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Am J Perinatol 2024; 41(16): 2243-2251
DOI: 10.1055/s-0044-1786546
Original Article

Antenatal Breast Milk Expression Survey of Individuals Whose Pregnancy Was Complicated by Diabetes: Exploring Knowledge, Perceptions, Experiences, and Milk Volume Expressed

Sarah Mess
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin
,
Anna Palatnik 
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin
,
Erwin Cabacungan
2   Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
› Author Affiliations Funding This work was supported partially by 1R01HD108194 (PI: A.P.).
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Abstract

Objective Antenatal breast milk expression (ABE) offers a host of benefits, including reduced formula consumption, support for breastfeeding success, and increased maternal satisfaction. Despite these advantages, experience with ABE differs significantly, often leading to anxiety over perceived inadequate milk supply and eventual breastfeeding cessation. This study comprehensively evaluates the knowledge, attitudes, and real-world experiences of individuals with gestational or pregestational diabetes concerning ABE, with a focus on total milk volume expressed prior to birth.

Study Design Utilizing a convenience sampling method, we surveyed individuals with gestational or pregestational diabetes from three health care facilities who were trained in ABE. Knowledge and perceptions were gauged through presurvey statements, while postsurvey statements were employed to measure experiences, both using a 5-point Likert scale. In parallel, a retrospective study assessed both maternal and infant outcomes among the same participant pool. Statistical comparisons between individuals with and without reservations were made using the Wilcoxon signed rank sum, Mann–Whitney, chi-square, and Fisher's exact tests.

Results Of the 138 participants, 75% completed both survey segments, and 61% expressed reservations about ABE. Both groups were demographically similar and showed comparable newborn outcomes. However, individuals with reservations experienced heightened pain during ABE, reported lesser lactation support, and were less willing to repeat the process compared to those individuals without reservations. The median total ABE volume was significantly lower by 14 mL among those with reservations (7 vs. 21 mL, p = 0.009). Although both groups demonstrated improved attitudes toward the utility of ABE for individuals with gestational or pregestational diabetes, no significant shift occurred in the perception of ABE difficulty.

Conclusion Our results indicate that individuals with gestational or pregestational diabetes who have reservations about ABE face unique challenges and tend to express lower milk volumes. This underlines the need for specialized interventions and ongoing research to address antenatal lactation support and alleviate ABE-related concerns among individuals with gestational or pregestational diabetes.

Key Points

  • Reservations of ABE were associated with reduced milk volumes.

  • Regardless of reservations, ABE was felt to be beneficial.

  • Our results underscore the need for more ABE education for those with reservations.

Keywords

antenatal breast milk expression - diabetic individuals - milk volumes - colostrum

Note

The findings of this study were presented in part during the 53rd Annual Wisconsin Association of Perinatal Care Conference in Lake Elkhart, WI on October 10'th, 2023.


Authors' Contributions

Each author has indicated that they have met the journal's requirements for authorship.


Supplementary Material



Publication History

Received: 01 March 2024

Accepted: 05 April 2024

Article published online:
09 May 2024

© 2024. Thieme. All rights reserved.

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