Table 2 Perceived barriers by nurse and midwives to promote breastfeeding (n = 170)

Barriers associated with mother and infant

Medical interventions for infant

Separation of mother and infant following delivery due to admission of infant to GCU/NICU

Supplementation of artificial milk for infant due to hypoglycemia

Difficulties with breastfeeding due to mother’s condition

Physiological and physical characteristics among woman with GDM affecting breastfeeding

Low intention of mothers and family to breastfeed

Barriers associated with health professionals

Issues around breastfeeding support for women with GDM at individual level

Low awareness among health professionals about GDM

Lack of knowledge and skills among health professionals regarding GDM and breastfeeding support

Lack of basic breastfeeding support for women with or without GDM

Lack of additional support for breastfeeding among women with GDM

Lack of health guidance on the effects of breastfeeding to prevent type 2 diabetes mellitus

Issues around collaboration within professions and between different departments and professions

Differences in competence and approach to GDM and breastfeeding among nurse and midwives

Lack of coordination among different health professionals and departments

Differing approaches among health professionals to breastfeeding for women with GDM

Organizational barriers

Lack of resources for breastfeeding support

Lack of manpower

Lack of time and opportunity to provide health guidance for breastfeeding

Difficulty in securing time for staff training

In-hospital support systems and policies that hinder the promotion of breastfeeding

Hospital management systems that make breastfeeding support difficult

Hospital policies restricting early skin to skin contact, early initiation of lactation, and rooming-in

Routine artificial milk supplements to infants

Lack of continuous interprofessional support system

Lack of support following discharge

Difficulties in collaborating with other facilities