Abstract
Study background and aim: Besides adaptation to breastfeeding and to a changed lifestyle after childbirth mothers with type 1 diabetes have to deal with erratic glycaemia. The aim in this paper was to explore patterns in and associations between well-being, diabetes management, and breastfeeding in mothers with type 1 diabetes up to six months after childbirth, and to compare well-being in mothers with type 1 diabetes to a reference group of mothers without diabetes. Methods: In a prospective observational survey with a case-control design, 108 mothers with type 1 diabetes were matched for parity and gestational week with 104 women in a reference group during 2007-2009. Telephone interviews were conducted two and six months postpartum using the Psychological General Well-Being index and a questionnaire on experience of diabetes management and breastfeeding. Associations were evaluated with a stepwise multivariate regression model. Findings: Mothers with diabetes reported lower levels of general well-being and lower vitality than women in the reference group at six months after childbirth, lower general health at two and six months. A majority reported considerably more unstable glycaemia, especially in the first two months, and more hypoglycaemic episodes during the breastfeeding period. Explanatory factor for better well-being at two months was the lesser extent to which breastfeeding influenced diabetes management. At six months this factor, and longer duration of diabetes, explained better well-being. Conclusion: Well-being in mothers with type 1 diabetes is negatively influenced if breastfeeding affects diabetes management. This suggests that social support from both professionals and peers is particularly important to these women.
Highlights
Given the numerous benefits to breastfeeding it is a global recommendation that mothers should exclusively breastfeed their infants for the first six months of their lives [1]; including women with diabetes [2]
The need for breastfeeding counselling and psychosocial support has been highlighted in a few studies [7,11], only a few have focused on support for diabetes management
The findings of this study show that well-being during the first months after childbirth was associated with difficulties with diabetes management, probably due to higher degree of glycaemic instability
Summary
Given the numerous benefits to breastfeeding it is a global recommendation that mothers should exclusively breastfeed their infants for the first six months of their lives [1]; including women with diabetes [2]. In mothers with Type 1 diabetes breastfeeding has been found to be less frequent and of shorter duration [7,8]. The need for breastfeeding counselling and psychosocial support has been highlighted in a few studies [7,11], only a few have focused on support for diabetes management. These studies indicate that the extensive professional care provided during pregnancy and childbirth is often interrupted suddenly, and there is a gap in the continuity of care before reestablishment of contact with the ordinary diabetes clinic [12,13]
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