Themes and illustrative quotes
| Theme | Illustrative quotes |
| Wary of medicalisation | |
| Adjusting to an ‘abnormal pregnancy’ | When you’re pregnant, you’re trying to figure it out anyway and then you’ve got the added complication of diabetes. (GDM, 20 s) I cried on the phone … I was like, ‘I don’t know what I’m doing, I don’t know what’s going on!’ (T1DM, 20 s) |
| Seeking continuity of care | The continuity of care is so important! (GDM, 20 s) |
| Determination to reduce formula | We managed to avoid a few top up feeds from the formula. (GDM, 20 s) Get as much as you can! Because it is better than formula! (T1DM, 20 s) |
| Fear of invasive intervention | It heartbreaking actually because they ended up having to put in drips and things to stabilise it [BGL]. (GDM, 40 s) |
| Underlying altruism | |
| Providing the best for baby | It was an important thing to do for the baby so you just do it. (GDM, 40 s) The milk beforehand was so good for the baby. (GDM, 30 s) |
| Preparing for inevitable complications | I knew very early that I’d be having a (caesarean section). So should’ve anything happen there was that (colostrum) there. (GDM, 30 s) |
| Eager for milk donation | There was a mother struggling and she didn’t have any and I couldn’t have been happier to give her some of mine. (GDM, 30 s) Even if your baby doesn’t need it, there’s possibilities that other babies would be able to use it as well. (GDM, 40 s) |
| Internal pressure to succeed | |
| Coping with confronting information | It’s just an overwhelming lot of information. (GDM, 20 s) |
| Disheartened by failures | I was just one of those women that didn’t get a colostrum. I tried so hard! (GDM, 20 s) I tried a bit earlier on and I was unsuccessful to get anything. (GDM, 30 s) |
| Constant fear of insufficient supply | I just kept looking at all the packets of stuff that I hadn’t filled and thought ‘I’ve just got to get these filled’. (GDM, 30 s) I remember him (obstetrician) going ‘Calm down he’ll be fine’ I’m like, ‘I’m freaking out, I don’t have any colostrum!’ (GDM, 20 s) |
| Overwhelming guilt | If I didn’t do it and she needed it, I’d only have myself to blame if it wasn’t there. (GDM, 30 s) I just felt that my body could give more. I just didn’t put the time in. (T1DM, 20 s) |
| Concern for future breastfeeding success | I was beginning to actually get scared I would never make milk. (GDM, 20 s) |
| Frustrated by waste | |
| Encroaching on time | It (expressing) was taking me probably a couple of hours to do a night. (GDM, 30 s) So yeah it (expressing) was just time consuming. (GDM, 30 s) |
| Squandering a precious resource | I showed up with 20mls of colostrum thinking I’ m sweet and disappeared in three feeds! (GDM, 20 s) It seemed like a waste that it [colostrum] eventually went in the bin.(GDM, 30 s) |
| Ambiguous about necessity | I didn’t end up using the milk. My daughter didn’t need it. (GDM, 30 s) It was just quite ambiguous…. Why am I really doing this? (T1DM, 20 s) |
| Self-management and ownership | |
| Adapting to awkwardness | I felt like it [expressing] was a bit weird. Then when I started to collect I was like ‘Okay I get it’. (T1DM, 20 s) It didn’t seem odd or unusual, just natural. (GDM, 40 s) |
| Developing strategies for success | I had specimen cups that I collected in and I had all the syringes and had caps and all the labels already printed. (GDM, 30 s) I used warm compresses and made sure that I was nice and warm as well. And I would heat up a flannel and pop that over my breast before I tried to express. (GDM, 40 s) |
| Actively seeking education | I YouTubed, the best way to actually collect. (GDM, 30 s) I did some research on it and I saw the benefits. (T1DM, 20 s) |
| Gaining confidence to request help | I went over and she (lactation consultant) helped me out on her own personal time because it was something I was worried about. (GDM, 20 s) Go to lactation consultant and make sure you know how to do it properly. (GDM, 30 s) |
| Accepting personal limitations | Just knowing that the little that you have is better than nothing. (GDM, 30 s) You are disappointed with yourself that you couldn’t get it but next time you got heaps … swings and roundabouts. (GDM, 40 s) |
| Building fortitude for motherhood | |
| Physically preparing for breast feeding | It [expressing] made breastfeeding this time really a lot easier. I didn’t really breastfeed my first baby. (GDM, 30 s) I felt like that [breastfeeding] was quite easy for me to do. Whereas other women, they’d have to learn that technique. (T1DM, 20 s) |
| Symbolic for an imminent infant | It was all part of what you do to prepare for a baby. (GDM, 40 s) |
| Establishing early relationships with supports | If I hadn’t [expressed] I wouldn’t have known where to go and probably wouldn’t have felt comfortable reaching out but I’d already made those relationships. (GDM, 30 s) I had confidence knowing [I could] walk to [lactation consultant’s] with baby and she’ll help me. (GDM, 20 s) |
| Approaching challenges with realistic optimism | I guess looking at the bigger picture and just thinking about the baby. (GDM, 30 s) |
BGL, blood glucose level; GDM, gestational diabetes mellitus; T1DM, type I diabetes mellitus.