Breastfeeding practices among women with diabetes: a cross-sectional study in a Tunisian hospital

Abstract

Introduction: in literature, women with diabetes breastfeed less than other women of childbearing age. Our study aimed to determine the rates and modalities of breastfeeding in women with diabetes during six months post-delivery and to determine the factors associated with it.

Methods: a prospective descriptive observational study was conducted in the Department of Nutritional Diseases "D" at the National Institute of Nutrition of Tunis over 18 months from January 2022 to June 2023. Breastfeeding in women with diabetes was assessed at one week (T1) in 78 patients, two months (T2) in 52 patients and six months (T3) post-delivery in 30 patients. Women with gestational diabetes and women who had an abortion, an intrauterine fetal death, or neonatal death, were excluded. Multivariable logistic regression analysis was performed to identify factors associated with breastfeeding.

Results: the mean age of participants was 35.1±4.8 years. Most patients (82%) had type 2 diabetes. Exclusive breastfeeding rates were 40%, 44%, and 10% at T1, T2, and T3, respectively. Partial breastfeeding rates were 42%, 33%, and 40%, respectively. Multivariable analysis showed that the husband's encouragement (aOR: 2.45, 95% CI 1.34-4.12; p=0.003) was positively associated with breastfeeding, while prematurity (aOR: 0.56, 95% CI 0.34-0.92; p=0.02) was negatively associated. Other barriers included insufficient milk (p=0.001) and breast refusal (p < 0.001).

Conclusion: factors promoting or hindering breastfeeding, such as family support and neonatal complications, should be systematically addressed in the postpartum care of women with diabetes.