Preview
Creation Date
10-2017
Description
Infants born to diabetic mothers (IDDM, DM II or Gestational Diabetes) have an increased risk of hypoglycemia within the first couple of hours after birth and a delay in milk production. Infants at risk for hypoglycemia are often given formula for glucose stabilization and/or separated from their mothers due to a NICU admission. Colostrum, which is produced around the twelfth week of pregnancy is the optimal source of nutrition for at risk newborns and can be easily expressed by 36 weeks of pregnancy, however, many providers are unaware of this practice and are skeptical due to the potential risk of preterm labor. Antenatal expression of colostrum for diabetic mothers will assist in stabilizing hypoglycemia in at risk newborns by using energy rich colostrum which in turn will optimize early milk production and decrease formula supplementation and/or mother baby separation. Research surrounding this area has been limited to retrospective studies and very few randomized trials in which investigators failed to determine statistical significance in outcomes for the variables measured among the groups being studied. A recent randomized trial showed that rates of admissions to NICU among infants did not differ between the group assigned to antenatal milk expression and the group assigned to standard care. This was a finding inconsistent with few other retrospective and cohort studies that showed a 33% admission rate to NICU among the infants whose mothers expressed milk versus 21% among infants with mothers on standard care. The same study, however, described no difference among infants in regards to Apgar scores, birth weight, and length of breast feeding. This research proposal has two aims: introduce the practice of antenatal expression of colostrum for indicated population and describe the safety and efficacy of this practice to the members of the interdisciplinary team at Baystate Medical Center, and to determine the safety and efficacy of this practice through establishment of a study protocol and recruitment of eligible participants.