Barriers and facilitators of breastfeeding in women affected by diabetes: A systematic review.

The growing population of diabetes which includes women of childbearing age leads to adverse maternal-child health outcomes. This systematic review aims to determine the barriers of breastfeeding in women affected by diabetes in pregnancy; considering the psychologically and physiologically issues and identifying the benefits and risks of breastfeeding to mother and offspring. Recommendations will be sort to facilitate future guidance for intervention of low breastfeeding rates in this population. This review builds on the systemic review by Taylor et al. 2005, using a similar analytical approach, but different quality appraisal and search methods. Seven databases including Medline, CINAHL, Scopus, Nursing Academic Collection, Web of Science, Academic Search Complete and Cochrane database from 2004–2017 were reviewed with search terms containing diabetes, breastfeeding and infant nutrition. Eighteen articles met the selection criteria and quality appraisal of these articles was conducted using the mixed methods appraisal tool (MMAT). Women with diabetes complicated pregnancy were found to have low breastfeeding intentions, initiation and continuation. Breastfeeding may have both long and short-term effects in relation to delaying development of Type 2 Diabetes Mellitus, improving insulin sensitivity and glucose tolerance in mothers. Therefore, it is strongly recommended that this population be supported to exclusively breastfeed their offspring for at least the first three months of life.