Poster Session 3
Daniella Rogerson, MD, MS (she/her/hers)
Resident Physician
University of California San Diego Health
San Diego, CA, United States
Marni B. Jacobs, PhD
University of California, San Diego Health
San Diego, California, United States
Minhazur R. Sarker, MD (he/him/his)
Fellow
University of California, San Diego
San Diego, California, United States
Kim Boggess, MD (she/her/hers)
Professor
University of North Carolina at Chapel HIll
Chapel Hill, North Carolina, United States
Ashley N. Battarbee, MD, MSCR
Assistant Professor
Center for Women’s Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Gladys (Sandy) A. Ramos, MD
Attending Physician
University of California, San Diego
San Diego, California, United States
Neonatal hypoglycemia (NH) is common in pregnancies with diabetes mellitus (DM) and can lead to neonatal intensive care unit (NICU) admission, a known barrier to breastfeeding (BF). We hypothesized that BF rates are lower after NICU admission among infants with NH compared to NICU admission without NH. This study compares BF rates among gravidas with DM with neonatal NICU admission.
Study Design:
This is a secondary analysis of the MOMPOD randomized controlled trial of metformin versus placebo in insulin treated DM. Participants with live births and intention to BF were included. NH was defined as glucose < 40mg/dL or requiring IV glucose within 72 hours. A BF questionnaire was collected 30 days postpartum. Primary outcome was exclusive and partial BF among participants with neonatal NICU admission with NH versus other indications. Secondary outcomes were time and reasons for BF cessation. Characteristics were compared with Chi-square and t-tests or Wilcoxon; multivariable regression tests were performed.
Results:
Of 468 participants who completed a BF survey, 378 were included. 142 neonates were admitted to the NICU: 102 with NH and 40 without. Neonates admitted to the NICU with NH were more often born by cesarean and had higher birthweight than those without (p < 0.05, Table 1). No BF, exclusive BF, and partial BF did not differ between groups; this remained true when adjusting for birthweight and mode of delivery (aOR 0.62, 95% CI 0.25 – 1.51, aOR 2.72, 95% CI 0.54 –13.60, aOR 1.10, 95% CI 0.44 – 2.70, Table 2). Participants who stopped BF did so at an average of 2.8 weeks for both groups (p=0.91) and for similar reasons (trouble latching, pain, poor weight gain, low supply, p > 0.05, data not shown).
Conclusion:
Among pregnancies complicated by DM, NICU admission with NH did not pose additional barriers to BF compared with NICU admission in general, although analysis is limited by sample size. Future studies examining specific reasons for BF cessation pertinent to NH are needed to understand which factors affect BF in this population.
