Factors Associated With Breastfeeding Among Women With Gestational Diabetes

Abstract

Background: Breastfeeding offers benefits to mother and child but is frequently not practiced among women whose pregnancy is complicated by gestational diabetes mellitus. Factors associated with not initiating or not maintaining breastfeeding among these women have been little investigated. Research aims: (1) To evaluate the frequency of breastfeeding for 30 days among women with a recent pregnancy complicated by gestational diabetes and (2) to determine factors associated with not initiating or not maintaining breastfeeding. Methods: Between January 2014 and July 2017 we enrolled women with gestational diabetes at high-risk prenatal services in three Brazilian cities. We collected baseline sociodemographic and health data and followed up with participants by telephone. Using Kaplan–Meier curves, we calculated the proportions of participants not initiating breastfeeding or not maintaining it for at least 30 days. We used Poisson regression with robust variance to identify factors related to this outcome. Results: Of the 2328 participants with complete information, 2236 (96.1%) initiated breastfeeding, and 2166 (93.1%) maintained breastfeeding for 30 days. Not having breastfed the previous infant (relative risk [RR] = 5.02, 95% CI [3.39, 7.45]), smoking during pregnancy (RR = 2.37, 95% CI [1.48, 3.80]), infant with health problems (RR = 2.25, 95% CI [1.27, 3.99]), early preterm birth (RR = 2.49, 95% CI [1.07, 5.77]), and not intending to breastfeed (RR = 3.73, 95% CI [1.89, 7.33]) were related to not maintaining breastfeeding for at least 30 days. Conclusions: Breastfeeding initiation was nearly universal among participants, and most maintained breastfeeding for 30 days. Factors relating to not breastfeeding at 30 days were easily identifiable.

Impact of gestational diabetes mellitus on the duration of breastfeeding in primiparous women: an observational cohort study

“…In line with previous studies, we found that non-smokers, higher educated, and married women had a longer duration of breastfeeding [20,37,39]. Some studies have shown that delivery complications, such as Caesarean section, or serious health problems of the newborn lead to lactation difficulties [19,20,38]. We did not observe such an influence.…”

“…Lactation difficulties among women with GDM are at least partly explained by their higher likelihood of obesity and delivery complications, including cesarean section, compared women without Gestational diabetes mellitus [18,19]. Further, neonates of women with GDM seem to have an increased risk for both low birthweight and macrosomia as well as admissions to neonatal intensive care unit, all of which may have a detrimental influence on breastfeeding [20,21]. Most previous data originate from study cohorts consisting of both primiparous and multiparous women.…”

Predictors of Prenatal Breastfeeding Self-Efficacy in Expectant Mothers with Gestational Diabetes Mellitus

“…The independent variables included the sociodemographic data, which showed correlations with the breastfeeding self-efficacy scale in the literature [ 1 , 13 , 26 ], such as age, BMI, level of education, mother’s occupation, husband’s monthly income, place of residence, smoking status, and chronic diseases other than GDM parity status. Other factors that showed correlations in the literature were included [ 9 , 13 , 21 , 22 , 27 ] such as previous breastfeeding experience, satisfaction with previous breastfeeding experience, previous breastfeeding duration, inquiry about the intention to breastfeed the coming newborn, and health education sources.…”

“…Research has demonstrated that various factors can lead to barriers to successful breastfeeding. One of these factors is gestational diabetes mellitus (GDM) [ 1 ], which is defined as “the type of glucose intolerance that develops in the second and third trimester of pregnancy, resulting in hyperglycemia of variable severity” [ 2 ].…”

Breastfeeding support and barriers to women with gestational diabetes mellitus: a nationwide cross-sectional survey of hospitals in Japan

“…Likewise, according to a study conducted in Japan [ 10 ], the breastfeeding rate among women with GDM is lower than that of women without GDM. There are many factors that influence the initiation and continuation of women’s breastfeeding [ 11 ]. However, according to Rollins et al [ 12 ], the health system and services are among the main factors associated with the status of breastfeeding.…”