Impact of breastfeeding on risk of glucose intolerance in early postpartum after gestational diabetes

Front Endocrinol (Lausanne). 2024 Jun 12:15:1374682. doi: 10.3389/fendo.2024.1374682. eCollection 2024.

Abstract

Aims: To determine the impact of breastfeeding on the risk of postpartum glucose intolerance in women with gestational diabetes.

Methods: Sub-analysis of two multi-centric prospective cohort studies (BEDIP-N and MELINDA) in 1008 women with gestational diabetes. Data were collected during pregnancy and at a mean of 12 weeks postpartum. Multivariate logistic regression was used to estimate the effect of breastfeeding on glucose intolerance, with adjustment for ethnicity, education, income, professional activity and BMI.

Results: Of all participants, 56.3% (567) breastfed exclusively, 10.1% (102) gave mixed milk feeding and 33.6% (339) did not breastfeed. Mean breastfeeding duration was 3.8 ± 2.4 and 3.7 ± 2.1 months in the breastfeeding and mixed milk feeding groups (p=0.496). The rate of glucose intolerance was lower in both the breastfeeding [22.3% (126)] and mixed milk feeding [25.5% (26)] groups compared to the no breastfeeding group [29.5% (100)], with an adjusted OR of 0.7 (95% CI 0.5-1.0) for glucose intolerance in the breastfeeding group compared to no breastfeeding group and an adjusted OR of 0.7 (95% CI 0.4-1.2) for the mixed milk feeding group compared to the no breastfeeding group. Postpartum, breastfeeding women had a lower BMI, less often postpartum weight retention, lower fasting triglycerides, less insulin resistance and a higher insulin secretion-sensitivity index-2 than the mixed milk feeding and no breastfeeding group. The mixed milk feeding group was more often from an non-White background, had a lower blood pressure and lower fasting triglycerides compared to the no breastfeeding group.

Conclusions: Breastfeeding (exclusive and mixed milk feeding) is associated with less glucose intolerance and a better metabolic profile in early postpartum in women with gestational diabetes.

Keywords: breastfeeding; gestational diabetes mellitus; impaired beta-cell function; insulin resistance; mixed milk feeding; postpartum glucose intolerance.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Breast Feeding*
  • Diabetes, Gestational*
  • Female
  • Glucose Intolerance* / epidemiology
  • Glucose Intolerance* / etiology
  • Humans
  • Postpartum Period*
  • Pregnancy
  • Prospective Studies
  • Risk Factors

Substances

  • Blood Glucose

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The author(s) declare that the BEDIP-N study received funding from Belgian National Lottery, the Fund of the Academic studies of UZ Leuven, and the Fund Yvonne and Jacques François-de Meurs of the King Boudewijn Foundation. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication. The author(s) declare that the MELINDA study received funding from research fund of UZ Leuven and by an unrestricted grant of Novo Nordisk. The following companies provided limited research grants: Sanofi, AstraZeneca, Boehringer-Ingelheim and Lilly. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.