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

Abstract

Breastfeeding is beneficial for mothers with gestational diabetes mellitus (GDM). Saudi Arabia is considered one of the countries with the highest prevalence of GDM. Mothers with GDM have a low intention to breastfeed and are less likely to continue breastfeeding. This study aimed to measure breastfeeding self-efficacy among expectant mothers with GDM and quantify its determinants. This cross-sectional study recruited expectant mothers with GDM from an antenatal care clinic and queried them on breastfeeding knowledge and attitudes using the Arabic validated prenatal breastfeeding self-efficacy scale (PBSES). The study took place at the Medical City of King Saud University, during January–April 2021. The average PBSES score among 145 GDM Saudi participants was 64.07 ± 16.3. Higher academic level, previous satisfactory breastfeeding experiences, breastfeeding intention, six months or more breastfeeding experience, and health education were significantly positively correlated with PBSES score. A higher knowledge score was also correlated with a higher PBSES score (p = 0.002). Longer breastfeeding duration (β.197, p = 0.036), satisfactory previous breastfeeding experience (β.218, p = 0.020), and higher knowledge score (β.259, p = 0.004) were significant predictors of a high PBSES score. Breastfeeding self-efficacy is low among expectant Saudi mothers with GDM, especially those with unsatisfactory previous experience or low knowledge scores. Establishing systematic education about breastfeeding during antenatal care is recommended to improve breastfeeding experience and improve GDM outcomes.

Determinants of High Breastfeeding Self-Efficacy among Nursing Mothers in Najran, Saudi Arabia

“…The present study found that adequate breastfeeding knowledge and positive attitudes predict higher BSE. At a national level, a recent Saudi study showed that mothers with gestational diabetes mellitus who had good breastfeeding knowledge were more likely to have higher BSE [33]. The significant role of knowledge in the current study indicates the importance of promoting strategies to improve nursing mothers' breastfeeding awareness and self-efficacy.…”

“…A high educational level may enhance BSE, empowering the mother in terms of health-seeking behavior and health education. Prior studies emphasized the important role of a high educational level in raising women's BSE and consequently enhancing successful breastfeeding practices [33,34]. In addition, cross-sectional surveys conducted in Taiwan suggested that educational level was positively associated with an increased likelihood of BSE, particularly among university-educated mothers [35].…”

Is the Frequency of Postpartum Breastfeeding Counseling Associated with Exclusive Breastfeeding at Six Months? An Analytical Cross-Sectional Study

“…The first section asked about social and demographic characteristics, while the second section asked about obstetrics, antenatal, perinatal, and postnatal history. These two sections were constructed by the investigators based on a literature review and the ten steps of the WHO's Baby Friendly Hospital Initiative (BFHI) [6,[8][9][10][11]14,15,29,30]. The third section asked about the exposure to counseling types and frequency (the exposure of interest), which is based on the WHO's 2018 guidelines on breastfeeding counseling [16] and McFadden et al's systemic review and meta-analysis [13].…”

“…They also need it for professional medical advice in situations such as mastitis and feeding a premature infant, as well as psychological support. Previous studies in Saudi Arabia have focused only on the one-way health education aspect of breastfeeding counseling [8,11,12,14,15].…”

“…The same applies for having a university education and being a housewife [18,20]. The second includes obstetrics and breastfeeding history including multiparity, vaginal delivery, full-term delivery, the weight of the infant at childbirth, having received counseling after delivery at the facility, a history of breastfeeding their previous child, and colostrum feeding [11,15,[18][19][20]. The third includes behavior change constructs such as having high self-efficacy, having intention, and having breastfeeding knowledge [11,15].…”