Nursing Department in Tongji Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China.
School of Medical and Health Management, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2022 Oct 3;13:955484. doi: 10.3389/fendo.2022.955484. eCollection 2022.
Gestational diabetes mellitus (GDM) is a condition in which women develop hyperglycemia during pregnancy, and is associated with long-term health burden on both mother and their offspring, such as future type 2 diabetes mellitus (T2DM). Although breastfeeding was expected to mitigate metabolic sequelae for both mothers and their newborns, the prevalence of breastfeeding in GDM mothers are sub-optimal worldwide.
To explore the experience of disease among mothers with GDM and how they develop feeding behaviors.
This study was conducted in three branches of an integrated tertiary hospital in the central area of China. Mothers who were diagnosed with GDM, had no other complications, and gave birth before no more than 6 months were approached based on a purposive sampling. GDM mothers' experience of the disease and breastfeeding were collected in-depth interviews. A theory-driven thematic analysis based on Health Belief Model (HBM) was applied for data analysis. Inductive reasoning was used to identify emerging themes which were not included in HBM.
16 GDM mothers were included in the current study, with nine using breastfeeding, six mixed feeding and one artificial feeding, respectively. Nine themes were identified, including: 1) GDM diagnosis and severity; 2) information searching and GDM knowledge;3) GDM management; 4) perceived susceptibility of future diabetes;5) perceived severity of future diabetes;6) perceived benefits of breastfeeding;7) perceived barriers of breastfeeding;8) decision making process of feeding and social support. Generally, mothers with GDM lack reliable sources of information, considered the disease as a minor and transient illness during pregnancy, and failed to realize the long-term risk of GDM and the protective effect of breastfeeding to themselves and their babies. They rarely considered GDM in their feeding decision. Instead, the formation of feeding behaviors depends on the balance between the benefits and barriers of breastfeeding as well as the level of social support.
To promote breastfeeding, a multi-facet intervention targeted on healthcare providers (HCPs), GDM mothers and their networks was important to help GDM mothers better and correctly understand the disease and breastfeeding, and increase their capacity of breastfeeding.
妊娠糖尿病（GDM）是一种女性在怀孕期间发生高血糖的疾病，会给母婴双方带来长期的健康负担，例如未来的 2 型糖尿病（T2DM）。尽管母乳喂养有望减轻母婴双方的代谢后遗症，但在全球范围内，GDM 母亲的母乳喂养率并不理想。
探讨 GDM 母亲的疾病体验以及她们如何形成喂养行为。
本研究在中国中部地区的一家综合性三级医院的三个分支机构进行。根据目的抽样法，选取诊断为 GDM、无其他并发症且分娩时间不超过 6 个月的母亲。通过深入访谈收集 GDM 母亲对疾病和母乳喂养的体验。应用基于健康信念模型（HBM）的理论驱动主题分析进行数据分析。采用归纳推理识别 HBM 中未包含的新出现主题。
本研究纳入了 16 名 GDM 母亲，其中 9 名采用母乳喂养，6 名混合喂养，1 名人工喂养。确定了 9 个主题，包括：1）GDM 诊断和严重程度；2）信息搜索和 GDM 知识；3）GDM 管理；4）对未来糖尿病的易感性认知；5）对未来糖尿病的严重程度认知；6）母乳喂养的益处认知；7）母乳喂养的障碍认知；8）喂养决策过程和社会支持。一般来说，GDM 母亲缺乏可靠的信息来源，认为该疾病在怀孕期间是一种轻微的、短暂的疾病，未能意识到 GDM 的长期风险以及母乳喂养对自己和婴儿的保护作用。她们在喂养决策中很少考虑 GDM。相反，喂养行为的形成取决于母乳喂养的益处和障碍的平衡以及社会支持的水平。
为了促进母乳喂养，针对医疗保健提供者（HCPs）、GDM 母亲及其网络的多方面干预措施非常重要，这有助于 GDM 母亲更好、更正确地理解疾病和母乳喂养，并提高她们的母乳喂养能力。
