Socio-demographic and psychological determinants of exclusive breastfeeding after six months postpartum — a Polish case-cohort study

Women's Satisfaction with Breastfeeding and Risk of Exclusive Breastfeeding Interruption

This prospective cohort study was conducted to evaluate the association between women's satisfaction with breastfeeding at 1 month post-partum and the risk of exclusive breastfeeding (EBF) interruption before 6 months. 287 mother-infant dyads randomly selected from two maternity hospitals were followed from birth to 24 months of infant's age. Women's satisfaction with breastfeeding was assessed using the Maternal Breastfeeding Evaluation Scale (MBFES) at 1 month. The association between women's satisfaction with breastfeeding and risk of EBF interruption before 6 months was estimated using Cox proportional hazards model. Kaplan-Meier survival curves for EBF were compared between women with lower satisfaction with breastfeeding (MBFES score < median 124) and those with higher satisfaction (MBFES score ≥ 124). Median EBF duration in women with higher satisfaction was 120 days (95%CI 109-131), vs. 26 days (95%CI 19-33) in less satisfied women. Each additional point on MBFES promoted a reduction of 2.0% in the risk of EBF interruption. Among women with satisfaction scores < 124, the risk of EBF interruption was 86% higher when compared with those ≥ 124 (adjusted hazard ratio 1.86; 95%CI 1.41-2.46). Lower maternal satisfaction with breastfeeding in the first month post-partum is associated with a higher risk of EBF interruption before 6 months.

Examining exclusive breastfeeding in Iranian mothers using the five-factor model of personality traits

Objectives

The initiation of exclusive breastfeeding and its continuation plays a vital role in maternal and child health. This study investigates the prediction of exclusive breastfeeding in Iranian mothers using the five-factor model.

Methods

A descriptive correlational study was conducted using cluster random sampling. and 120 mothers with children aged 6 to 12 months, referred to health centres of Shiraz University of Medical Sciences in Valfagr and Enghelab in Iran, participated in this cross-sectional study. The participants were requested to fill 3 questionnaire containing demographic questionnaire, the exclusive breastfeeding scale, and the Big Five factors (BFF) questionnaire of personality traits. The data were collected between May and December 2019 and analysed using Pearson's correlation coefficient and multiple regression.

Results

The results showed that the agreeableness trait had the highest score (mean score = 16.13, SD = 2.10) and the neuroticism trait had the lowest score (mean score = 12.13, SD = 2.68). The main results indicated a significant relationship between the extraversion trait and exclusive breastfeeding (r = 0.36, p < 0.01). In the regression analysis, the results were indicative of the positive prediction of exclusive breastfeeding for the extraversion (p < 0.01, β = 0.43) and the conscientiousness traits (p < 0.05, β = 0.18).

Conclusions

Personality traits may potentially affect exclusive breastfeeding and could be a useful tool in reducing impediments to exclusive breastfeeding and in identifying mothers who need more mental support.

Women's Mental Health as a Factor Associated with Exclusive Breastfeeding and Breastfeeding Duration: Data from a Longitudinal Study in Greece

Background: This study investigated the relationship between exclusive breastfeeding and breastfeeding duration, and maternal psychological well-being in the perinatal period. Methods: A longitudinal study involving a retrospective follow-up of a group of 1080 women from pregnancy to the 1st year postpartum, who gave birth during the 5-year period between January 2014 and January 2019 in Athens, Greece, was designed. Women’s history and two psychometric tools—the Edinburg Postpartum Depression Scale (EPDS) and the Patient Health Questionnaire-9 (PHQ-9) administered at 5-time points—were used for data collection. Logistic regression analysis and a series of multiple analysis of variance (MANOVA) tests were performed. Results: The chance for exclusive breastfeeding (giving only breast milk) appeared to decrease (a) with an increase of the scores for psychometric tools antenatally (PHQ-9, p = 0.030) or at the 6th week postpartum (EPDS, p < 0.001 and PHQ-9, p < 0.001), (b) with an increase in the number of psychotherapeutic sessions needed antenatally (p = 0.030), and (c) when the initiation of psychotherapy was necessary postpartum (p = 0.002). Additionally, a shorter duration of any breastfeeding (with or without formula or other types of food/drink) seems to be associated with (a) the occurrence of pathological mental health symptoms (p = 0.029), (b) increased PHQ-9 scores antenatally (p = 0.018), (c) increased EPDS scores at the 6th week (p = 0.004) and the 12th month postpartum (p = 0.031), (d) the initiation of psychotherapy postpartum (p = 0.040), and e) the need for more than 13 psychotherapeutic sessions (p = 0.020). Conclusions: This study demonstrates a negative relationship between exclusive breastfeeding and breastfeeding duration, and poor maternal mental health in the perinatal period.

An evaluation of a prenatal individualised mixed management intervention addressing breastfeeding outcomes and postpartum depression: A ramdomised controlled trial

AIMS AND OBJECTIVES

To determine the effects of an individualised mixed management combined lactation education and psychoeducation intervention on breastfeeding outcomes and postpartum depression (PPD) at 3 and 42 days postpartum.

BACKGROUND

Pregnant women with antenatal depression are prone to postpartum depression and failure in breastfeeding.

DESIGN

Eligible women participated in a randomised single-blind controlled trial. Results are reported as per the CONSORT 2010 statement.

METHODS

Participants were recruited from December 2017-August 2018 at a major teaching hospital located in Shanghai. Primiparous women (n = 182) with an Edinburgh Postnatal Depression Scale score ≥9 were randomly enrolled in the intervention group (n = 91) or the control group (n = 91). The intervention group participated in a 4-session face-to-face mixed management intervention targeting perinatal depression and breastfeeding. The control group received usual care. Breastfeeding and psychological outcomes were measured during the third trimester (≥28 weeks and <35 weeks), and at 3 and 42 days postpartum.

RESULTS

There were statistically significant differences in rates of overall and exclusive breastfeeding, initial breastfeeding experience, breastfeeding behaviour and self-efficacy between the two groups at 3 and 42 days postpartum (p < .05). Intention-to-treat linear mixed model analysis showed that EPDS scores were statistically significantly different between groups over time (F = 20.42, p < .001). Intervention group were more satisfied with their husbands' care and care received during the first month postpartum (p < .05).

CONCLUSIONS

The results demonstrate the effectiveness and feasibility of delivering an individualised mixed management intervention combining lactation guidance with psychological support during pregnancy.

RELEVANCE TO CLINICAL PRACTICE

This study supports the need to identify pregnant women at risk of perinatal depression and indicates that the prenatal individualised mixed management intervention has the potential to reduce PPD and help achieve better breastfeeding outcomes.