Friday Dec 13, 2013 (foodconsumer.org) -- Maternal obesity and insulin therapy during pregnancy delay lactogenesis, which is needed for the production of milk, in women with recent gestational diabetes mellitus.

Susana L Matias from University of California in Davis, California and colleagues conducted the study and found prepregnancy obesity and insulin treatment during pregnancy was associated with high odds of delayed lactogenesis in women with recent gestational diabetes mellitus.

The timely onset of lactogenesis is important for normal breastfeeding and newborn health.  The current study was to investigate the prevalence and risk factors linked to delayed onset of lactogenesis in a racially and ethnically diverse study population of postpartum women with recent gestational diabetes mellitus.

Enrolled in the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy (SWIFT) were 883 women diagnosed gestational diabetes mellitus at week 6 to 9 postpartum, who delivered at Kaiser Permanente Northern California hospitals from 2008 through 2011. Delayed lactogenesis was evaluated at week 6 to 9 postpartum and defined as occurring 72 hours postpartum.

Delayed lactogenesis was found in 33% of women and was 56% more likely to be diagnosed in women with prepregnancy obesity.  Delayed lactogenesis was also found 211% more likely in women receiving gestational diabetes mellitus and 56% more likely found in those practicing suboptimal in-hospital breastfeeding.

Older women were less likely to experience delayed lactogenesis but only in those who had had more than one child earlier.

The study concluded "One-third of women with recent GDM experienced delayed OL. Maternal obesity, insulin treatment, and suboptimal in-hospital breastfeeding were key risk factors for delayed OL(lactogenesis)."

Foods that promote milk production or lactogenesis include oatmeal, carrots, spinach, water, salmon, apricots, brown rice, asparagus, papaya, and hummus.  Nutritious foods are important for milk production.  Also newborns should be allowed to suck nipples from time to time to stimulate the production of milk. (david Liu PHD)