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. 2019 Feb;35(1):49-58.
doi: 10.1177/0890334418767832. Epub 2018 Jul 3.

Associations of Maternal Beliefs and Distress in Pregnancy and Postpartum With Breastfeeding Initiation and Early Cessation

Genevieve Ritchie-Ewing  1 , Amanda M Mitchell  2 , Lisa M Christian  3   4
Affiliations

Associations of Maternal Beliefs and Distress in Pregnancy and Postpartum With Breastfeeding Initiation and Early Cessation

Genevieve Ritchie-Ewing et al. J Hum Lact. 2019 Feb.

Abstract

Background:: Breastfeeding plays an important role in both maternal and infant health and well-being. While researchers have examined the relationship between postpartum psychological distress and breastfeeding behaviors, few have investigated links between prenatal distress, postpartum distress, and breastfeeding behaviors over time.

Research aim:: We aimed to determine if prenatal breastfeeding beliefs and psychological distress during and after pregnancy were associated with initiation and early cessation rates of breastfeeding.

Methods:: In our secondary data analysis, a nonexperimental longitudinal one-group design was used. We assessed pregnant women ( N = 70) during four perinatal visits (early, mid, and late pregnancy and 7-10 weeks postpartum). Participants completed self-report surveys about psychological distress and depressive symptoms at each visit, breastfeeding beliefs during the third visit, and breastfeeding behaviors at the postpartum visit.

Results:: Participants who breastfed for ⩾8 weeks had more positive beliefs about breastfeeding prior to delivery than participants with early cessation, who in turn had more positive beliefs than those who never initiated. Participants with early cessation reported heightened levels of pregnancy-specific distress in early pregnancy compared to those who continued breastfeeding or never initiated. Participants who continued breastfeeding for ⩾8 weeks reported less general anxiety and depressive symptoms in postpartum than those who discontinued or never initiated.

Conclusions:: Prenatal beliefs about breastfeeding, pregnancy-specific distress in early pregnancy, and general anxiety and depressive symptoms in postpartum are associated with breastfeeding initiation and continuation. Of clinical relevance, addressing prenatal and postpartum distress in the implementation of breastfeeding practice interventions could improve breastfeeding rates.

Keywords: breastfeeding duration; breastfeeding initiation; breastfeeding practices; maternal psychology.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Total scores on the BBS (M ± SE) from the third trimester visit (Visit 3) by breastfeeding group. Higher scores indicate more positive beliefs. **p ⩽ .01.
Figure 2.
Figure 2.
Subscale scores on the BBS (M ± SE) from the third trimester visit (Visit 3) by breastfeeding group. Higher scores indicate more positive beliefs. *p ⩽ .05. **p ⩽ .01.
Figure 3.
Figure 3.
Pregnancy-specific distress (per scores on the NUPDQ; mean ± SE) by breastfeeding group across pregnancy. * ps ⩽ .05.
Figure 4.
Figure 4.
Depressive symptoms (per scores on the CES-D; M ± SE) by breastfeeding group across pregnancy and postpartum. *ps ⩽ .04.
Figure 5.
Figure 5.
Anxiety (per scores on the STAI; M ± SE) by breastfeeding group across pregnancy and postpartum. *ps ⩽ .04.
Figure 6.
Figure 6.
Perceived stress (per scores on the PSS; M ± SE) by breastfeeding group across pregnancy and postpartum.
See this image and copyright information in PMC

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