The complications experienced by women with diabetes in pregnancy can be a barrier to successful breastfeeding. Affected women are at risk of delayed lactation, are less likely to breastfeed exclusively, and have a shorter duration of breastfeeding.
The World Health Organisation (WHO) recommends breastfeeding for six months exclusively and continued breastfeeding, combined with solid foods, for up to two years.
Diabetes affects 13 per cent of pregnant women in Australia. Some women with the condition are advised to express breast milk in the last weeks of pregnancy to collect a supply for their babies. The Diabetes and Antenatal Milk Expressing (DAME) research trial was conducted at the Women’s and five other Victorian sites between 2011-2015. That trial found women with diabetes and a low-risk pregnancy could safely express breast milk in late pregnancy without causing any harm to their babies.
A sub-study of the DAME research titled ‘Is there any point in me doing this?’ involved semi-structured interviews with 10 women involved in the previous research, this time during 2017.
Of the 10 women, three were unable to express any breast milk during the last weeks of pregnancy while the other seven expressed a range of volumes. The women shared their views and experiences from empowerment to disappointment, worry about themselves and their baby, their experience of health professional support and family support, or concerns with their expressing.
Lead Researcher Anita Moorhead said while it was common for women to be advised to undertake antenatal expressing, this advice was based upon limited evidence. She said it remains critical to listen to and learn from participants.
“We found that advising women to do antenatal expressing did not lead to poorer health outcomes for women’s infants, but it is important to understand any other consequences, both positive and negative,” Ms Moorhead said.
“New knowledge of the lived experience of women with diabetes who have expressed in pregnancy should influence the advice that health professionals give.
“By understanding their experience, we can identify the women and babies that would benefit from expressing, and better support the women who will express.”