A systematic review of breastfeeding prevalence, duration and determining factors in women with type 1 and type 2 diabetes mellitus.
Fiona L Britten, Emma Shipton, Madeline Duke et al.
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In 30 seconds
This systematic review examined breastfeeding prevalence, duration and associated factors among women with pregestational type 1 or type 2 diabetes. Women with type 1 diabetes had lower breastfeeding prevalence and shorter duration than normoglycaemic women, while evidence for type 2 diabetes was insufficient to draw conclusions. Factors associated with reduced prevalence or duration included higher body mass index, lower maternal education and less frequent early breastfeeding. Only two studies identified an independent association with diabetes, and none controlled for all likely confounders.
Key findings
- Women with type 1 diabetes had lower breastfeeding prevalence and shorter duration than normoglycaemic women.
- Evidence was insufficient to determine breastfeeding prevalence or duration in women with type 2 diabetes.
- Higher body mass index, lower maternal education and less frequent early breastfeeding were associated with reduced prevalence or duration.
- Only two studies found an independent association with diabetes; no studies controlled for all likely confounders.
Why it matters
Breastfeeding patterns in pregestational diabetes remain incompletely characterised, particularly for type 2 diabetes. The review identifies potentially relevant maternal and early feeding factors, but confounding limits conclusions about diabetes itself. Better evidence on prevalence and associated factors could inform the development of support strategies, given the metabolic benefits of lactation noted by the authors.
What to keep in mind
The underlying studies did not control for all likely confounders, and evidence for type 2 diabetes was insufficient.