Prevalence and associated factors of breastfeeding in women with gestational diabetes in a University Hospital in Thailand

Abstract

Background Gestational diabetes mellitus (GDM), which is a medical complication that develops during pregnancy, is associated with several long-term health problems. Despite several benefits of exclusive breastfeeding (EBF), including reduction in long-term health problems in mothers with GDM, few studies have investigated breastfeeding in women with GDM and information in the Thai population is lacking. The aim of the study was to determine the prevalence of breastfeeding and the factors associated with breastfeeding during the first six months postpartum in women with GDM. Methods A questionnaire-based prospective study was conducted during November 2014 to June 2017. Study participants were first interviewed on the second day post-delivery, and then by telephone at 6 weeks, 3 months and 6 months postpartum. Breastfeeding assessment based on infant feeding practice in the last 24-h period was classified according to World Health Organization definitions. Results A total 229 women were enrolled in this study. Prevalence of any breastfeeding at 24 h, 6 weeks, 3 months, and 6 months postpartum was 28.8% ( n = 66), 94.3% ( n = 214), 71% ( n = 154), and 49.8% ( n = 104), respectively. Prevalence of EBF was 35.9% ( n = 78) at 3 months, and 23% ( n = 48) at 6 months after delivery. Maternal intention to breastfeed for 6 months was an independent predictor for both 6 months EBF (RR 16.38; 95% CI 2.29, 116.99) and any breastfeeding (RR 2.65; 95% CI 1.65, 4.25). Breastfeeding initiation within 24 h postpartum (RR 1.38; 95% CI 1.08, 1.76) and being a government officer or private business owner (RR 1.66; 95% CI 1.03, 2.68) were independent predictors of any breastfeeding and EBF for 6 months, respectively. Conclusion The prevalence of breastfeeding in Thai women with GDM was lower than the national and global target goal. Maternal intention to breastfeed for at least 6 months and breastfeeding initiation were important factors associated with 6 months’ breastfeeding. In order to improve the breastfeeding rate and duration, health care providers should support women’s feeding decision, emphasize the benefits of breastfeeding to enhance breastfeeding intention, seek to remove or minimize barriers to the initiation of breastfeeding and reduce mother-infant separation time.

Gestational Diabetes Mellitus in Southeast Asia: A Scoping Review

“…The interruption of breastfeeding has also been considered a complication among Southeast Asian women with GDM. These women have shorter breastfeeding durations than those without GDM in Thailand [84,85] and Vietnam [86]. The higher rates of obstetric and neonatal complications for both infants and GDM mothers [87], delays in the initiation of copious milk production [88], and suboptimal breastfeeding after hospital discharge [89] could be the reasons that lead to early breastfeeding cessation in this population.…”

Relationship between Maternal Postpartum Intention to Breastfeed and Actual Breastfeeding Duration — Four Provinces, China, 2015–2017

“…Nevertheless, breastfeeding duration in China is still far below the global nutrition targets (2). Several studies have reported that maternal antenatal intention to breastfeed is a strong predictor of actual duration of breastfeeding (3). Maternal postpartum intention could be much more associated with actual breastfeeding duration because of shorter time intervals and fewer impeding factors present during pregnancy, compared to maternal antenatal intention.…”

“…Maternal postpartum intention could be much more associated with actual breastfeeding duration because of shorter time intervals and fewer impeding factors present during pregnancy, compared to maternal antenatal intention. However, very little research has been done to determine if the maternal postpartum intention to breastfeed increases the duration of feeding in some mothers ( 4 ). This study was performed to examine the relationship between maternal postpartum intention and actual breastfeeding duration to provide data on the impact of extended breastfeeding duration.…”

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

“…Despite all these facts, previous studies have shown that mothers with GDM have less intention to breastfeed than mothers without GDM and are less likely to continue breastfeeding [ 12 , 13 ]. Several barriers to adherence to breastfeeding have been identified, including lack of family support, lack of knowledge about breastfeeding benefits, maternal psychological factors, and smoking [ 11 , 14 , 15 , 16 , 17 , 18 ]. Cesarean section (elective or emergency), which is more prevalent among GDM mothers, has also been shown to play a significant role in delaying breastfeeding initiation, which then affects breastfeeding duration and continuation [ 19 , 20 , 21 ].…”