Casey, Jordan Rita Rose, Mogg, Erin Louise, Banks, Jennifer, Braniff, Kathleen, and Heal, Clare (2019) Perspectives and experiences of collecting antenatal colostrum in women who have had diabetes during pregnancy: a North Queensland semi-structured interview study. BMJ Open, 9. e021513.

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Abstract

Objectives: To explore and describe the experiences and perspectives of collecting and storing colostrum in the antenatal period in women who have had diabetes in pregnancy.

Design: Face-to-face, semi-structured interviews analysed with purposive sampling and thematic analysis.

Setting: A regional hospital in North Queensland with a high prevalence of diabetes in pregnancy.

Participants: Six women with a previous pregnancy complicated by diabetes who were advised to collect and store colostrum in pregnancy.

Results: Six themes were identified: wariness of medicalisation (adjusting to an ‘abnormal’ pregnancy, seeking continuity of care, determination to reduce formula, fear of invasive intervention); underlying altruism (providing the best for baby, preparing for complications, eager for milk donation); internal pressure to succeed (coping with confronting information, disheartened by failures, constant fear of insufficient supply, overwhelming guilt, concern for future breastfeeding success); self-management and ownership (adapting to awkwardness, developing strategies for success, actively seeking education, gaining confidence to request help, accepting personal limitations); frustrated by waste (encroaching on time, squandering a precious resource, ambiguous about necessity) and building fortitude for motherhood (physically preparing for breast feeding, symbolic of the imminent infant, establishing early relationships with supports, approaching challenges with realistic optimism).

Conclusion: Women with diabetes in pregnancy experience guilt and stress about the added risk of hypoglycaemia to their babies and strive to provide the best for their babies by collecting and storing colostrum, even if this leads to distress to themselves. It is crucial that these women be provided accurate, realistic advice about the benefits and disadvantages of collecting colostrum in the antenatal period.

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