This study investigated the breastfeeding knowledge level of pregnant women with GDM and explored its influence factors. Pregnant women with GDM had an average level of breastfeeding knowledge. However, some misconceptions of breastfeeding knowledge still existed in GDM population. Multiple linear regression analysis found that gestational age, family per capita monthly income, educational level, knowledge source were the independent protective factors for breastfeeding knowledge level and minority nationality was the independent risk factor for breastfeeding knowledge level. The educational level had the greatest influence on the breastfeeding knowledge level of GDM pregnant women.
This study showed that the 99.1% of GDM pregnant women had breastfeeding intention before delivery, which was higher than 73.2% reported by Dai and 92.17% reported by in Zhang[23, 24]. It revealed that GDM pregnant women had a higher willingness to breastfeed. In Japan, researchers found that 96% of pregnant women expressed an intention to breastfeed. However, the breastfeeding rate was only 46% in 4 weeks postpartum. Although there was a strong desire to breastfeed before delivery, pregnant women may stop breastfeeding when they encounter difficulties or obstacles that are difficult to solve in postpartum. Therefore, it suggested that nurses or midwifery should pay more attention to GDM pregnant women who have breastfeeding intention and strengthen their intention by health education or peer education. Additionally, nurses or midwifery should focus on postnatal breastfeeding status of GDM women and assisted them to solve the difficulties to breastfeeding in a timely manner. Moreover, to form correct breastfeeding cognition and improve breastfeeding rate of women with GDM, scientific and systematic health education should be carried on these population.
This study showed that pregnant women with GDM had an average level of breastfeeding knowledge. However, some misconceptions of breastfeeding knowledge still existed in GDM population. Pregnant women with different sociodemographic characteristics had different understanding degree of breastfeeding knowledge. GDM pregnant women who did not receive health education of breastfeeding had insufficient understanding of breastfeeding conditions, such as ‘breast size affecting milk secretion’. However, GDM pregnant women who received health education on breastfeeding had significantly higher knowledge level, which was consistent with the conclusion of Thomas’s report. GDM pregnant women who had lower educational level, premature birth, and lower family per capita income, and whose husband had lower educational level were not optimistic about the mastery of breastfeeding knowledge about breastfeeding conditions and breastfeeding benefits, which was supported by some researchers’ reports [16, 20, 26]. Research revealed that the higher the knowledge level of breastfeeding, the less likely it is to terminate breastfeeding early. Breastfeeding knowledge education can help avoid the occurrence of early interruption of breastfeeding, suggesting that breastfeeding knowledge education was necessary for GDM pregnant women.
Multivariate regression analysis revealed that gestational age, education level, family per capita monthly income, knowledge source were independent protective factor for breastfeeding knowledge level. This result was similar to Thomas’ study. The study found that breastfeeding counseling, socioeconomic status and educational level had a great impact on breastfeeding cognition of primipara. However, Thomas’s study did not report the impact of gestational age and knowledge source on breastfeeding cognitions. This study showed that the education level has the greatest influence on the knowledge of breastfeeding. Therefore, in nursing work, pregnant women with lower educational level cannot be ignored. These population had weaker ability to understand and grasp the knowledge. Therefore, there was a need for detailed and in-depth health education on breastfeeding for low-educational-level pregnant women. There was a growing concern among pregnant women about the breastfeeding knowledge with the increasing of gestational age. Study had shown that 66.3% of pregnant women were willing to receive knowledge education in the second trimester, which was the time for pregnant women to have regular prenatal examination. Therefore, medical staff should make full use of this period to educate pregnant women about breastfeeding. Moreover, studies had found that the medical staff is the main source of breastfeeding knowledge of women and is also the main object for help of any difficulty of women. In some countries and regions, pregnant women get knowledge mainly by means of the media and women's magazines[16, 27]. Therefore, GDM pregnant women should be provided health education on breastfeeding through a variety of ways, which is conducive to improving the knowledge level of breastfeeding. More diversified forms of health education should be carried out, such as breastfeeding salons and WeChat network platforms, and Internet media resources should be fully utilized to carry out health education.
This study had 2 limitation. First, only one hospital was included in this study, which is the one of the best hospitals of west China. Our participants almost are well educated and have high household income. So, this may reduce the representativeness of the sample in this study. Second, Multiple linear regression analysis showed that the influencing factors studied in this study could only explain 20.7% of the variation in breastfeeding knowledge score, revealing that there are other factors that did not be found and need to be studied.