“Feeding the baby breast milk shouldn’t be a problem” breastfeeding confidence and intention in pregnant persons with type 2 diabetes mellitus from Thailand

Breastfeeding initiation has been found to be lower in pregnant persons with type 2 diabetes mellitus (T2DM). However, no studies have explored the potential impact of T2DM during pregnancy on breastfeeding plans among Thai pregnant persons. This study aimed to describe breastfeeding confidence and intention during pregnancy among Thai pregnant persons with T2DM. This qualitative analysis utilized data from a parent study with a convergent parallel mixed-methods design. This study was guided by the National Institute on Minority Health and Health Disparities (NIMHD) Framework. Eligible participants were pregnant persons diagnosed with T2DM, aged 20-44 years, and proficient in speaking Thai. The pregnant persons participated in semi-structured interviews and completed three questionnaires: demographic, infant feeding intentions, and breastfeeding self-efficacy. Data analysis involved descriptive statistics for quantitative data and directed content analysis for qualitative data. Twelve interviews revealed four main themes: breastfeeding intentions during pregnancy, breastfeeding confidence throughout pregnancy, breastfeeding barriers (such as previous challenging experiences and physical distance between mother and baby), and breastfeeding facilitators (including benefits and cost-effectiveness, consumption of Thai foods and herbs, and the availability of breast milk shipping services). This study offers insights into the intentions and confidence of Thai pregnant persons with T2DM regarding breastfeeding their baby after childbirth. To improve breastfeeding outcomes, the pregnancy period could serve as an opportunity to assess breastfeeding confidence, barriers, and facilitators that influence breastfeeding intentions among pregnant persons with diabetes.