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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIntensive breastfeeding decreased the risk of developing diabetes for women within 2 years after experiencing gestational diabetes mellitus (GDM) compared with exclusive formula feeding. This article presents these data from the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy study [SWIFT; R01 HD050625, Gunderson PI].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EBreastfeeding\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPregnancy\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EBreastfeeding\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPregnancy\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIntensive breastfeeding (BF) decreased the risk of developing diabetes for women within 2 years after experiencing gestational diabetes mellitus (GDM) compared with exclusive formula feeding (FF). Erica P. Gunderson, PhD, MS, MPH, Senior Research Scientist, Kaiser Permanente, Oakland, California, USA, presented these data from the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy study [SWIFT; R01 HD050625, Gunderson PI].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe few studies of outcomes of BF after GDM pregnancy have reported conflicting results, likely because of reverse causation or residual confounding, such as recall bias, the influences of other healthy lifestyle behaviors closely related to lactation, differences in GDM severity and treatment, and adverse perinatal outcomes that may determine lactation success. The purpose of the SWIFT study was to evaluate the effect of lactation on the progression to diabetes in women with a recent GDM pregnancy. The study was designed to evaluate and control for potential sources of reverse causation or residual confounding.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the multicenter, prospective, observational study of 1035 women with GDM enrolled between 2008 and 2011, participants consented to 3 in-person exams within 2 years that included 2-hour 75-g oral glucose tolerance tests (OGTTs), received 10 monthly mailings throughout the first year, and participated in 3 telephone interviews (at \u0026gt; 32 weeks gestation, and at 1 and 6 months postpartum). Women aged 20 to 45 years were eligible if they had a singleton, live birth at \u2265 35 weeks of gestation; were free of diabetes at 6 to 9 weeks postpartum; did not have preexisting diabetes; were not planning another pregnancy within 2 years; and were either intensively BF or FF at enrollment. The study population was racially and ethnically diverse; 24% were white, 31% Hispanic, 8% black, and 36% Asian.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary outcome was incident diabetes as measured by a 2-hour, 75-g OGTT. Lactation measures were quantitative and included intensity at baseline, which was 6 to 9 weeks postpartum, and subsequent monthly assessments of intensity and duration of BF and FF during the 2-year follow-up. Covariates included prenatal clinical outcomes, maternal and infant perinatal outcomes, and anthropometric measures, sociodemographics, and postpartum lifestyle behaviors.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe study classified women into four infant-feeding-intensity groups at 6 to 9 weeks postpartum: exclusive BF, mostly BF (\u0026lt; 6 oz formula per day), high FF (\u0026gt; 17 oz per day with some breast milk), and exclusive FF. There was no significant difference in prenatal 100-g OGTT results for women by BF or FF-intensity groups. Intensive BF (mostly or exclusive) was reported by 72%, 67%, and 54% of women at 1, 2, and 4 months postpartum, respectively. In addition, there were no significant differences in family history of diabetes, GDM treatment, gestational age, or prenatal 3-hour OGTT z-score among the breastfeeding intensity groups or the breastfeeding duration groups (0 to 2 months, 2 to \u0026lt; 6 months, 6 to 14 months, and \u0026gt; 14 months).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ECompared with women who exclusively formula feed, the risk of developing diabetes within 2 years after delivery was lower with increasing BF intensity at 6 to 9 weeks postpartum, starting with high FF and some breast milk (HR, 0.61; 95% CI, 0.34 to 1.08), mostly breastfeeding (HR, 0.66; 95% CI, 0.41 to 1.07), to the lowest risk for the exclusively breastfeeding group (HR, 0.39; 95% CI, 0.22 to 0.77), after adjustment for race and ethnicity, prepregnancy body mass index, prenatal 3-hour OGTT z-score, and GDM treatment (trend p = .04). Lower risk of incident diabetes within 2 years postpartum was also associated with increasing duration of BF, with greatest benefit experienced by women who breastfed for \u0026gt; 14 months compared with women who breastfed for 0 to 2 months in the fully adjusted model (p = .045; \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14601\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14601\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14601\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003EEffect of Duration of Breastfeeding on Diabetes Incidence Within 2 Years After Gestational Diabetes\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-12\u0022\u003EThe risk of developing diabetes after GDM was reduced with a longer duration of intensive BF in the SWIFT study.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/19\/20.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp2xd\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzp2xd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}