Prenatal Breastfeeding Attitudes and Postpartum Breastfeeding Experiences among Women with Gestational Diabetes Mellitus as Compared to Nondiabetic Women
Authors: Doughty Kimberly N. , Ronnenberg Alayne G. , Reeves Katherine W. , Qian Jing , Sibeko Lindiwe 
Published: November 2023

Objective

Despite established benefits of breastfeeding for women with gestational diabetes mellitus (GDM) and their infants, women with GDM breastfeed at lower rates than nondiabetic women. The reasons for this disparity are not well researched. The objective of this study was to assess the relationship between GDM and factors that may contribute to differences in breastfeeding behaviors; specifically, prenatal breastfeeding knowledge, attitudes, and beliefs and postpartum hospital experiences and problems with breastfeeding.

Methods

We utilized data from the Infant Feeding Practices Study II, which included healthy women from across the U.S. with singleton pregnancies and their infants. Infants were born at or near term (35 0/7 weeks of gestational age) and weighed at least 5 lbs at birth. We conducted a cross‐sectional analysis of breastfeeding knowledge, attitudes, and beliefs during pregnancy and a prospective analysis of self‐reported diagnosis with GDM and lactation‐related hospital experiences as well as problems with breastfeeding after delivery. We calculated descriptive statistics and used multivariable logistic regression to estimate the associations between GDM and outcomes with adjustment for confounders.

Results

Our prenatal sample included 195 women with GDM and 2,815 women with healthy pregnancies. Of these, complete data were available postpartum for 107 women with GDM and 1,626 healthy women. Women with GDM were less likely to say that breastfeeding is the best way to feed a baby (adjusted OR, 0.62; 95% CI, 0.46–0.85) and more likely to indicate that their baby's father believed the baby should be formula‐fed (adjusted OR, 1.74; 95% CI, 1.02–2.97) or mixed fed (adjusted OR, 1.78; 95% CI, 1.21–2.61), and to indicate that their obstetrician or other physician believed the baby should be formula‐fed (adjusted OR, 2.82; 95% CI, 1.17–6.79). Women with GDM were less likely to report feeling somewhat or very comfortable breastfeeding in front of their women friends (adjusted OR, 0.70; 95% CI, 0.50–0.98). After delivery, infants born to women with GDM were less likely to stay in the mother's room at the hospital (adjusted OR, 0.55; 95% CI, 0.36–0.85). In the first two weeks after delivery, GDM mothers who tried to breastfeed were more likely to report that the baby had trouble sucking (adjusted OR, 1.66; 95% CI, 1.08–2.54) or was not interested in breastfeeding (adjusted OR, 2.06; 95% CI, 1.07–3.98).

Conclusions

In this study, women with GDM had somewhat less favorable attitudes toward breastfeeding, less perceived support from partners and physicians for breastfeeding, and less comfort breastfeeding in front of women friends. Some early breastfeeding problems were more common in women with GDM than nondiabetic women. Women with GDM may need additional support for breastfeeding prenatally and after delivery to improve their breastfeeding outcomes.

Support or Funding Information

None