Breastfeeding barriers and facilitators in Thai postpartum women with type 2 diabetes mellitus

Background: Breastfeeding positively influences glucose regulation in postpartum women with diabetes. Aim: This study aimed to describe breastfeeding barriers and facilitators in postpartum women with type 2 diabetes mellitus (T2DM). Methods: This qualitative analysis utilized data from a parent study with a convergent parallel mixed-methods design. We interviewed postpartum women with T2DM and extracted fasting plasma glucose levels from medical records taken at 4 to 6 weeks after childbirth. Results: Eight postpartum women with T2DM participated. Those who exclusively breastfed had normal fasting plasma glucose levels. Six themes emerged as breastfeeding barriers and facilitators across individual, interpersonal, and societal levels. Individual barriers included low milk production, dietary cravings, and emotional challenges of first-time motherhood. Interpersonal barriers involved lactation issues, baby conditions, and mother–baby separation post-birth. Societal barriers included short maternal leave, workplace difficulties with pumping, baby's location, and healthcare costs. Individual facilitators included breastfeeding intention and dietary practices to boost milk. Interpersonal facilitators were understanding baby cues and family support. Societal facilitators were involved in Thai postpartum traditions, health literacy, and lactation rooms in hospitals. Conclusions: Our findings highlighted the importance of identifying women's barriers and facilitators in breastfeeding, addressing physical and emotional challenges, and conducting lactation assessments. The study emphasized the need for increased workplace support for ongoing breastfeeding and individualized support that considers cultural beliefs and hospital practices.

Duke Scholars

Author Aunchalee E Loscalzo Palmquist Duke Global Health Institute