Perinatal lactation protocol and outcome in mothers with and without insulin-dependent diabetes mellitus.

This study compared the course of lactation from days 2 to 84 postpartum in 33 women with insulin-dependent diabetes mellitus (IDDM); 33 women without diabetes selected by using gestational age of the infant, method of delivery, sex of the infant, and prior lactation experience as a means of ensuring similar patterns in factors known to influence success (control subjects); and 11 healthy reference subjects who delivered vaginally. Nutritionists visited the mothers on days 2, 3, 7, 14, 42, and 84 postpartum; obtained prenatal and perinatal medical information; and questioned the mothers on their breast-feeding experience. Women with IDDM were able to establish lactation despite postpartum separation from their infants, delays in the start of breast-feeding, reduced frequency of feeding, increased use of supplemental feedings, and the high rate of cesarean section. Clinicians must recognize the need to provide appropriate counseling so that mothers with IDDM will not be discouraged by problems with breast-feeding.