(336) Breastfeeding Intention, Initiation, and Continuation in Pregnant Patients with Sickle Cell Disease

Mothers with sickle cell disease have more barriers that may either prevent them from breast feeding or discontinue early. The aim of this study is to compare the rates of breastfeeding intention, initiation, and discontinuation at 6 weeks in patients with sickle cell disease (SCD) versus patients without SCD.

Study Design: A retrospective matched cohort study was performed between January 1, 2018 to July 31, 2023 to examine the risk of SMM with SCD in the first year postpartum. Inclusion criteria were pregnant patients with SCD who received their prenatal and postpartum care at a single tertiary academic center. We randomly selected two non-exposed patients for every SCD patients, matched for age and year of delivery. Baseline characteristics were summarized using frequencies and percentages for categorical variables and mean and standard deviation for continuous variables overall. Chi square analysis and a two-population proportion test was used to compare breastfeeding rates between SCD and non-exposed cohorts.

Results:

We identified 25 eligible patients with SCD with singleton pregnancies who received their pregnancy and postpartum care up to one year at our institution. Baseline demographics were similar between both SCD and non-SCD groups including age, parity, and insurance. There were differences however in race and ethnicity. SCD patients were more likely to be non-Hispanic Black. Intention to breastfeed was similar in patients with SCD versus non-SCD (96% (24/25) versus 94% (47/50), P=0.9523). Similarly, breastfeeding initiation less than 7 days postpartum was 88% (22/25) in patients with SCD compared to 90% (45/50) in non-SCD patients (P=0.9045).  Only 48% (12/25) of SCD patients and 70% (35/50) of non-SCD patients continued to breast feed after 6 weeks postpartum (P=0.0629).

Conclusion:

While we did not find a difference in breastfeeding intention, initiation or discontinuation rates between mothers with sickle cell disease and those without sickle cell disease, there was a trend in discontinuation of breastfeeding at 6 weeks in SCD patients that should be explored with a larger population.