Examining maternal age, breastfeeding self-efficacy and health locus of control in psychological wellbeing of mothers

Human Milk-The Biofluid That Nourishes Infants from the First Day of Life

Human milk is a biofluid with a unique composition among mammalian milks. Besides this milk's major components, its bioactive compounds, like hormones, immune factors, and oligosaccharides, are unique and important for infant growth and development. The best form of nutrition for term and preterm infants is the mother's own milk. However, in the absence of the mother's own milk, donor milk should be made available. Milk banks support neonatal intensive care units by providing preterm infants with human milk that generally has reasonable nutritive value for this sensitive population. However, neither mother's own milk nor donor milk has sufficient energy content for the growth of preterm babies, so adequate human milk supplementation is crucial for their progress. Due to the different characteristics of human breast milk, as well as ubiquitous environmental pollutants, such as microplastics, new methods are required for monitoring the quality and characteristics of human milk, which will lay a solid foundation for the further development and progress of human milk research.

Breastfeeding Self-Efficacy, Personal Well-Being and Related Factors in Pregnant Women Living in a District of Istanbul

In this study, we examined breastfeeding self-efficacy levels, well-being and sociodemographic factors in pregnant women. The population of this descriptive study consisted of women with a pregnancy of 27 weeks or more in the Sultanbeyli district of Istanbul, Türkiye. A questionnaire was administered via telephone calls to pregnant women aged 18 years and older. The first part of the questionnaire included questions regarding breastfeeding history and sociodemographic information. The second part included the Prenatal Breastfeeding Self-Efficacy Scale, and the last part included the Personal Well-Being Scale. Higher scale scores indicate higher levels of self-efficacy and well-being. In total, 385 women participated in the study. The median age of the pregnant women was 28.0 years (18.0-43.0). The median gestational week was 33.0 (27.0-42.0). Among women who had received breastfeeding counseling, those with a higher level of knowledge about breastfeeding had higher breastfeeding self-efficacy (p < 0.05). Women with better economic status also had higher well-being scores (p < 0.05). There was a positive correlation between well-being and breastfeeding self-efficacy approaching the statistical significance level (p = 0.052). It is important to consider factors that may be associated with women's well-being and self-efficacy.

A Survey of Breastfeeding Attitudes and Health Locus of Control in the Nigerian Population

OBJECTIVES

Breastfeeding is important to infant health and survival in sub-Saharan Africa. To promote breastfeeding effectively, understanding of psychological factors associated with infant feeding choices is required. This study investigated breastfeeding attitudes and health locus of control (HLoC) in a Nigerian community sample.

METHODS

Men and women (N = 400) (71% female; mean age 34.2 years/ range 18-86 years) were recruited through community groups in Nigeria. Self-report survey by questionnaire measured breastfeeding attitudes using the Iowa Infant Feeding Attitude Scale (IIFAS) and health locus of control using the Multidimensional Health Locus of Control Scale (MHLoCs).

RESULTS MEAN

IIFAS scores (mean = 57.7; sd = 7.8) became less favourable with increasing age (p = 0.02). Men had higher IIFAS scores (mean = 58.6; sd = 7.6) than women (mean = 56.6; sd = 8.0) indicating more favourable attitudes toward breastfeeding (p = 0.02). Women scored higher than men on external chance HLoC (ECHLoC) (p = 0.003) and external powerful others HLoC (EPHLoC) (p = 0.02). Increasing age was associated with higher scores on ECHLoC (p < 0.01) and EPHLoC (p < 0.01). Multiple linear regression analysis was significant (p < 0.001) and explained 7.8% of variance in breastfeeding attitude. Lower IIFAS scores, reflecting more negative attitudes to breastfeeding, were associated with higher ECHLoC (p < 0.01) and EPOHLoC (p < 0.05). Higher IIFAS scores, reflecting more positive attitudes to breastfeeding, were associated with greater IHLoC (p < 0.01). Neither age nor gender were associated with IIFAS scores in the final model.

CONCLUSIONS

This implies a need to explore health locus of control when promoting positive attitudes to breastfeeding and supporting families in breastfeeding advocacy.

The relationship of psychological well-being and cognitive emotions with breastfeeding self-efficacy in mothers in the postpartum period

To determine the relationship of psychological well-being and cognitive emotion regulation and breastfeeding self-efficacy in mothers in the postpartum period. The research was designed as cross-sectional and correlational and carried out between 1 November 2021 and 1 January 2022 in the pediatric outpatient clinic of a Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Responses from a total of 325 mothers who were in postpartum 1-6 months were analyzed. Data were collected using a Personal Information Form, the Scales of Psychological Well-Being (SPWB), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). The following factors were found to be important associated risk factors that negatively affected breastfeeding self-efficacy in 29% of the mothers (F = 14.536, p < .001): mothers' poor mental health, using self-blaming maladaptive cognitive coping strategy, inability to use positive reappraisal coping strategy, and feeding the baby only formula or both breast milk and formula. Weak and positive correlations were found between psychological well-being of mothers and adaptive cognitive coping subdimensions, and negative and weak correlations were found between psychological well-being of the mothers and maladaptive cognitive coping subdimensions (p < .001). Breastfeeding self-efficacy of mothers in a well psychological state, who can use adaptive cognitive coping strategies, and who exclusively breastfeed their babies is positively affected.

Promoting maternal self efficacy and paternal attitudes towards breastfeeding: a randomized controlled trial

BACKGROUND

Counseling is one of the ways to improve the quantity and quality of breastfeeding. The present study was conducted to investigate the effect of couple-centered counseling on fathers' attitudes and mothers' self-efficacy towards breastfeeding.

METHODS

This randomized controlled trial study was conducted on 60 primigravida pregnant women and their spouses who were randomly selected among the pregnant women referred to the two maternity hospitals of Malayer City, a city in the province Hamadan in western Iran. Data collection tools included the demographic characteristics questionnaire, Breastfeeding Self-Efficacy Questionnaire, and Iowa Infant Feeding Attitude Scale. The intervention was performed according to the principles of GATHER counseling (Greet, Ask, Tell, Help, Explain, and Return). Mothers' self-efficacy and fathers' attitudes toward breastfeeding were assessed before the intervention and 4 weeks after birth in both groups. Data were analyzed with SPSS version 23 software and using a significance level of p = 0.05.

RESULTS

The participants of the control and test groups were homogeneous in terms of demographic characteristics. The change in mothers' breastfeeding self-efficacy score after intervention in the test group had a statistically significant difference compared to the control group (30.43 ± 2.53; 95%CI: 25.41,35.44), and the change in the score of fathers' attitude towards breastfeeding had a statistically significant difference after the intervention in the test group compared to the control group (19.3 ± 2.05; 95%CI: -23.36, -15.23). In the test group, the change in fathers' attitude towards breastfeeding after the intervention was significant compared to before the intervention (30.36 ± 2.38; 95%CI: 25.43, 35.25).

CONCLUSIONS

Appropriate counseling programs can change fathers' attitudes toward breastfeeding and increase mothers' breastfeeding self-efficacy, so couples' presence in breastfeeding counseling is recommended.

Demographics, health literacy and health locus of control beliefs of Australian women who take complementary medicine products during pregnancy and breastfeeding: A cross-sectional, online, national survey

Background

Pregnant and breastfeeding women's use of complementary medicine products (CMPs) is common, and possibly associated with autonomous health care behaviours. However, the health literacy levels and health locus of control (HLOC) beliefs of women who use CMPs in pregnancy and lactation have not been previously assessed in a large Australian sample.

Aim

The aim of this study is to determine the health literacy levels and HLOC beliefs of women who use CMPs in pregnancy and lactation and determine the types of CMPs used.

Methods

A cross‐sectional, national, online survey of Australian pregnant or breastfeeding women aged 18 years and older, and currently using CMPs was conducted.

Results

A total of 810 completed surveys (354 pregnant and 456 breastfeeding women) were analysed. Most had adequate functional health literacy levels (93.3%). Health care practitioners (HCPs) HLOC mean scores were the highest for the sample, followed by Internal HLOC beliefs mean scores. Almost all (n = 809) took at least one dietary supplement, the most popular being pregnancy and breastfeeding multivitamins, iron supplements and probiotics. Use was generally in line with clinical recommendations, except for low rates of iodine supplementation. Herbal medicine use was lower for the total sample (57.3%, n = 464), but significantly higher (p < .0001) for the breastfeeding cohort, with consumers taking one to four herbal medicines each. The most popular herbs were raspberry leaf, ginger, peppermint and chamomile (pregnant respondents) and chamomile, ginger and fenugreek (breastfeeding respondents).

Conclusions

Respondents were health literate, with high scores for Internal and HCP HLOC scales, suggesting that they are likely to demonstrate self‐efficacy, positive health behaviours and work well in partnership with HCPs. HCPs can facilitate discussions with pregnant and breastfeeding women using CMPs, while considering women's health literacy levels, health beliefs and goals.

Maternal mental health and child well-being in Nigeria: A systematic review

Maternal mental health distress has a disease burden of severe adverse effects for both mother and child. This review identified maternal mental health concerns, their impact on child growth and the current practice of maternal healthcare for both mothers and their children in Nigeria. The Population, phenomenon of Interest and Context (PICo) model was adopted to formulate the review strategy, and five databases were searched for published articles between 1999 and 2019. Databases include Scopus, PubMed, ProQuest, Applied Social Science Index and Abstracts and Web of Science. Boolean operators (AND/OR/NOT) helped to ensure rigorous use of search terms which include 'maternal', 'pre/peri/postnatal', 'mental health', 'mental illness', 'disorders', 'intervention,' 'Nigeria', 'child', 'infant growth', and 'wellbeing'. Thirty-four studies met the inclusion criteria, and extracted data were qualitatively synthesised and analysed thematically. Five themes emerged. These include (i) marital difficulties, (ii) relationship status of the mother, (iii) child's gender, (iv) mode of child delivery and (v) child growth and development. The review showed a significant paucity of literature on the impact of specific maternal mental health problems on child physical growth and cognitive development. We concluded that culturally appropriate and evidence-based psychological interventions for maternal mental health problems would benefit Nigerian indigenous mothers. Therefore, the study recommends randomised controlled trials that are culturally appropriate and cost-effective for distressed mothers with children.

Predictors of maternal parenting self-efficacy for infants and toddlers: A Jordanian study

AIM

This study aimed to investigate the predictors of maternal parenting self-efficacy when the children concerned are in the early years of life.

METHOD

A descriptive-analytical research study was carried out among 213 women who were in the early months of the postpartum period and attending healthcare facilities in Irbid, Jordan. The State Anxiety Inventory (SAI) and the Maternal Parenting Self-Efficacy (PMP S-E) tool were used to collect the data.

RESULTS

A significant correlation was found between the scores in self-efficacy and the quality of marriage relations (B = 3.56, P = 001), family income (B = 1.97, P = .05), employment (B = 4.027, P = .027), education (B = 2.48, P = .004), and living with extended family (B = 5.28, P = .02).

CONCLUSION

The findings of this study show that MPSE is significantly associated with various predictors. These predictors are the mother's education, income, whether she lives with extended family, her quality of marriage, and her employment. Maternal anxiety was found not to be a predictor for MPSE and this may explain other factors such as social support and living with extended family.

IMPLICATION

It is essential for nurses to understand maternal parenting self-efficacy, therefore, including the concept of maternal parenting self-efficacy in nursing curricula can help raise awareness of this important concept. Understanding maternal parenting self-efficacy is necessary for nurses to evaluate the mothers' parenting self-efficacy.

Characterisation of sucking dynamics of breastfeeding preterm infants: a cross sectional study

BACKGROUND

Full breastfeeding is the ultimate aim for preterm infants to ensure they receive the full benefits of human milk however, preterm infants face a number of challenges associated with their immaturity and associated morbidities. In order to facilitate oral feeding, it is essential to have a sound knowledge of the sucking dynamics of the breastfed infant. The aim of this study was to measure and describe the sucking dynamics of the preterm breastfeeding infant.

METHODS

A prospective cross sectional observational study was carried out at King Edward Memorial Hospital, Perth. 38 mothers and their preterm infants (birth gestation age: 23.6-33.3 weeks; corrected gestation age 32.7 to 39.9 weeks) were recruited. Intra-oral vacuum levels, tongue movement and milk intake for a single breastfeed was measured. Statistical analysis employed linear regression and linear mixed effects models.

RESULTS

Synchronised ultrasound and intra-oral vacuum measurements show that the preterm infant generates vacuum by lowering their tongue in a parallel fashion, without distortion of the nipple/nipple shield. Baseline (B), mean (M) and (P) peak suck burst vacuums weakened over the course of a feed (B: p = 0.015; M: p = 0.018; P: p = 0.044) and mean and peak vacuums were weaker if the mother fed with a nipple shield (M: p = 0.012; P: p = 0.021). Infant milk intakes were higher when infants sucked for longer (p = 0.002), sucked for a greater proportion of the feed (p = 0.002), or had a greater sucking efficiency (p < 0.001).

CONCLUSIONS

Breastfeeding preterm infants generated intra-oral vacuum in the same manner as term infants. Nipple shields were associated with weaker intra-oral vacuums. However, vacuum strengths were not associated with milk intake rather time spent actively sucking was related to milk volumes. Further research is required to elucidate factors that influence preterm infant milk intake during breastfeeding.