Production of breast milk in pregnant women with and without Gestational Diabetes Mellitus

Authors

DOI:

https://doi.org/10.31101/jkk.3158

Keywords:

gestational diabetes mellitus; GDM; pregnant women; breast milk production

Abstract

Gestational diabetes mellitus (GDM) is a health disorder associated with an increased risk of type 2 diabetes mellitus in both mother and baby. Breastfeeding is one way for mothers to reduce this risk. This study aims to determine breast milk production in GDM and non-GDM pregnant women. The research design was a prospective cohort and involved 12 pregnant women. The inclusion criteria were GDM and non-GDM pregnant women aged 28-31 weeks and willing to be respondents. The Jakarta Regional Hospital research used questionnaire instruments and breast milk production observation sheets. Chi-square statistical test analysis. The research results showed a significant relationship between the status of GDM and non-GDM pregnant women and breast milk production (P value 0.05). The maximum breast milk production of GDM pregnant women is less than non-GDM, with maximum breast milk production of 0.3cc and 0.5cc. GDM pregnant women produce lower breast milk production than non-GDM pregnant women. Breast milk production in pregnant women with GDM is slower than in pregnant women without GDM. This can be seen from the research results, which show that 58.3% of non-GDM pregnant women have expressed breast milk (on average starting at 17 weeks of gestation). Of pregnant women with GDM, only 8.3% have ever expressed breast milk (starting from the 31st week). Education on breastfeeding during pregnancy and maternal nutrition is necessary to increase maternal self-efficacy. Researchers hope to observe long-term breastfeeding expenditure from pregnancy to six months or even two years. 

Author Biography

Suryani Manurung, Poltekkes Jakarta 1

Departement of Nursing

References

ACOG. (2018). ACOG Practice Bulletin No. 190: Gestational Diabetes Mellitus. Obstetrics and Gynecology, 131(2), e49–e64. https://doi.org/10.1097/AOG.0000000000002501

Avellar, A. C. de S., Oliveira, M. N., Caixeta, F., Souza, R. C. V. E., Teixeira, A., Faria, A. M. C., Silveira-Nunes, G., Faria, E. S., & Maioli, T. U. (2022). Gestational diabetes mellitus changes human colostrum immune composition. Frontiers in Immunology, 13(June), 910807. https://doi.org/10.3389/fimmu.2022.910807

Azami, M., Badfar, G., Soleymani, A., & Rahmati, S. (2019). The association between gestational diabetes and postpartum depression: A systematic review and meta-analysis. Diabetes Research and Clinical Practice, 149, 147–155. https://doi.org/10.1016/j.diabres.2019.01.034

Bærug, A., Sletner, L., Laake, P., Fretheim, A., Løland, B. F., Waage, C. W., Birkeland, K. I., & Jenum, A. K. (2018). Recent gestational diabetes was associated with mothers stopping predominant breastfeeding earlier in a multi-ethnic population. Acta Paediatrica, 107(6), 1028–1035. https://doi.org/10.1111/apa.14274

Bjerregaard, L. G., Pedersen, D. C., Mortensen, E. L., Sørensen, T. I. A., & Baker, J. L. (2019). Breastfeeding duration in infancy and adult risks of type 2 diabetes in a high‐income country. Maternal & Child Nutrition, 15(4), e12869. https://doi.org/10.1111/mcn.12869

Boriboonhirunsarn, D., & Waiyanikorn, R. (2016). Emergency cesarean section rate between women with gestational diabetes and normal pregnant women. Taiwanese Journal of Obstetrics and Gynecology, 55(1), 64–67. https://doi.org/10.1016/j.tjog.2015.08.024

Capobianco, G., Gulotta, A., Tupponi, G., Dessole, F., Pola, M., Virdis, G., Petrillo, M., Mais, V., Olzai, G., Antonucci, R., Saderi, L., Cherchi, P. L., Dessole, S., & Sotgiu, G. (2020). Materno-Fetal and Neonatal Complications of Diabetes in Pregnancy: A Retrospective Study. Journal of Clinical Medicine, 9(9), 2707. https://doi.org/10.3390/jcm9092707

Catov, J. M., Sun, B., Bertolet, M., Snyder, G. G., Lewis, C. E., Allen, N. B., Shikany, J. M., Ingram, K. H., Appiah, D., & Gunderson, E. P. (2020). Changes in Cardiometabolic Risk Factors Before and After Gestational Diabetes: A Prospective Life-Course Analysis in CARDIA Women. Obesity (Silver Spring, Md.), 28(8), 1397–1404. https://doi.org/10.1002/oby.22848

Chamberlain, C. R., Wilson, A. N., Amir, L. H., O’Dea, K., Campbell, S., Leonard, D., Ritte, R., Mulcahy, M., Eades, S., & Wolfe, R. (2017). Low rates of predominant breastfeeding in hospital after gestational diabetes, particularly among Indigenous women in Australia. Australian and New Zealand Journal of Public Health, 41(2), 144–150. https://doi.org/10.1111/1753-6405.12629

Cho, N. H., Ahn, C. H., Moon, J. H., Kwak, S. H., Choi, S. H., Lim, S., Park, K. S., Metzger, B. E., & Jang, H. C. (2016). Metabolic syndrome independently predicts future diabetes in women with a history of gestational diabetes mellitus. Medicine, 95(35), e4582. https://doi.org/10.1097/MD.0000000000004582

Choudhury, A. A., & Devi Rajeswari, V. (2021). Gestational diabetes mellitus—A metabolic and reproductive disorder. Biomedicine & Pharmacotherapy, 143, 112183. https://doi.org/10.1016/j.biopha.2021.112183

Delanerolle, G., Phiri, P., Zeng, Y., Marston, K., Tempest, N., Busuulwa, P., Shetty, A., Goodison, W., Muniraman, H., Duffy, G., Elliot, K., Maclean, A., Majumder, K., Hirsch, M., Rathod, S., Raymont, V., Shi, J. Q., & Hapangama, D. K. (2021). A systematic review and meta-analysis of gestational diabetes mellitus and mental health among BAME populations. EClinicalMedicine, p. 38. https://doi.org/10.1016/j.eclinm.2021.101016

Doughty, K. N., & Taylor, S. N. (2021). Barriers and benefits to breastfeeding with gestational diabetes. Seminars in Perinatology, 45(2), 151385. https://doi.org/10.1016/j.semperi.2020.151385

Eades, C. E., Styles, M., Leese, G. P., Cheyne, H., & Evans, J. M. (2015). Progression from gestational diabetes to type 2 diabetes in one region of Scotland: An observational follow-up study. BMC Pregnancy and Childbirth, pp. 15, 11. https://doi.org/10.1186/s12884-015-0457-8

Franzago, M., Fraticelli, F., Stuppia, L., & Vitacolonna, E. (2019). Nutrigenetics, epigenetics and gestational diabetes: Consequences in mother and child. Epigenetics, 14(3), 215–235. https://doi.org/10.1080/15592294.2019.1582277

Golan, Y., & Assaraf, Y. G. (2020). Genetic and Physiological Factors Affecting Human Milk Production and Composition. Nutrients, 12(5), 1500. https://doi.org/10.3390/nu12051500

Greco, E., Calanducci, M., Nicolaides, K. H., Barry, E. V. H., Huda, M. S. B., & Iliodromiti, S. (2023). Gestational diabetes mellitus and adverse maternal and perinatal outcomes in twin and singleton pregnancies: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2023.08.011

Gunderson, E. P., Lewis, C. E., Lin, Y., Sorel, M., Gross, M., Sidney, S., Jacobs, D. R., Jr, Shikany, J. M., & Quesenberry, C. P., Jr. (2018). Lactation Duration and Progression to Diabetes in Women Across the Childbearing Years: The 30-Year CARDIA Study. JAMA Internal Medicine, 178(3), 328–337. https://doi.org/10.1001/jamainternmed.2017.7978

Haile, Z. T., Oza-Frank, R., Azulay Chertok, I. R., & Passen, N. (2016). Association between History of Gestational Diabetes and Exclusive Breastfeeding at Hospital Discharge. Journal of Human Lactation, 32(3), NP36–NP43. https://doi.org/10.1177/0890334415618936

Jirakittidul, P., Panichyawat, N., Chotrungrote, B., & Mala, A. (2019). Prevalence and associated factors of breastfeeding in women with gestational diabetes in a University Hospital in Thailand. International Breastfeeding Journal, 14(1), 34. https://doi.org/10.1186/s13006-019-0227-8

Juan, J., & Yang, H. (2020). Prevalence, prevention, and lifestyle intervention of gestational giabetes mellitus in China. Multidisciplinary Digital Publishing Institute (MDPI), 17(25), 45. https://doi.org/10.3390/ijerph17249517

Kramer, C. K., Campbell, S., & Retnakaran, R. (2019). Gestational diabetes and the risk of cardiovascular disease in women: A systematic review and meta-analysis. Diabetologia, 62(6), 905–914. https://doi.org/10.1007/s00125-019-4840-2

Kumari, R., Dalal, V., Kachhawa, G., Sahoo, I., Khadgawat, R., Mahey, R., Kulshrestha, V., Vanamail, P., Sharma, J. B., Bhatla, N., & Kriplani, A. (2018). Maternal and Perinatal Outcome in Gestational Diabetes Mellitus in a Tertiary Care Hospital in Delhi. Indian Journal of Endocrinology and Metabolism, 22(1), 116–120. https://doi.org/10.4103/ijem.IJEM_582_17

Lee, K. W., Loh, H. C., Chong, S. C., Ching, S. M., Devaraj, N. K., Tusimin, M., Hamid, H. A., & Hoo, F. K. (2020). Prevalence of anxiety among gestational diabetes mellitus patients: A systematic review and meta-analysis. World Journal of Meta-Analysis, 8(3), 275–284. https://doi.org/10.13105/wjma.v8.i3.275

Lee, S. M., Shivakumar, M., Park, J. W., Jung, Y. M., Choe, E. K., Kwak, S. H., Oh, S., Park, J. S., Jun, J. K., Kim, D., & Yun, J.-S. (2022). Long-term cardiovascular outcomes of gestational diabetes mellitus: A prospective UK Biobank study. Cardiovascular Diabetology, 21(1), 221. https://doi.org/10.1186/s12933-022-01663-w

Leng, J., Shao, P., Zhang, C., Tian, H., Zhang, F., Zhang, S., Dong, L., Li, L., Yu, Z., Chan, J. C. N., Hu, G., & Yang, X. (2015). Prevalence of Gestational Diabetes Mellitus and Its Risk Factors in Chinese Pregnant Women: A Prospective Population-Based Study in Tianjin, China. PLOS ONE, 10(3), e0121029. https://doi.org/10.1371/journal.pone.0121029

Li, G., Wei, T., Ni, W., Zhang, A., Zhang, J., Xing, Y., & Xing, Q. (2020). Incidence and Risk Factors of Gestational Diabetes Mellitus: A Prospective Cohort Study in Qingdao, China. Frontiers in Endocrinology, 11. https://www.frontiersin.org/articles/10.3389/fendo.2020.00636

Li, Y., Ren, X., He, L., Li, J., Zhang, S., & Chen, W. (2020). Maternal age and the risk of gestational diabetes mellitus: A systematic review and meta-analysis of over 120 million participants. Diabetes Research and Clinical Practice, 162, 108044. https://doi.org/10.1016/j.diabres.2020.108044

Li, Z., Cheng, Y., Wang, D., Chen, H., Chen, H., Ming, W.-K., & Wang, Z. (2020). Incidence Rate of Type 2 Diabetes Mellitus after Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of 170,139 Women. Journal of Diabetes Research, 2020, 3076463. https://doi.org/10.1155/2020/3076463

Mantzorou, M., Papandreou, D., Pavlidou, E., Papadopoulou, S. K., Tolia, M., Mentzelou, M., Poutsidi, A., Antasouras, G., Vasios, G. K., & Giaginis, C. (2023). Maternal Gestational Diabetes Is Associated with High Risk of Childhood Overweight and Obesity: A Cross-Sectional Study in Pre-School Children Aged 2–5 Years. Medicina, 59(3), Article 3. https://doi.org/10.3390/medicina59030455

Melov, S. J., White, L., Simmons, M., Kirby, A., Stulz, V., Padmanabhan, S., Alahakoon, T. I., Pasupathy, D., & Cheung, N. W. (2022). The BLIiNG study - Breastfeeding length and intensity in gestational diabetes and metabolic effects in a subsequent pregnancy: A cohort study. Midwifery, 107, 103262. https://doi.org/10.1016/j.midw.2022.103262

Moody, Ottie-Boakye, Gyasi-Antwi, P., Adams, G., Eduful, E., asah-poku, kwaku, Annan, L., Laryea, D., Sarfo-Kantanka, O., L., W., Okyere, S., Karen, S., E., B.-A., & Ian, S. (2020). Global Prevalence of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. The American Journal of Medicine.

Much, D., Beyerlein, A., Roßbauer, M., Hummel, S., & Ziegler, A.-G. (2014). Beneficial effects of breastfeeding in women with gestational diabetes mellitus. Molecular Metabolism, 3(3), 284–292. https://doi.org/10.1016/j.molmet.2014.01.002

Muche, A. A., Olayemi, O. O., & Gete, Y. K. (2020). Effects of gestational diabetes mellitus on risk of adverse maternal outcomes: A prospective cohort study in Northwest Ethiopia. BMC Pregnancy and Childbirth, 20(1), 73. https://doi.org/10.1186/s12884-020-2759-8

Nagel, E. M., Howland, M. A., Pando, C., Stang, J., Mason, S. M., Fields, D. A., & Demerath, E. W. (2022). Maternal Psychological Distress and Lactation and Breastfeeding Outcomes: A Narrative Review. Clinical Therapeutics, 44(2), 215–227. https://doi.org/10.1016/j.clinthera.2021.11.007

Nguyen, P. T. H., Binns, C. W., Nguyen, C. L., Ha, A. V. V., Chu, T. K., Duong, D. V., Do, D. V., & Lee, A. H. (2019). Gestational Diabetes Mellitus Reduces Breastfeeding Duration: A Prospective Cohort Study. Breastfeeding Medicine, 14(1), 39–45. https://doi.org/10.1089/bfm.2018.0112

Noctor, E., & Dunne, F. P. (2015). Type 2 diabetes after gestational diabetes: The influence of changing diagnostic criteria. World Journal of Diabetes, 6(2), 234–244. https://doi.org/10.4239/wjd.v6.i2.234

Nommsen-Rivers, L. A. (2016). Does Insulin Explain the Relation between Maternal Obesity and Poor Lactation Outcomes? An Overview of the Literature. Advances in Nutrition, 7(2), 407–414. https://doi.org/10.3945/an.115.011007

Nur, R., Nurul Fajriah, R., Larasati, R. D., Dirpan, A., & Rusydi, M. (2021). Status of breast care during pregnancy with milk production and disease. Breast Disease, 40(S1), S85–S89. https://doi.org/10.3233/BD-219012

Pang, W. W., Geddes, D. T., Lai, C. T., Chan, S. Y., Chan, Y. H., Cheong, C. Y., Fok, D., Chua, M. C., Lim, S. B., Huang, J., Pundir, S., Tan, K. H., Yap, F., Godfrey, K. M., Gluckman, P. D., Shek, L. P., Vickers, M. H., Eriksson, J. G., Chong, Y. S., … Godfrey, K. M. (2021). The association of maternal gestational hyperglycemia with breastfeeding duration and markers of milk production. American Journal of Clinical Nutrition, 114(3), 1219–1228. https://doi.org/10.1093/ajcn/nqab142

Pham, Q., Patel, P., Baban, B., Yu, J., & Bhatia, J. (2020). Factors Affecting the Composition of Expressed Fresh Human Milk. Breastfeeding Medicine, 15(9), 551–558. https://doi.org/10.1089/bfm.2020.0195

Pillay, J., & Davis, T. J. (2022). Physiology, lactation. In National Institutes of Health (NIH). StatPearls.

Purnamasari, D., Waspadji, S., Adam, J. M., Rudijanto, A., & Tahapary, D. (2013). Indonesian Clinical Practice Guidelines for Diabetes in Pregnancy. Journal of the ASEAN Federation of Endocrine Societies, 28(1), Article 1.

Qian, P., Duan, L., Lin, R., Du, X., Wang, D., Liu, C., & Zeng, T. (2022). How breastfeeding behavior develops in women with gestational diabetes mellitus: A qualitative study based on health belief model in China. Frontiers in Endocrinology, 13. https://www.frontiersin.org/articles/10.3389/fendo.2022.955484

Qian, P., Duan, L., Lin, R., Du, X., Wang, D., Zeng, T., & Liu, C. (2023). Decision-making process of breastfeeding behavior in mothers with gestational diabetes mellitus based on health belief model. BMC Pregnancy and Childbirth, 23(1), 242. https://doi.org/10.1186/s12884-023-05527-3

Robinson, D. J., Coons, M., Haensel, H., Vallis, M., & Yale, J.-F. (2018). Diabetes and Mental Health. Canadian Journal of Diabetes, 42, S130–S141. https://doi.org/10.1016/j.jcjd.2017.10.031

Saucedo, R., Valencia, J., Isabel Peña-Cano, M., Morales-Avila, E., & Zárate, A. (2020). Breastfeeding and gestational diabetes. In A. Ray (Ed.), Gestational Diabetes Mellitus—An Overview with Some Recent Advances (pp. 1–23). IntechOpen. https://doi.org/10.5772/intechopen.82000

Słupecka-Ziemilska, M., Wychowański, P., & Puzianowska-Kuznicka, M. (2020). Gestational Diabetes Mellitus Affects Offspring’s Epigenome. Is There a Way to Reduce the Negative Consequences? Nutrients, 12(9), Article 9. https://doi.org/10.3390/nu12092792

Song, C., Lyu, Y., Li, C., Liu, P., Li, J., Ma, R. C., & Yang, X. (2018). Long-term risk of diabetes in women at varying durations after gestational diabetes: A systematic review and meta-analysis with more than 2 million women. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 19(3), 421–429. https://doi.org/10.1111/obr.12645

Spaight, C., Gross, J., Horsch, A., & Puder, J. J. (2016). Gestational Diabetes Mellitus. Endocrine Development, 31, 163–178. https://doi.org/10.1159/000439413

Supinganto, A., Pramana, C., Irnawaty, L., Kumalasari, M. L. F., Nurhidayah, & Isnawati, S. P. (2021). Manajemen laktasi berbasis evidence based terkini. In C. Pramana (Ed.), Sebatik. Sebatik.

Suwaydi, M. A., Wlodek, M. E., Lai, C. T., Prosser, S. A., Geddes, D. T., & Perrella, S. L. (2022). Delayed secretory activation and low milk production in women with gestational diabetes: A case series. BMC Pregnancy and Childbirth, 22(1), 350. https://doi.org/10.1186/s12884-022-04685-0

Ten-doménech, I., Ramos-garcia, V., Piñeiro-ramos, J. D., Gormaz, M., Parra-llorca, A., Vento, M., Kuligowski, J., & Quintás, G. (2020). Current practice in untargeted human milk metabolomics. Metabolites, 10(2), 43. https://doi.org/10.3390/metabo10020043

Vounzoulaki, E., Khunti, K., Abner, S. C., Tan, B. K., Davies, M. J., & Gillies, C. L. (2020). Progression to type 2 diabetes in women with a known history of gestational diabetes: Systematic review and meta-analysis. BMJ, 369, m1361. https://doi.org/10.1136/bmj.m1361

Wang, H., Li, N., Chivese, T., Werfalli, M., Sun, H., Yuen, L., Hoegfeldt, C. A., Elise Powe, C., Immanuel, J., Karuranga, S., Divakar, H., Levitt, Na., Li, C., Simmons, D., Yang, X., & IDF Diabetes Atlas Committee Hyperglycaemia in Pregnancy Special Interest Group. (2022). IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria. Diabetes Research and Clinical Practice, 183, 109050. https://doi.org/10.1016/j.diabres.2021.109050

Watt, A. P., Lefevre, C., Wong, C. S., Nicholas, K. R., & Sharp, J. A. (2021). Insulin regulates human mammosphere development and function. Cell and Tissue Research, 384(2), 333–352. https://doi.org/10.1007/s00441-020-03360-0

Widiarta, M. B. O., & Megaputri, P. S. (2022). Ansietas saat hamil menurunkan produksi ASI saat 24 jam persalinan. Healthcare Nursing Journal, 4(2), 7.

Wilson, C. A., Newham, J., Rankin, J., Ismail, K., Simonoff, E., Reynolds, R. M., Stoll, N., & Howard, L. M. (2020). Is there an increased risk of perinatal mental disorder in women with gestational diabetes? A systematic review and meta-analysis. Diabetic Medicine: A Journal of the British Diabetic Association, 37(4), 602–622. https://doi.org/10.1111/dme.14170

Ye, W., Luo, C., Huang, J., Li, C., Liu, Z., & Liu, F. (2022). Gestational diabetes mellitus and adverse pregnancy outcomes: Systematic review and meta-analysis. BMJ, 377, e067946. https://doi.org/10.1136/bmj-2021-067946

Yue, S., Thi, V. T. K., Dung, L. P., Nhu, B. T. H., Kestelyn, E., Thuan, D. T., Thanh, L. Q., & Hirst, J. E. (2022). Clinical consequences of gestational diabetes mellitus and maternal obesity as defined by asian BMI thresholds in Viet Nam: A prospective, hospital-based, cohort study. BMC Pregnancy and Childbirth, 22(1), 1–11. https://doi.org/10.1186/s12884-022-04533-1

Downloads

Published

2023-12-23

How to Cite

Manurung, S., wati, R. amalia, & Hariyanti, H. (2023). Production of breast milk in pregnant women with and without Gestational Diabetes Mellitus . Jurnal Kebidanan Dan Keperawatan Aisyiyah, 19(2), 72–81. https://doi.org/10.31101/jkk.3158

Issue

Section

Original Research

Citation Check

Similar Articles

<< < 1 2 3 4 5 6 7 > >> 

You may also start an advanced similarity search for this article.