Breastfeeding Challenges and Determinants among Mothers withGestational Diabetes: A Systematic Review

نویسندگان

1 Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Midwifery, Research Student Committee, Mashhad University of Medical Sciences, Mashhad, Iran

3 Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Midwifery, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran

doi
10.22074/ijfs.2025.2029123.1686
چکیده

Background: The prevalence of gestational diabetes has increased in parallel with risk factors such as obesity, a familyhistory of diabetes, and advanced maternal age. Studies suggest that gestational diabetes may negatively affectbreastfeeding outcomes. This systematic review aimed to investigate the relationship between gestational diabetes andbreastfeeding, as well as the contributing factors influencing breastfeeding among affected women.Materials and Methods: Articles published up to January 2023, with an update through 2025, were included. A comprehensivesearch was conducted across databases including Medline, PubMed, Scopus, and others, using relevantkeywords such as gestational diabetes, breastfeeding, blood sugar, misconception, cultural factors, and predisposingfactors. Quantitative studies were assessed using the STROBE checklist, and qualitative studies were evaluated usingthe CASP tool. Key challenges identified include delayed onset of lactogenesis, misconceptions regarding diabetestransmission, and insufficient support.Results: A total of 19 studies (16 quantitative and 3 qualitative) were included. Analysis revealed several trends: tenquantitative studies reported a reduction in exclusive breastfeeding duration; three indicated lower breastfeeding ratesat hospital discharge; and three studies identified difficulties in breastfeeding initiation and continuation. Notably,three studies found similar breastfeeding continuation rates between mothers with gestational diabetes and healthycontrols. Factors associated with reduced breastfeeding included maternal obesity, cesarean delivery, prematurity,advanced maternal age, racial disparities, insulin treatment, limited knowledge about complementary feeding, misconceptionsabout exclusive breastfeeding, and concerns over diabetes transmission through breast milk.Conclusion: Addressing breastfeeding barriers among mothers with gestational diabetes requires targeted education,social support, and attention to professional challenges. Additional barriers included insufficient organizational resources,lack of hospital policies supporting breastfeeding, inadequate post-discharge support, and poor coordinationwith other healthcare facilities. Strengthening post-discharge support and inter-facility collaboration is essential. Futurelongitudinal and qualitative research should integrate cultural and psychosocial dimensions into evidence-basedpractices.