Antenatal colostrum harvesting for pregnant women with diabetes in preparation for breastfeeding
Catherine Ellen Rietveld
9 March 2012
Rietveld, C. (2012). Antenatal colostrum harvesting for pregnant women with diabetes in preparation for breastfeeding. (A thesis submitted in partial fulfilment of the degree of Master of Midwifery at Otago Polytechnic) [PDF 2,116KB]
Purpose: During recent years the breastfeeding support offered to women with diabetes mellitus has been changing. In many hospitals women with diabetes have been recommended to express their colostrum antenatally for use in the newborn period in order to minimise the administration of cows’ milk formula and promote full or exclusive breastfeeding. To date these changes have not been supported by research but rather anecdotal evidence. This pilot study is the beginning steps to providing some research based evidence around this practice. The purpose of this pilot study is to firstly explore the possibility that antenatal colostrum harvesting is achievable for women with diabetes in pregnancy. Secondly to examine the feasibility of mothers and core midwifery staff using banked colostrum in the hospital setting as part of the care of babies with hypoglycaemia. The tools and processes used in this pilot study are assessed for their suitability for use in a larger study powered to provide statistically significant results.
Method: Ten participants were recruited from Christchurch Women’s Hospital Maternity Outpatients Department. Participants were taught colostrum expression techniques and then asked to record episodes and volumes of antenatal colostrum harvesting from 34 weeks gestation. Birth and postnatal data was collected from hospital records. Breastfeeding information was collected from a telephone interview between eight and ten days postpartum, and women completed a participant satisfaction survey, at two weeks postpartum. These data were analysed quantitatively and common themes were extracted from the satisfaction survey comments.
Results: No statistical tests were applied to this data as it was a small pilot study with no control group. This pilot study demonstrated that these women were able to harvest, store and transport their colostrum safely for use in the hospital setting. The results were less compelling with respect to the hospital processes around using the colostrum for hypoglycaemic infants. However some of the study participants supplemented their babies with their banked colostrum indicating that it was accessible.
Conclusion: The tools and processes were used successfully in this pilot study suggesting it would be feasible to conduct a larger study to determine whether or not antenatal colostrum harvesting and banking facilitates exclusive or full breastfeeding for women with diabetes. Further study is need in this area to provide evidence for an existing practice which may have positive outcomes for mothers with diabetes and their babies.
Key words: Human Pregnancy; Antenatal; Colostrum; Diabetes; Colostrum Harvesting; Breastfeeding.
Catherine's thesis was supervised by Sally Baddock and Suzanne Miller.
This thesis is available under Creative Commons Attribution-NonCommercial licence CC BY-NC 4.0 International.