St. Luke's International University- Graduate School, Women's Health and Midwifery, Tokyo, Japan.
Midwifery Policy Committee, Japan Academy of Midwifery, Tokyo, Japan.
BMC Pregnancy Childbirth. 2021 Aug 13;21(1):555. doi: 10.1186/s12884-021-04032-9.
Despite the benefits of breastfeeding for women with Gestational Diabetes Mellitus (GDM) and their infants, breastfeeding is less likely to be performed by this group. This study aimed to examine the current levels of implementation of breastfeeding support to women with GDM in Japan and to clarify barriers to promoting breastfeeding among this population.
A 25-item questionnaire was developed by the authors to investigate the current levels of implementation of breastfeeding support for women with GDM provided in hospitals, and to explore barriers for promoting breastfeeding among these women. The questionnaire was sent to all 1046 hospitals facilitating childbirth in Japan. Descriptive statistics were used to analyze the quantitative data, and content analysis was used to analyze qualitative data from the open-ended questions.
All 296 respondents were included in this study. Regarding breastfeeding support, 95.2% of the respondents provided general information on breastfeeding to GDM women during antenatal midwife consultations. However, the benefits of breastfeeding for preventing type 2 diabetes were addressed by only 48.0%. Likewise, although follow-up services (e.g., telephone support or breastfeeding consultations) were conducted in 88.9% of hospitals, only 50.7% of hospitals informed women that breastfeeding decreases the risk of developing type 2 diabetes after GDM. Regarding barriers, seven categories and 20 subcategories about promoting breastfeeding for women with GDM were extracted and abstracted into the following three themes: Barriers associated with mother and infant, Barriers associated with health professionals, and Organizational barriers.
In Japan, most hospitals that responded provided general breastfeeding support from the antenatal to postpartum periods. However, the benefits of breastfeeding in terms of preventing the incidence of type 2 diabetes following GDM were insufficiently communicated to women with GDM. Furthermore, there were numerous barriers to promoting breastfeeding among women with GDM.
尽管母乳喂养对患有妊娠糖尿病(GDM)的女性及其婴儿有诸多益处,但这一群体的母乳喂养率却较低。本研究旨在评估日本目前为 GDM 女性提供母乳喂养支持的实施水平,并阐明在该人群中促进母乳喂养的障碍。
作者制定了一份 25 项的问卷,以调查日本各医院为 GDM 女性提供的母乳喂养支持的实施现状,并探讨该人群中促进母乳喂养的障碍。问卷发送给了日本所有 1046 家助产医院。使用描述性统计分析来分析定量数据,并对开放式问题的定性数据进行内容分析。
本研究共纳入 296 名受访者。在母乳喂养支持方面,95.2%的受访者在产前助产士咨询期间向 GDM 女性提供了母乳喂养的一般信息。然而,仅有 48.0%的受访者提到了母乳喂养对预防 2 型糖尿病的益处。同样,尽管 88.9%的医院提供了随访服务(如电话支持或母乳喂养咨询),但只有 50.7%的医院告知 GDM 女性母乳喂养可降低发展为 2 型糖尿病的风险。在促进 GDM 女性母乳喂养的障碍方面,共提取并抽象出 7 个类别和 20 个子类别,分为三个主题:与母婴相关的障碍、与卫生保健专业人员相关的障碍和组织障碍。
在日本,大多数回复的医院都在产前到产后期间提供了一般的母乳喂养支持。然而,GDM 女性对母乳喂养在预防 GDM 后 2 型糖尿病发生方面的益处了解不足。此外,促进 GDM 女性母乳喂养还存在诸多障碍。