A Cluster Randomized Trial of Tailored Breastfeeding Support for Women with Gestational Diabetes

Alison M. Stuebe, Karen Bonuck, Reuben Adatorwovor, Todd A. Schwartz, Diane C. Berry

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background: Women with gestational diabetes mellitus (GDM) and their infants are at increased risk of developing metabolic disease; however, longer breastfeeding is associated with a reduction in these risks. We tested an intervention to increase breastfeeding duration among women with GDM. Materials and Methods: We conducted a cluster randomized trial to determine the efficacy of a breastfeeding education and support program for women with GDM. Women were enrolled between 22 and 36 weeks of pregnancy and cluster randomized to an experimental lifestyle intervention or wait-list control group. Breastfeeding duration and intensity were prespecified secondary outcomes of the trial. Duration of exclusive and any breastfeeding was assessed at 6 weeks and at 4, 7, and 10 months postpartum. We quantified differences in breastfeeding rates using Kaplan-Meier estimates, log-rank tests, and Cox regression models. Results: We enrolled 100 women, of whom 52% were African American, 31% non-Hispanic white, 11% Hispanic, 9% American Indian or Alaskan Native, 2% Asian, 2% other, and 4% more than one race. In models accounting for within-cluster correlation and adjusted for study site, breastfeeding intention, and African American race, women allocated to the intervention group were less likely to stop breastfeeding (adjusted hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.21-0.74) or to introduce formula (adjusted HR 0.50, 95% CI 0.34-0.72). Conclusion: Our results suggest that targeted breastfeeding education for women with GDM is feasible and efficacious.

Original languageEnglish
Pages (from-to)504-513
Number of pages10
JournalBreastfeeding Medicine
Issue number10
StatePublished - Dec 2016

Bibliographical note

Publisher Copyright:
© 2016, Mary Ann Liebert, Inc.


  • Breastfeeding
  • gestational diabetes
  • lactation

ASJC Scopus subject areas

  • Pediatrics
  • Health Policy
  • Obstetrics and Gynecology
  • Maternity and Midwifery


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