Research
Factors Associated With Breastfeeding Up To 6 Months Postpartum in Mothers With Diabetes

https://doi.org/10.1111/j.1552-6909.2009.01052.xGet rights and content

ABSTRACT

Objectives

To identify breastfeeding behavior in a group of women with diabetes and to determine factors that may influence breastfeeding rates in this population.

Design

A 2-year retrospective study.

Setting

Derby City General Hospital, Derby, UK.

Participants

Ninety-four women with diabetes.

Methods

Data were collected using questionnaire and maternal clinical records.

Results

Women with gestational diabetes mellitus intended to and breastfed more than women with type 1 and type 2 diabetes at 2 weeks postpartum (p<.05). Logistic regression showed that the type of diabetes was the most significant predictor of breastfeeding at birth (p<.05). At 1, 2, and 6 weeks and 4 months postpartum, maternal body mass index was negatively associated with breastfeeding (p<.05). At 6 months, socioeconomic status predicted breastfeeding (p<.05).

Conclusion

Type of diabetes is a significant predictor of breastfeeding initiation. At later stages of postpartum, maternal body mass index and socioeconomic status were significant predictors of infant feeding method. Identification of these factors can help in developing appropriate and timely interventions to more effectively promote breastfeeding.

Section snippets

Background

Simmons, Conroy, and Thompson (2005) suggested strong commitment and high rates of successful breastfeeding in women who had type 2 diabetes and in women who had gestational diabetes mellitus (GDM). They showed that the rate of breastfeeding in women who had diabetes was about 78% at discharge from hospital, although mothers with type 2 diabetes were less likely to breastfeed at the first feed or at discharge than mothers with GDM (41.4% vs. 68%, p=.01 and 69% vs. 84%, p=.04, respectively). Two

Methods

The current study included women who attended a combined obstetric/diabetic clinic in Derby City General Hospitals, UK, between September 2001 and August 2003. The data for 257 women with diabetes were available. Two hundred and thirty-five of the women had sufficiently detailed contact information and were asked to complete the retrospective questionnaire. Of these, 43 women were diagnosed with type 1 or type 2 diabetes, and 192 had GDM.

The invited women were known to have diabetes based on

Results

The total response rate was 40% (94/235). The women were divided into the following categories: 15 women with type 1 diabetes, 11 with type 2 diabetes, and 68 women with GDM. At the time of the survey, the average age of the infants was 21.5 months (SD=7, range=10-34 months). The data were analyzed in two stages. Interdiabetic group comparisons were analyzed, and logistic regression was performed in order to assess the predictors of breastfeeding at each postpartum measurement stage.

Table 1

Discussion

This is one of the few studies that provides information on the pattern of breastfeeding and attempts to explore factors that may influence breastfeeding rates up to 6 months postpartum in women with diabetes. The findings indicated that type of diabetes affected breastfeeding intentions and behavior, with women with GDM more likely to breastfeed than women with type 1 and type 2 diabetes. Women with type 1 diabetes expressed less intention to breastfeed than the other groups, and at almost all

Conclusion

In summary, the authors found that women with type 1 diabetes breastfed in lower proportions than the other women who have diabetes. Nevertheless, determination and willingness as well as ability to breastfeed were observed among all types of women with diabetes. At 6 months postpartum, the rates of breastfeeding were not significantly different among different diabetic groups. Similar to the general population, maternal BMI and socioeconomic status were significant contributing factors

Acknowledgment

The authors thank Fiona Dickinson, Karen Payne, Rachel Law, and John Kalk for assistance with study development and Jean Russell and Apostolos Fakis for statistical assistance.

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