Abstract
Problem
Women with gestational diabetes have higher rates of introducing infant formula before
leaving hospital.
Background
Despite health professional support, less women with gestational diabetes exclusively
breastfeed in hospital.
Aim
To find factors that positively influence in-hospital exclusive breastfeeding practices
among women with gestational diabetes.
Methods
An online search was performed in Medline, Scopus, Pubmed, CINAHL and Cochrane databases.
Studies containing the keywords gestational diabetes and breastfeeding were retrieved.
Findings
Authors identified 1935 papers from search criteria. Twenty-six papers with no restrictions
on research design met inclusion criteria and were included in the review. Factors
were divided into personal, antenatal, intrapartum and postnatal factors. The main
modifiable factors that were associated with improved in-hospital exclusive breastfeeding
rates were having a strong intention to breastfeed, being confident, feeling supported
and having continuity of education and support. Women’s main reasons to introduce
formula were related to baby’s hypoglycaemia, delayed lactogenesis II and perceived
low milk supply. Skin-to-skin contact after birth combined with frequent breastfeeds
were effective ways to improve in-hospital exclusive breastfeeding rates.
Conclusion
Influencing factors such as women’s breastfeeding intention, confidence and ongoing
support are no different to the general population of women. However, promoting skin-to-skin
contact after birth combined with frequent feeds are crucial for women with gestational
diabetes who are more likely to introduce formula due to delayed lactogenesis II and
fear of neonatal hypoglycaemia. There is a need for developing educational and supportive
interventions that are tailored specifically for women who have gestational diabetes.
Keywords
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Article info
Publication history
Published online: March 18, 2021
Accepted:
March 8,
2021
Received in revised form:
March 7,
2021
Received:
September 30,
2020
Identification
Copyright
© 2021 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
