Women with Type 2 diabetes breastfed less than women without the condition in a small prospective controlled study, but the gap appears tied more to higher body mass index than to diabetes itself, according to EMJ. The findings, published in Diabetologia in 2026, come from a comparison designed to test whether diabetes independently shapes feeding outcomes after pregnancy.
The research was led by Britten and colleagues and reported by EMJ. It compared women with Type 2 diabetes against normoglycaemic controls matched for age and parity, splitting the controls into two groups: one matched for BMI and one with normal BMI. Feeding data at four months were available for 29 women with diabetes, 29 BMI-matched controls and 28 normal-BMI controls.
Full breastfeeding rates were 24% in the diabetes group, 38% in the BMI-matched controls and 64% in the normal-BMI controls. Any breastfeeding was reported by 55%, 54% and 82% of the three groups respectively.
Neither measure differed significantly between women with diabetes and the BMI-matched controls. Both were lower among women with diabetes than among the normal-BMI controls.
Why it matters
The study's central point is methodological as much as clinical. When researchers compare a group with a chronic condition to a general healthy population, the two groups can differ in many ways at once. Body mass index is one of those differences, and the results suggest it carries real weight in this context.
For maternity and diabetes teams, the practical message is that a diabetes diagnosis should not be treated as a predetermined feeding outcome. The authors' comparison indicates that a gap observed against a normal-BMI population may reflect several overlapping influences rather than one condition acting alone.
The findings also caution against overreading a non-significant result. A small sample does not prove that diabetes has no independent effect; it leaves open how large any effect might be and whether a larger study would detect it.
What the hospital data showed
Women with diabetes nursed less often in the first 24 hours after birth, and their newborns were given formula in hospital more frequently than infants in the control groups. Among the diabetes group, neonatal hypoglycaemia was the most common reason formula was first used.
That detail matters for how the results are read. When supplementation is part of treating low blood sugar in a newborn, it is a clinical intervention rather than a lapse in breastfeeding support. The authors' framing suggests the more useful question is how necessary medical care and a mother's feeding intentions can be supported at the same time.
Limits the authors acknowledge
The study is observational, so it cannot establish that higher BMI causes reduced breastfeeding. It can only show an association. The small number of participants also prevented the researchers from running a full multivariable adjustment, which means other factors could not be fully separated out in the analysis.
Matching for BMI narrows one source of difference between groups but does not eliminate every social, biological or care-related distinction. The authors note that uncertainty therefore remains about the true size of any diabetes-related effect.
What to watch
The authors call for larger studies that could tease apart the contributions of BMI, metabolic health, neonatal care and other circumstances, and that could test which support strategies help women who want to breastfeed continue doing so. For now, the study points toward assessing individual feeding barriers across pregnancy, the hospital stay and the months after discharge, rather than assuming a diagnosis decides the outcome.
