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Randomized Controlled Trial
. 2021 Nov;37(4):761-774.
doi: 10.1177/0890334421991058. Epub 2021 Feb 11.

Randomized Clinical Trial of a Prenatal Breastfeeding and Mental Health Mixed Management Intervention

Ying Zhao  1 , Qiping Lin  2 , Xinli Zhu  2 , Jing Wang  2
Affiliations
Randomized Controlled Trial

Randomized Clinical Trial of a Prenatal Breastfeeding and Mental Health Mixed Management Intervention

Ying Zhao et al. J Hum Lact. 2021 Nov.

Abstract

Background: The continuity of maternal depressive symptoms throughout the perinatal period and breastfeeding problems have adverse influences on breastfeeding.

Research aim: To compare the feeding patterns and breastfeeding experiences, maternal health and mental health, and breastfeeding self-efficacy between women with depressive symptoms who participated in a prenatal individualized mixed management intervention and those who received usual care.

Methods: Chinese primigravida (N = 182) with an Edinburgh Postnatal Depression Scale score ≥ 9 in late pregnancy (≥ 28 weeks and < 35 weeks) were randomly assigned to the intervention group (n = 84) or the control group (n = 84). Intervention group participants received four sessions of individualized mixed management combining psycho-education and breastfeeding education. Breastfeeding self-efficacy, feeding patterns, maternal depression, and health status were evaluated in both groups.

Results: Significant differences were noted between the groups in breastfeeding self-efficacy at 42 days postpartum (p < .05) and feeding patterns at 3 months and 6 months postpartum (p < .05). Repeated measures analysis of variance showed significant differences in the EPDS scores between groups at three postpartum time points (p < .05). The intervention group had significantly lower postpartum depression as diagnosed by the MINI (p < .05).

Conclusions: A prenatal individualized mixed management intervention holds promise as an effective prevention and health promotion program addressing breastfeeding outcomes and maternal mental health.This RCT was registered (ChiCTR-IOR-17013761) with Chinese Clinical Trial Registry, http://www.chictr.org.cn/enIndex.aspx on 12/7/2017.

Keywords: breastfeeding; breastfeeding barriers; breastfeeding duration; breastfeeding promotion; breastfeeding self-efficacy scale-short form; edinburgh postnatal depression scale; maternal psychology; mini-international neuropsychiatric interview; postpartum depression.

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