Is onset of lactation delayed in women with diabetes in pregnancy? A systematic review.

AIM: To determine if women with diabetes in pregnancy have a delayed onset of lactation through a systematic review of the literature. METHODS: We searched databases including MEDLINE, Web of Science, PubMed, CINAHL Plus and PsychINFO for articles assessing diabetes in pregnancy and lactogenesis. Thirty-one articles were screened and 10 articles were included in the systematic review. We extracted data on diabetes in pregnancy and onset of lactation (secretory activation or lactogenesis II). RESULTS: The 10 studies examining the association between women with diabetes in pregnancy and delayed onset of lactation reported a significant delay in women with diabetes compared with women without diabetes. Two studies assessed the impact of metabolic control on lactogenesis, and found an association between poorer metabolic control and delayed onset of lactation. CONCLUSIONS: Although this review has found evidence of an association between women experiencing diabetes during pregnancy and delayed onset of lactation, the presence of many potential confounding factors need to be acknowledged.