title: Breastfeeding practices in women with type 1 diabetes: a discussion of the psychosocial factors and policies in Sweden and Australia.
abstract: BACKGROUND
  Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion.
  
  
  OBJECTIVE
  The aim of this paper is to discuss psychosocial factors, policies and practices that impact on the breastfeeding practices of women with T1DM.
  
  
  RESULTS
  Swedish research indicates that the overall breastfeeding rate in women with T1DM remains significantly lower than in women without diabetes in the first 2 and 6 months after childbirth with no differences in exclusive breastfeeding. Breastfeeding initiation and continuation among women with T1DM in Sweden has been shown to be influenced by health services delivery, supportive breastfeeding policies and socio-economic factors, particular perceived support from social networks and health professionals.
  
  
  CONCLUSIONS
  There is limited research on the impact of attitudes towards breastfeeding, emotional and social well-being and diabetes-related stress on the decision of women with T1DM to initiate and continue to breastfeed for at least 6 months. A more comprehensive understanding of the breastfeeding practices and psychosocial factors operating during the first 6 months after birth for women with T1DM will be instrumental in the future design of interventions promoting initiation and continuation of breastfeeding in Sweden, Australia and elsewhere.
authors.affiliation: School of Nursing and Midwifery, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood 3125, Victoria, Australia. Electronic address: bodil.rasmussen@deakin.edu.au.
authors.forename: Bodil
authors.initials: B
authors.lastname: Rasmussen
authors.affiliation: School of Psychology, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood 3125, Victoria, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Skouteris
authors.affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Berg
authors.affiliation: School of Nursing and Midwifery, Deakin University, 1 Gheringhap St, Geelong, Victoria, Australia.
authors.forename: Cate
authors.initials: C
authors.lastname: Nagle
authors.affiliation: School of Psychology, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood 3125, Victoria, Australia.
authors.forename: Heather
authors.initials: H
authors.lastname: Morris
authors.affiliation: The University of Melbourne, The Royal Melbourne and Women's Hospitals, Parkville, Victoria, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Nankervis
authors.affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Sparud-Lundin
mesh_terms: D001315:Australia / Q000453:epidemiology; D001942:Breast Feeding; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009035:Mothers / Q000523:psychology*; D011181:Postnatal Care; D012944:Social Support; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology
keywords: Australia; Breastfeeding; Psychosocial; Sweden; Type 1 diabetes mellitus