An exploration of differences in infant feeding practices among women with and without diabetes in pregnancy: A mixed-methods study

Aims (1) To determine the likelihood of full breastfeeding at 3 months postpartum in women with and without diabetes in pregnancy (DiP); (2) to explore the associations between diabetes management practices and infant feeding practices in those who had DiP and (3) to examine women's experiences of feeding their infants after having DiP. Methods The quantitative study used data from Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study. Participants who had DiP (n = 62) were matched 1:3 to participants without DiP for pre-pregnancy BMI, parity, mode of delivery and pre-term birth. Infant feeding questionnaires, prospective breastfeeding diaries and medical chart data were analysed to determine likelihood of fully breastfeeding at 3 months postpartum. For the qualitative study, interviews were conducted with postpartum women who had DiP to explore the experiences of infant feeding. Interviews were thematically analysed, and the results were compared between women who were categorized as 'full breast feeders' or 'mixed feeders'. Results The odds of fully breastfeeding were 50% lower in women with DiP than women without DiP (OR: 0.50, 95% CI 0.25-0.99, p = 0.04). Qualitative interviews identified that although all women showed resilience in the face of infant feeding challenges, those who were fully breastfeeding reported seeking out external infant feeding supports, for example, classes or Doula's. Mixed Feeders perceived there was a lack of infant feeding information and support given to them prior to giving birth. Conclusion Women with DiP may require additional prenatal and postnatal infant feeding support to be better prepared to overcome feeding challenges they may face.

Automated summary

Women with diabetes in pregnancy (DiP) have a 50% lower likelihood of fully breastfeeding at 3 months postpartum compared to women without DiP. Qualitative interviews revealed that full breast feeders tended to seek external infant feeding support, such as classes or Doula's, while mixed feeders perceived a lack of information and support prior to giving birth. This suggests that women with DiP may benefit from additional prenatal and postnatal infant feeding support to overcome feeding challenges.