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 postpart um in 33 women with insulin-dependent diabetes mellitus (IDDM); 33 wom en without diabetes selected by using gestational age of the infant, m ethod of delivery, sex of the infant, and prior lactation experience a s a means of ensuring similar patterns in factors known to influence s uccess (control subjects); and 11 healthy reference subjects who deliv ered vaginally. Nutritionists visited the mothers on days 2, 3, 7, 14, 42, and 84 postpartum; obtained prenatal and perinatal medical inform ation; and questioned the mothers on their breast-feeding experience. Women with IDDM were able to establish lactation despite postpartum se paration from their infants, delays in the start of breast-feeding, re duced frequency of feeding, increased use of supplemental feedings, an d the high rate of cesarean section. Clinicians must recognize the nee d to provide appropriate counseling so that mothers with IDDM will not be discouraged by problems with breast-feeding.