Sheffield Hallam University, 32 Collegiate Crescent, Sheffield, UK.
Int Breastfeed J. 2012 Dec 1;7(1):18. doi: 10.1186/1746-4358-7-18.
Women with diabetes are sometimes advised to express breast milk antenatally to prepare for breastfeeding and to store colostrum for infant feeding in preventing or treating hypoglycaemia after the birth. The acceptability, risks and benefits of this practice have not been evaluated. This was aimed to investigate the pattern of antenatal breast expression uptake and its relationship with birth outcomes in women with diabetes.
This was part of a two year retrospective cohort study of pregnant women with diabetes (type 1, 2 and gestational diabetes) who gave birth during 2001-2003 in Derby Hospitals NHS Foundation Trust (n = 94). The information on the practice of antenatal breastfeeding expression and birth outcomes was collected via self-administered questionnaires and by examining maternity records.
Thirty-seven percent of women (35/94) recalled that they were advised to express antenatally and 17% did (16/94). The mean gestational age at birth for women who hand-expressed was lower than that for those who did not (mean difference (MD) (95% confidence intervals (CI)): -1.2 (-2.4 to 0.04), p = 0.06). A higher proportion of babies from the antenatal expression group were admitted to special care baby units (SCBU) (MD (95% CI): 21% (-3.9 to 46.3).
Less than half the women who stated that they were advised to express, did so. There seems to be an indication that antenatal breast milk expression and lower gestational age at birth are associated. The trend of a higher rate of SCBU admission for babies from the breast milk expression group compared to those who did not express antenatally is of concern. An appropriately-powered randomised controlled trial is needed to determine the safety of this practice and its acceptability to women and health professionals before it can be recommended for implementation in practice.
对于糖尿病女性，有时建议其在产前挤出母乳，为母乳喂养做准备，并储存初乳以备婴儿出生后低血糖时使用。但这种做法的可接受性、风险和益处尚未得到评估。本研究旨在调查糖尿病女性产前挤奶的情况及其与分娩结局的关系。
这是一项为期两年的回顾性队列研究的一部分，研究对象为 2001-2003 年在德比医院 NHS 基金会信托（n = 94）分娩的糖尿病女性（1 型、2 型和妊娠期糖尿病）。通过自我管理问卷和检查产妇记录收集产前母乳喂养挤出和分娩结局的信息。
37%（35/94）的女性回忆说曾被建议产前挤奶，17%（16/94）的女性实际进行了挤奶。手挤奶女性的出生孕周比未手挤奶女性低（平均差异（MD）（95%置信区间（CI））：-1.2（-2.4 至 0.04），p = 0.06）。来自产前挤奶组的婴儿有更高比例被送入新生儿特别护理病房（SCBU）（MD（95% CI）：21%（-3.9 至 46.3）。
不到一半的报告称曾被建议挤奶的女性进行了挤奶。似乎有迹象表明，产前母乳挤出和较低的出生孕周之间存在关联。与未产前挤奶的婴儿相比，来自母乳挤出组的婴儿更有可能被送入新生儿特别护理病房，这一趋势令人担忧。需要一项有足够样本量的随机对照试验来确定这种做法的安全性及其对女性和卫生专业人员的可接受性，然后才能推荐在实践中实施。
