Is it safe to express milk before giving birth?

Some women, especially with diabetes, are recommended to express milk while still pregnant and to save it for their newborn, yet no evidence exists for this practice.

A study published in today’s Lancet aimed to determine the safety and efficacy of antenatal expressing in women with diabetes in pregnancy.

pregnancy-466129_1920 The study found that expressing while pregnant is safe for women with diabetes in low-risk pregnancies in late pregnancy (from around 36 weeks). After studying over 600 women, the authors found no increase in early births or admissions to neonatal intensive care. However, one in four women couldn’t collect any colostrum.

Before the trial, researchers had only run three small studies of expressing colostrum while pregnant, and no randomised trials for women without diabetes.

The authors advice to women with questions about expressing while pregnant is to ask their health care professional about their individual situation.

Read more at The Conversation

Full reference: Forster, Della A et al. | Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomised controlled trial | The Lancet , Volume 389 , Issue 10085 , 2204 – 2213

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A Structured Transition Program Among Young Adults With Type 1 Diabetes

Pyatak, E. et al. Journal of Adolescent Health. Published online: November 23 2016

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Purpose: We identified and treated young adults with type 1 diabetes who had been lost to follow-up during their transfer from pediatric to adult care, comparing their clinical, psychosocial, and health care utilization outcomes to participants receiving continuous care (CC) throughout the transition to adult care.

 

Conclusions: Our study suggests that, for young adults with a history of lapses in care, a structured transition program is effective in lowering A1C, reducing severe hypoglycemia and emergency department utilization, and improving uptake of routine diabetes care. Loss to follow-up and psychosocial concerns remain significant challenges in this population.

Read the full abstract here

I Should but I Can’t: Controlled Motivation and Self-Efficacy Are Related to Disordered Eating Behaviors in Adolescents With Type 1 Diabetes

Eisenberg, M.H. Journal of Adolescent Health. Published online: August 2016

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Purpose: Among adolescents with type 1 diabetes, disordered eating behaviors (DEBs) are more prevalent and have more serious health implications than in adolescents without diabetes, necessitating identification of modifiable correlates of DEB in this population. This study hypothesized that (1) autonomous motivation and (2) controlled motivation for healthy eating (i.e., eating healthfully because it is important to oneself vs. important to others, respectively) are associated with DEB among adolescents with type 1 diabetes. The third hypothesis was that baseline healthy eating self-efficacy moderates these associations.

Methods: Adolescents with type 1 diabetes (n = 90; 13–16 years) participating in a behavioral nutrition intervention efficacy trial reported DEB, controlled and autonomous motivation, and self-efficacy at baseline, 6, 12, and 18 months. Linear-mixed models estimated associations of controlled and autonomous motivation with DEB, adjusting for treatment group, body mass index, socioeconomic status, age, and gender. Separate models investigated the interaction of self-efficacy with each motivation type.

Results: Controlled motivation was positively associated with DEB (B = 2.18 ± .33, p < .001); the association was stronger for those with lower self-efficacy (B = 3.33 ± .55, p < .001) than those with higher self-efficacy (B = 1.36 ± .36, p < .001). Autonomous motivation was not associated with DEB (B = −.70 ± .43, p = .11).

Conclusions: Findings identify controlled motivation for healthy eating as a novel correlate of DEB among adolescents with type 1 diabetes and show that self-efficacy can modify this association. Motivation and self-efficacy for healthy eating represent potential intervention targets to reduce DEB in adolescents with type 1 diabetes.

Read the abstract here

Archives of Disease in Childhood: March 2016, Volume 101, Issue 3

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Image source: ADC

Highlights from the March issue include:

  • Female genital mutilation: see pages 212, 267 and 207.
  • The legal basis for compulsorily detaining children and young people for treatment: see page 210.
  • Families priorities in life limiting illness: see page 247.
  • Coeliac screening in type 1 diabetes: see page 230.
  • Management of speech and language disorders: see pages 272 and 278.

View the full ‘Highlights from this issue’ by
R Mark Beattie here

Below: Mark Beattie discusses the March 2016 Atoms section of the journal, highlighting the most interesting papers from the issue.

 

Read the issue here