ETHICS AND DISSEMINATION Research ethics board approval will not be required due to the nature of the study's methodology. The results of this review will be disseminated through peer-reviewed publication and presentation at relevant conferences. TRAIL REGISTRATION NUMBER Open Science Framework (osf.io/gfp2q).
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Affiliation(s)
- Imane Foudil-Bey
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Malia Sq Murphy
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Erin J Keely
- Department of Obstetrics, Gynecology and Newborn Care, University of Ottawa, Ottawa, Ontario, Canada
- Division of Endocrinology and Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Darine El-Chaâr
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Obstetrics, Gynecology and Newborn Care, University of Ottawa, Ottawa, Ontario, Canada
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5
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Factors associated with breastfeeding to 3 months postpartum among women with type 1 and type 2 diabetes mellitus: An exploratory study. Women Birth 2020; 33:e274-e279. [DOI: 10.1016/j.wombi.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 06/08/2019] [Accepted: 06/08/2019] [Indexed: 11/20/2022]
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Weinel H, Cusack L. Lessons Learned From the Introduction of an Antenatal Human Milk Expression Clinic for Women With Diabetes. J Hum Lact 2019; 35:725-728. [PMID: 30920894 DOI: 10.1177/0890334419836981] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Helen Weinel
- Northern Adelaide Local Health Network SA Health, Lyell McEwin Hospital, South Australia
| | - Lynette Cusack
- The University of Adelaide, Faculty of Health and Medical Sciences, North Terrace Adelaide, South Australia
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Rasmussen B, Nankervis A, Skouteris H, McNamara C, Nagle C, Steele C, Bruce L, Holton S, Wynter K. Psychosocial wellbeing among new mothers with diabetes: Exploratory analysis of the postnatal wellbeing in transition questionnaire. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 22:100457. [PMID: 31442748 DOI: 10.1016/j.srhc.2019.100457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/14/2019] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The Postnatal Wellbeing in Transition (PostTrans) Questionnaire assesses psychosocial wellbeing among women transitioning to motherhood while managing pre-existing diabetes. Face and content validity have been previously reported; however the PostTrans questionnaire has 51 items which imposes a substantial burden on respondents. The aim of this study was exploratory analysis of the PostTrans questionnaire to investigate whether a reduction in the number of items was statistically supported, and whether clinically meaningful subscales could be derived. METHODS A prospective cohort of women with type 1 or type 2 diabetes was recruited from three metropolitan hospitals in Melbourne, Australia. Women completed surveys across three postnatal time points. Data were pooled for the analysis. Suitability for factor analysis was confirmed and exploratory Principal Components Analysis with oblique rotation was conducted. RESULTS The number of responses in the pooled dataset was 117. The reduced PostTrans scale has 27 items and six factors, which together explain 68.7% of the variance. The subscales assess: feeling as if one is coping with diabetes and the infant; feeling anxious and guilty about diabetes; feeling supported by family; sensitivity to the opinions of others; prioritising self-care; and health professional support. CONCLUSION The number of items in the PostTrans Questionnaire was reduced from 51 to 27 items. Six meaningful subscales emerged, which can help health professionals identify and address areas in which women with diabetes are experiencing psychosocial difficulties. The revised scale provides a feasible instrument to be tested for psychometric properties in a larger sample.
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Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Australia; Centre for Quality and Patient Safety Research - Western Health Partnership, Sunshine Hospital, Furlong Road, St Albans 3021, Victoria, Australia.
| | - Alison Nankervis
- Departments of Diabetes and Endocrinology, Royal Melbourne and Women's Hospitals, Melbourne 3050, Victoria, Australia.
| | - Helen Skouteris
- Monash Centre for Health Research & Implementation, Faculty of Medicine, Nursing and Health Sciences, School of Public Health & Preventive Medicine, Level 1, 43-51 Kanooka Grove, Clayton, Locked Bag 29, Clayton 3168, Victoria, Australia.
| | - Catharine McNamara
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Australia; Diabetes Education, Mercy Hospital for Women, 163 Studley Road, Heidelberg 3084, Victoria, Australia.
| | - Cate Nagle
- Centre for Nursing and Midwifery Research, James Cook University, 1 James Cook Drive, Townsville 4811, Queensland, Australia; Townsville Hospital and Health Service, 100 Angus Drive, Townsville 4811, Queensland, Australia.
| | - Cheryl Steele
- Diabetes Education Services, Sunshine Hospital, Furlong Road, St Albans 3021, Victoria, Australia.
| | - Lauren Bruce
- Monash Centre for Health Research & Implementation, Faculty of Medicine, Nursing and Health Sciences, School of Public Health & Preventive Medicine, Level 1, 43-51 Kanooka Grove, Clayton, Locked Bag 29, Clayton 3168, Victoria, Australia.
| | - Sara Holton
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Australia; Centre for Quality and Patient Safety Research - Western Health Partnership, Sunshine Hospital, Furlong Road, St Albans 3021, Victoria, Australia.
| | - Karen Wynter
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Australia; Centre for Quality and Patient Safety Research - Western Health Partnership, Sunshine Hospital, Furlong Road, St Albans 3021, Victoria, Australia.
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8
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Nguyen PTH, Pham NM, Chu KT, Van Duong D, Van Do D. Gestational Diabetes and Breastfeeding Outcomes: A Systematic Review. Asia Pac J Public Health 2019; 31:183-198. [DOI: 10.1177/1010539519833497] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Studies of gestational diabetes mellitus in relation to breastfeeding are limited, while their findings are inconsistent. This systematic review was conducted to assess the associations between gestational diabetes and breastfeeding outcomes. An initial search of PubMed, Web of Science, and ProQuest identified 518 studies, and after applying the inclusion criteria, 16 studies were finally included in the review. Four studies reported that “exclusive/predominant/full breastfeeding” rates at discharge were lower in mothers with gestational diabetes than in those without gestational diabetes, and 2 studies showed a shorter duration of “exclusive/predominant breastfeeding” in the former than in the latter. However, most studies found no apparent difference in the rate of “breastfeeding initiation”, “any breastfeeding” duration, or “any breastfeeding” in hospital and at discharge between mothers with and without gestational diabetes. In summary, mothers with gestational diabetes were less likely to exclusively breastfeed their infants and may have a shorter breastfeeding duration than other mothers.
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Affiliation(s)
| | - Ngoc Minh Pham
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Khac Tan Chu
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | | | - Dung Van Do
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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9
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Cordero L, Stenger MR, Landon MB, Nankervis CA. In-hospital formula supplementation and breastfeeding initiation in infants born to women with pregestational diabetes mellitus. J Neonatal Perinatal Med 2019; 12:285-293. [PMID: 30932901 DOI: 10.3233/npm-180140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To ascertain the rate of in-hospital supplementation as it relates to early breastfeeding (BF) and early formula feeding (FF) and its effects on BF (exclusive and partial) at the time of discharge for infants born to women with pregestational diabetes mellitus (PGDM). METHODS Retrospective cohort investigation of 282 women with PGDM who intended to BF and their asymptomatic infants admitted to the newborn nursery for blood glucose monitoring and routine care. Early feeding was defined by the initial feeding if given within four hours of birth. RESULTS Of the 282 mother-infant dyads, for 134 (48%) early feeding was BF and for 148 (52%) early feeding was FF. Times from birth to BF and FF (median 1 hr, 0.3-6) were similar, while the time to first BF for those who FF and supplemented was longer (median 6 hr., 1-24). Ninety-seven infants (72%) who first BF also supplemented. Of these, 22 (23%) BF exclusively, 67 (69%) BF partially and 8 (8%) FF at discharge. One hundred seventeen (79%) who first FF also supplemented. Of these, 21 (18%) BF exclusively, 76 (65%) BF partially and 20 (17%) FF at discharge. CONCLUSION Regardless of the type of first feeding, the majority of infants born to women with PGDM require supplementation. Even when medically indicated, in-hospital supplementation is an obstacle, albeit not absolute, to exclusive BF at discharge. Parents should be reminded that occasional supplementation should not deter resumption and continuation of BF.
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Affiliation(s)
- L Cordero
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - M R Stenger
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - M B Landon
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - C A Nankervis
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
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Carlsson IM, Berg M, Adolfsson A, Sparud-Lundin C. Reprioritizing life: a conceptual model of how women with type 1 diabetes deal with main concerns in early motherhood. Int J Qual Stud Health Well-being 2018; 12:1394147. [PMID: 29092688 PMCID: PMC5678444 DOI: 10.1080/17482631.2017.1394147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: Becoming a mother is related to increased demands for women with type 1 diabetes mellitus, and more research is needed to identify their needs for support in everyday living. Thus, the aim of this study was to explore the main concerns in daily life in early motherhood for women with type 1 diabetes and how they deal with these concerns. Method: A grounded theory study was conducted in which 14 women with type 1 diabetes were interviewed individually 7 to 17 months after childbirth. Results: A conceptual model was identified with the core category “reprioritizing life”, and three related categories: adjusting to motherhood, taking command of the diabetes, and seeking like-minded women. Becoming a mother was a turning point towards a greater awareness and acceptance of prioritizing diabetes management and health, and thus, life. There was a gap in provision of diabetes care after birth and during the time of early motherhood compared with during pregnancy. Conclusions: Healthcare contacts already planned before delivery can promote person-centred care during the whole period from pregnancy to motherhood. Moreover, providing alternative sources for health information and peer support could improve the life situation during early motherhood.
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Affiliation(s)
- Ing-Marie Carlsson
- a School of Health and Welfare, Department of Health and Nursing , Halmstad University , Halmstad , Sweden
| | - Marie Berg
- b Centre for Person-Centered Care (GPCC) , Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.,c Department of Obstetrics and Gynecology , Sahlgrenska University Hospital , Gothenburg , Sweden
| | | | - Carina Sparud-Lundin
- b Centre for Person-Centered Care (GPCC) , Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
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Well-being, diabetes management and breastfeeding in mothers with type 1 diabetes – An explorative analysis. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 15:77-82. [DOI: 10.1016/j.srhc.2017.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/06/2017] [Accepted: 12/15/2017] [Indexed: 11/22/2022]
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Cordero L, Stenger MR, Landon MB, Nankervis CA. Early feeding, hypoglycemia and breastfeeding initiation in infants born to women with pregestational diabetes mellitus. J Neonatal Perinatal Med 2018; 11:357-364. [PMID: 30149473 DOI: 10.3233/npm-17145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine the effects of early breastfeeding (eBF) or early formula feeding (eFF) on hypoglycemia and on BF initiation in infants born to women with pregestational diabetes mellitus (PGDM) who intended to BF. METHODS Retrospective cohort investigation of 554 women with PGDM and their infants (IDMs) who delivered during 2008-2016. The first feeding (BF or FF) was considered early if given within 4 hours from birth. RESULTS 282 (51%) IDMs were admitted to the Well Baby Nursery. Of the 134 IDMs whose early feeding was BF, hypoglycemia affected 30% which was corrected with oral feedings in 78% of the cases. At discharge, 49% BF exclusively while 45% BF partially. Of the 148 IDMs whose early feeding was FF, hypoglycemia affected 40% which was corrected with oral feedings in 69% of the cases. At discharge, 14% BF exclusively while 48% BF partially. There were 272 (49%) IDMs admitted to the NICU. Their early feeding was BF (14%) and FF (86%). Hypoglycemia developed in 50% and 43% of these groups, respectively. Benefits of early feedings on hypoglycemia were masked by the routine use of IV dextrose infusions. At discharge, early BF led to exclusive BF in 45% and partial BF in 50% of the cases. Early FF led to exclusive BF in 17% and partial BF in 42% of the cases. CONCLUSIONS Early and continued feeding (BF preferably or FF if BF is not feasible) should be the first line of treatment for hypoglycemia. Early BF is paramount for BF initiation. Early FF is an obstacle, albeit not absolute, to BF initiation, thus it should not deter continued efforts to start or resume BF.
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Affiliation(s)
- L Cordero
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - M R Stenger
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - M B Landon
- Department of Obstetrics & Gynecology, The Ohio State University, Columbus, OH, USA
| | - C A Nankervis
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
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Tanase‐Nakao K, Arata N, Kawasaki M, Yasuhi I, Sone H, Mori R, Ota E. Potential protective effect of lactation against incidence of type 2 diabetes mellitus in women with previous gestational diabetes mellitus: A systematic review and meta-analysis. Diabetes Metab Res Rev 2017; 33:e2875. [PMID: 28072911 PMCID: PMC5434910 DOI: 10.1002/dmrr.2875] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/06/2016] [Accepted: 12/09/2016] [Indexed: 12/16/2022]
Abstract
Lactation may protect women with previous gestational diabetes mellitus (GDM) from developing type 2 diabetes mellitus, but the results of existing studies are inconsistent, ranging from null to beneficial. We aimed to conduct a systematic review to gather available evidence. Databases MEDLINE, CINAHL, PubMed, and EMBASE were searched on December 15, 2015, without restriction of language or publication year. A manual search was also conducted. We included observational studies (cross-sectional, case-control, and cohort study) with information on lactation and type 2 diabetes mellitus incidence among women with previous GDM. We excluded case studies without control data. Data synthesis was conducted by random-effect meta-analysis. Fourteen reports of 9 studies were included. Overall risk of bias using RoBANS ranged from low to unclear. Longer lactation for more than 4 to 12 weeks postpartum had risk reduction of type 2 diabetes mellitus compared with shorter lactation (OR 0.77, 95% CI 0.01-55.86; OR 0.56, 95% CI 0.35-0.89; OR 0.22, 95% CI 0.13-0.36; type 2 diabetes mellitus evaluation time < 2 y, 2-5 y, and >5 y, respectively). Exclusive lactation for more than 6 to 9 weeks postpartum also had lower risk of type 2 diabetes mellitus compared with exclusive formula (OR 0.42, 95% CI 0.22-0.81). The findings support the evidence that longer and exclusive lactation may be beneficial for type 2 diabetes mellitus prevention in women with previous GDM. However, the evidence relies only on observational studies. Therefore, further studies are required to address the true causal effect.
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Affiliation(s)
- Kanako Tanase‐Nakao
- Division of Maternal Medicine, Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Maki Kawasaki
- Department of Health PolicyNational Center for Child Health and DevelopmentTokyoJapan
| | - Ichiro Yasuhi
- Department of Obstetrics and GynecologyNational Hospital Organization Nagasaki Medical CenterNagasakiJapan
| | - Hirohito Sone
- Department of Hematology, Endocrinology and MetabolismNiigata University Faculty of MedicineNiigataJapan
| | - Rintaro Mori
- Department of Health PolicyNational Center for Child Health and DevelopmentTokyoJapan
| | - Erika Ota
- Department of Health PolicyNational Center for Child Health and DevelopmentTokyoJapan
- Department of Global Health Nursing, Graduate School of Nursing SciencesSt. Luke's International UniversityTokyoJapan
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