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Fuente-Moreno M, Garcia-Terol C, Domínguez-Salas S, Rubio-Valera M, Motrico E. Maternity care changes and postpartum mental health during the COVID-19 pandemic: a Spanish cross-sectional study. J Reprod Infant Psychol 2024; 42:753-768. [PMID: 36710435 DOI: 10.1080/02646838.2023.2171375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/17/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic led to abrupt changes in maternity care, but the impact of these changes has not yet been deeply evaluated. This study aimed to assess the impact of the unexpected changes in maternity care due to the COVID-19 pandemic on postpartum mental health (depression, anxiety and posttraumatic stress disorder). METHODS A cross-sectional, web-based study was conducted in Spain during the second half of 2020. The eligibility criteria were women≥18 years with a child≤6 months. The Edinburgh Postnatal Depression Scale (EPDS), the Generalized Anxiety Disorder-7 Screener (GAD-7) and a subset of the PTSD checklist (PCL-5) were used to assess postpartum mental health. Information regarding sociodemographic characteristics and maternity care changes was collected, and multivariate regression models were used. RESULTS Among 1781 participants, 29.3% and 33% had clinically significant depressive and anxiety symptoms, respectively. The most prevalent unexpected changes reported were related to the exclusion of supportive relatives during birth and postpartum. Changes reported during birth showed a minor association with PTSD symptomatology, and those that occurred during the postpartum period were associated with clinical depression, anxiety and PTSD symptoms. CONCLUSIONS The unexpected changes in maternity care due to the COVID-19 pandemic, especially those that occurred during the postpartum period, increased the risk of mental health problems.
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Affiliation(s)
- Marina Fuente-Moreno
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Clara Garcia-Terol
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Spain
| | | | - María Rubio-Valera
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
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Alptekin FB, Sucularlı E, Turgal E, Burhan HŞ, Güçlü O. Reducing the stress of mothers in the postpartum period: psychological inflexibility or mother-infant bonding. J Reprod Infant Psychol 2024:1-16. [PMID: 38899761 DOI: 10.1080/02646838.2024.2369578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Parental stress is a critical problem because it affects both the mental health of the mother and children's development. In addition to many factors related to birth and marriage, mother - infant bonding and psychological inflexibility are essential factors that can affect stress. In this study, we examined the effects of the psychological processes of mothers and factors related to pregnancy, mother, environment on parental stress, and their relationships. METHODS A sociodemographic variables scale, Acceptance and Action Questionnaire-II, Postpartum Bonding Questionnaire, and Parental Stress Scale were completed by 115 mothers in their first postpartum year. The model created with the correlation and regression results was subjected to path analysis. RESULTS Breastfeeding, psychological inflexibility, and mother - infant bonding are related to parental stress. The bonding problem is the mediator of the relationship between psychological inflexibility and parental stress. The entire effect of sleep quality on parental stress occurred through psychological inflexibility. CONCLUSION Efforts should be directed towards improving the bond between the mother and infant and enhancing the mother's psychological flexibility to lessen the negative impacts of stress. Breastfeeding should not be treated categorically, and its potential adverse effects should not be ignored.
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Affiliation(s)
| | - Eylül Sucularlı
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
| | - Ebru Turgal
- Faculty of Medicine, Department of Biostatistics, Ankara University, Ankara, Turkey
| | - Hüseyin Şehit Burhan
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
| | - Oya Güçlü
- Department of Psychiatry, Başakşehir Çam ve Sakura City Hospital, İstanbul, Turkey
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Lubis PN, Saputra M, Rabbani MW. A systematic review of the benefits of breastfeeding against postpartum depression in low-middle-income countries. J Ment Health 2024:1-13. [PMID: 38869015 DOI: 10.1080/09638237.2024.2361232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/16/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND The positive impact of breastfeeding against postpartum depression has been increasingly reported. However, no studies have systematically and critically examined current evidence on breastfeeding practices' influences on postpartum depression in LMICs. AIM To review the influence of breastfeeding on postpartum depression in LMICs. METHODS We searched original research in English published over the last ten years (2012 - 2022) within 8 databases: EBSCOhost, EMBASE, Pubmed, Sage Journals, Science Direct, APA PsycArticles, Taylor & Francis, Google Scholar, and citation tracking. The risk of bias assessment used The Newcastle Ottawa Scale and The Modified Jadad Scale. We followed the PRISMA statement after the protocol had been registered on the PROSPERO. The review included 21 of 11015 articles. RESULTS Of 21 articles, 16 examined breastfeeding practices, 2 each investigated breastfeeding self-efficacy and breastfeeding education, and 1 each assessed breastfeeding attitude and breastfeeding support. 3 randomized control trials and 5 cohorts revealed that breastfeeding decreased the EPDS scores. However, 4 cross-sectional studies indicated that breastfeeding is nonsignificantly associated with postpartum depression. CONCLUSION This review indicated that breastfeeding may alleviate or prevent postpartum depression. Our findings indicated that integrating breastfeeding-related programs and policies into postpartum depression prevention may benefit public health. REGISTRATION PROSPERO (CRD42022315143).
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Affiliation(s)
| | - Maman Saputra
- Tulodo Organizations and Universitas Terbuka, Indonesia
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Braithwaite EC, Oftedal A, Kaasen A, Ayorech Z, Bekkhus M. A history of depression and prenatal depression are associated with a lower likelihood of breastfeeding initiation and maintenance, and more breastfeeding problems. Arch Womens Ment Health 2024:10.1007/s00737-024-01479-5. [PMID: 38834917 DOI: 10.1007/s00737-024-01479-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 05/24/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation (giving the baby any breastmilk during the first week of life) and breastfeeding maintenance (giving the baby breastmilk for at least 6 months), and a greater likelihood of reporting breastfeeding problems. METHODS We analyzed data from the Norwegian Mother, Father, and Child cohort study (MoBa), N = 78,307. Mothers reported a lifetime history of depression during the second trimester of pregnancy, and current symptoms of depression during the third trimester using the Hopkins Symptoms Checklist short version (SCL-8). At six months postpartum, mothers self-reported breastfeeding initiation, maintenance, and difficulties. RESULTS Using binary logistic regression analyses, we report that a lifetime history of depression is associated with a lower likelihood of breastfeeding initiation (OR = 0.751, 95%CI = 0.650-0.938), breastfeeding maintenance (OR = 0.712, 95%CI = 0.669-0.785), and a greater likelihood of breastfeeding difficulties (OR = 1.86, 95%CI = 1.72-2.06). Similarly, prenatal depression was associated with a lower likelihood of breastfeeding initiation (OR = 0.904, 95%CI = 0.878-0.929), breastfeeding maintenance (OR = 0.929, 95%CI = 0.920-0.938), and a greater likelihood of breastfeeding difficulties (OR = 1.10, 95%CI = 1.09-1.12). Results remained largely unchanged when covaried for several confounding variables, including medication use. CONCLUSION We provide novel evidence that pre-conception and prenatal symptoms of depression are associated with breastfeeding outcomes. This information could be used to identify women very early in pregnancy who may need additional support with breastfeeding. There is also a need to fully understand the biopsychosocial mechanisms that mediate the relationship between depression prior to birth and breastfeeding outcomes.
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Affiliation(s)
- Elizabeth C Braithwaite
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK.
| | - Aurora Oftedal
- Department of Children and Families, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Kaasen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ziada Ayorech
- Promenta Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Mona Bekkhus
- Promenta Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
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Cassidy H, Taylor J, Burton AE, Owen A. A qualitative investigation of experiences of breastfeeding twins and multiples. Midwifery 2024; 135:104048. [PMID: 38852221 DOI: 10.1016/j.midw.2024.104048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/23/2024] [Accepted: 05/30/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Research has found that twins and multiples are less likely to be breastfed than singleton babies. Exploration of the experience of breastfeeding twins and multiples from parents' perspectives is limited, and we know little about the experiences of those who breastfeed twins and multiples and the possible barriers they face. AIM The aim of the research was to explore experiences of breastfeeding twins and multiples in the UK from the perspective of birthing parents. METHODS A qualitative online survey was carried out (n = 94), followed by online semi-structured interviews (n = 18). The data were analysed using reflexive thematic analysis. FINDINGS Four themes were developed from the data: (1) "It's one of the things I'm most proud of in my life" (2) The importance of support: "it definitely takes a village with twins" (3) Barriers and the pressure to formula feed: "all they wanted to do was stuff 'em full of formula" and (4) The dynamic experience of breastfeeding twins. DISCUSSION Many of the participants were able to feed their babies in part due to sheer determination and the refusal to give up when met with challenges. Breastfeeding was an important part of their identity as a mother, however mental health was often impacted by their experiences, as well as the challenges they faced when seeking support. CONCLUSION Breastfeeding twins and multiples is a challenging yet rewarding experience. Our findings indicate that further training and support is needed to enable healthcare providers to support parents of twins on their breastfeeding journey.
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Affiliation(s)
- H Cassidy
- School of Health, Science and Wellbeing Staffordshire University, UK
| | - J Taylor
- School of Health, Science and Wellbeing Staffordshire University, UK
| | - A E Burton
- School of Health, Science and Wellbeing Staffordshire University, UK
| | - A Owen
- School of Health, Science and Wellbeing Staffordshire University, UK.
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Mirzakhmetova D, Kamkhen V, Akhmetzhanova Z, Sarmuldayeva S, Ayazbekov A, Iskakova F. Predictors associated with night sleep disturbance among breastfeeding women. Prev Med 2024; 185:108011. [PMID: 38810788 DOI: 10.1016/j.ypmed.2024.108011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/23/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the incidence of somnological disorders among Kazakhstani women who breastfeed and to assess the association of this phenomenon with some medical and social characteristics. METHODS The authors used the standardized questionnaire of A.M. Vein and Y.I. Levin to assess nocturnal sleep among 1101 breastfeeding women in the Republic of Kazakhstan, applied Pearson's chi-square test to study the correlation between sleep disturbances and duration of breastfeeding, and multiple logistic regression to assess the influence of various medical and social factors on somnological disorders. Data collection occurred in February 2023. RESULTS On average, 80% of breastfeeding women (ranging from 79% to 85.9%) experienced some form of nocturnal sleep disorders, with no significant association found between these disorders and breastfeeding duration (p = 0.234), while urban residence, history of operative delivery, child's health issues, and low satisfaction levels with various aspects were associated with over twofold increased odds of experiencing sleep disorders (p ≤ 0.05). CONCLUSIONS The elevated prevalence of nocturnal sleep disorders among breastfeeding Kazakhstani women serves as a risk indicator for adverse health outcomes, with predictors including place of residence, obstetric complications, child health issues, and satisfaction levels with social conditions and personal expression opportunities.
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Affiliation(s)
- Dinara Mirzakhmetova
- Department of Obstetrics and Gynecology, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, Republic of Kazakhstan
| | - Vitalyi Kamkhen
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan.
| | | | - Sholpan Sarmuldayeva
- Department of Clinical Subjects, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan
| | - Ardak Ayazbekov
- Department of Obstetrics and Gynecology, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan, Republic of Kazakhstan
| | - Farida Iskakova
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan
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Hamnøy IL, Kjelsvik M, Baerug AB, Dahl BM. Breastfeeding mother's experiences with breastfeeding counselling: a qualitative study. Int Breastfeed J 2024; 19:34. [PMID: 38745330 PMCID: PMC11095000 DOI: 10.1186/s13006-024-00636-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Mothers are recommended to breastfeed their children but can find it challenging and experience breastfeeding problems. Qualified breastfeeding counselling from healthcare professionals can help mothers master breastfeeding, but there is a need to explore mothers' lived experiences with receiving breastfeeding counselling. We aimed to reveal breastfeeding mothers' experiences with receiving breastfeeding counselling from midwives and public health nurses (PHNs) to provide a deeper insight into the phenomenon of breastfeeding counselling, which may improve breastfeeding counselling in practice. METHODS A qualitative design with a hermeneutic phenomenological approach was used. Individual interviews of 11 breastfeeding mothers from Norway were conducted from September 2021 to 2022. Van Manen's guided existential inquiry guided the reflective process to provide deeper insights into the phenomenon of breastfeeding counselling. RESULTS The study captured the meaning of breastfeeding mothers' lived experiences with breastfeeding counselling. Three themes and eight sub-themes were found. Breastfeeding was at stake for the mothers because breastfeeding could be reduced or stopped, and qualified breastfeeding counselling from midwives and PHNs was essential for them to establish and continue breastfeeding. They needed to be perceived as both breastfeeding mothers and as women with their own needs to master everyday life during the breastfeeding period. CONCLUSIONS This study offers insights to midwives, PHNs and others offering breastfeeding counselling by facilitating an understanding of being a breastfeeding mother receiving breastfeeding counselling. Qualified breastfeeding counselling and a trusting relationship with midwives and PHNs are essential for mothers to establish and continue breastfeeding, while deficient counselling may cause breastfeeding difficulties. Mothers need to be treated as whole and competent persons to avoid objectification and fathers/partners need to be included in breastfeeding counselling. The 'Baby-Friendly Hospital Initiative' should be continued, and guidelines should align with the mothers' need to incorporate breastfeeding into their daily lives during the breastfeeding period.
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Affiliation(s)
| | | | | | - Berit Misund Dahl
- Norwegian University of Science and Technology, Ålesund, Norway
- University of Stavanger, Norwegian University of Science and Technology, Ålesund, Norway
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Djiadeu P, Begum H, Archibald C, Ekmekjian T, Busa G, Dansoh J, Van Nguyen P, Merckx J, Fleurant A. Risk of transmission of HIV to infants during breast/chest feeding when mothers/birthing parents living with HIV are on antiretroviral therapy: a protocol for a rapid review. BMJ Open 2024; 14:e084436. [PMID: 38719325 PMCID: PMC11086518 DOI: 10.1136/bmjopen-2024-084436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/12/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION HIV is a major public health issue affecting millions globally. Women and girls account for 46% of new HIV infections in 2022 and approximately 1.3 million females become pregnant every year. Vertical transmission of HIV from persons living with HIV (PLHIV) to infants may occur through different modalities, such as through breast/chest feeding. Notably, 82% of PLHIV who chose to breast/chest feed are on antiretroviral therapy (ART) when feeding their infants. Precise estimates of the risk of postpartum transmission to infants during breast/chest feeding at varying viral load levels remain a significant gap in the literature. METHODS AND ANALYSIS A rapid systematic search of electronic databases will be conducted from January 2005 to the present, including Medline, Embase and Global Health. The objective of this rapid review is to explore and assess the available evidence on the effect of varying viral load levels on the risk of HIV transmission to infants during breast/chest feeding when the birthing or gestational parent living with HIV is on ART. Study characteristics will be summarised and reported to support the narrative summary of the findings. The focus will be on the absolute risk of HIV transmission from birthing parent to infant during chest/breast feeding. The findings will also be stratified by month, including the risk of HIV transmission for 6 months and greater than 6 months postpartum. We will ascertain the risk of bias using A Measurement Tool to Assess Systematic Reviews 2, Quality of Prognosis Studies and Downs and Black checklist for the appropriate study type. A summary score will not be calculated, rather the strengths and limitations of the studies will be narratively described. ETHICS AND DISSEMINATION No human subjects will be involved in the research. The findings of this rapid review will inform a future systematic review and will be disseminated through peer-reviewed publications, presentations and conferences. PROSPERO REGISTRATION NUMBER CRD42024499393.
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Affiliation(s)
- Pascal Djiadeu
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- STBBI Guidance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Housne Begum
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- STBBI Guidance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Chris Archibald
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- STBBI Guidance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | | | - Giovanna Busa
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- STBBI Guidance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Jeffery Dansoh
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- STBBI Guidance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Phu Van Nguyen
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- STBBI Guidance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Joanna Merckx
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Annie Fleurant
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- STBBI Guidance, Public Health Agency of Canada, Ottawa, Ontario, Canada
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Schwab I, Wullenkord R, Eyssel F, Dresbach T, Scholten N. Lactation support in neonatal intensive care units in Germany from the mothers' perspective - a mixed-method study of the current status and needs. BMC Pregnancy Childbirth 2024; 24:282. [PMID: 38627697 PMCID: PMC11022450 DOI: 10.1186/s12884-024-06339-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Establishing successful lactation in mothers of very low birth weight (VLBW, <1500g) infants requires structured lactation support. Little is known about mothers' perspectives on lactation support in German neonatal intensive care units (NICUs). METHODS This paper features a convergent mixed-method approach that includes a retrospective, cross-sectional questionnaire and interview data to showcase mothers' perceptions of lactation support in NICUs. Content analysis of the interviews (n = 12) and a descriptive analysis of quantitative data (n = 533) were performed to illustrate the current status and need for lactation support in German NICUs. RESULTS The results show that lactation support in German NICUs is often inadequate and does not comply with recommendations based on the existing literature to encourage pumping and breastfeeding in mothers. The data imply that even if lactation is successfully initiated in most cases, it is often not maintained over time, which may be due to a lack of personal support and consistent information. CONCLUSION The overall structures and institutional guidelines for lactation support should be encouraged to promote nutrition with mother´s own milk in German NICUs.
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Affiliation(s)
- Isabella Schwab
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair for Health Services Research University of Cologne, Faculty of Medicine and University Hospital Cologne, Eupener Straße 129, 50933, Cologne, Germany
| | - Ricarda Wullenkord
- CITEC Center for Cognitive Interaction Technology, Bielefeld University, Inspiration 1, Bielefeld, 33619, Germany.
| | - Friederike Eyssel
- CITEC Center for Cognitive Interaction Technology, Bielefeld University, Inspiration 1, Bielefeld, 33619, Germany
| | - Till Dresbach
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Nadine Scholten
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair for Health Services Research University of Cologne, Faculty of Medicine and University Hospital Cologne, Eupener Straße 129, 50933, Cologne, Germany
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Yadollahi P, Padashian F, Doostfatemeh M. Five-factor model personality traits, exclusive breastfeeding, and self-efficacy: a mediational analysis. BMC Pregnancy Childbirth 2024; 24:279. [PMID: 38627657 PMCID: PMC11022404 DOI: 10.1186/s12884-024-06494-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Despite the World Health Organization's (WHO) emphasis on exclusive breastfeeding, the documents show a declining trend worldwide. Studies assert that the mother's personality traits appear to have an impact on this issue. This study aimed to investigate the potential influence of personality traits on exclusive breastfeeding, which might be channeled by self-efficacy as a mediator variable. METHODS Data were analyzed from the cross-sectional study. The exclusive breastfeeding scale, the breastfeeding self-efficacy questionnaire, and the Five-Factor Model questionnaire (as follows: neuroticism, extraversion, openness experience, agreeableness, and conscientiousness) were completed by120 Iranian volunteer mothers with an infant aged 6-12 months referred to health centers in Shiraz (a major city in southern Iran) between May to December 2019. The structural equation modeling (SEM) approach was used to obtain the direct and indirect effects of personality traits and self-efficacy on exclusive breastfeeding. RESULTS The study showed the significant direct effect of some personality traits (agreeableness, extraversion, and consciousness) and self-efficacy on exclusive breastfeeding. The indirect effect of extraversion on exclusive breastfeeding through self-efficacy was also obtained from the result of SEM analysis. The model fit the data satisfactorily, according to the fit indices criteria extracted from the mediational analysis. CONCLUSIONS Self-efficacy appears to be a significant predictor of exclusive breastfeeding. Therefore, exclusive breastfeeding could be enhanced by safe education in pregnancy, reinforcing the self-efficacy of pregnant women and considering their personality traits.
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Affiliation(s)
- Parvin Yadollahi
- Maternal-fetal Medicine Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Padashian
- Department of Midwifery, Behbahan Branch, Islamic Azad University, Behbahan, Iran
| | - Marziyeh Doostfatemeh
- Department of Biostatistics, Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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11
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Grattan RE, London SM, Bueno GE. Perceived pressure to breastfeed negatively impacts postpartum mental health outcomes over time. Front Public Health 2024; 12:1357965. [PMID: 38638486 PMCID: PMC11024305 DOI: 10.3389/fpubh.2024.1357965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction Positive maternal mental health is associated with improved outcomes for infants, and yet the consideration of maternal mental health is often neglected in breastfeeding interventions. Breastfeeding interventions typically focus on breastfeeding promotion, and do not always include supports for the mother. This may result in isolated perceived pressure to breastfeed, the mental health impacts of which are not well understood. Methods This mixed-methods, longitudinal study examined whether perceived pressure to breastfeed was associated with depression, suicide ideation, anxiety, birth trauma and stress concurrently and 4 weeks later for postpartum mothers. It also examined qualitative experiences of feeding. Results Perceived pressure to breastfeed was associated with increased anxiety, stress and birth trauma symptoms four weeks later. Thematic analysis suggested this may be due to difficulties living up to the "breast is best" ideal, believing breastfeeding was part of success as a mother, lack of choices and autonomy in feeding choices for infants and general lack of support. Discussion As such it appears we may be doing more harm than good by focusing our interventions for breastfeeding primarily on increasing pressure to breastfeed, and interventions should consider strategies for promoting positive maternal mental health alongside breastfeeding.
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Affiliation(s)
- Rebecca E. Grattan
- School of Psychology, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
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12
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Owen A, Cameron L, Cassidy H, Taylor J. The body image experiences of breastfeeding mothers in the UK: A qualitative exploration. J Health Psychol 2024; 29:275-288. [PMID: 37874008 DOI: 10.1177/13591053231206159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Abstract
Despite the well-documented benefits of breastfeeding, the UK has one of the lowest breastfeeding rates in the world. One of the areas that has been identified as impacting on a woman's experience of breastfeeding is body image. The aim of this study was to explore the body image experiences of breastfeeding mothers in the UK. Eighteen female participants were interviewed about their thoughts and feelings around their body image, specifically in relation to their breastfeeding. Three themes were developed following thematic analysis of the data: Breastfeeding as a functional tool, Body confidence and breastfeeding in public and Not feeling like the real me: a loss of identity. Implications of the findings are discussed, with suggestions for health promotion and ideas for encouraging a more positive body image in pregnant and breastfeeding women, with the hope of improving breastfeeding rates and experiences.
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Larose MP, Haeck C, Lefebvre P, Merrigan P. Examining the impact of a change in maternity leave policy in Canada on maternal mental health care visits to the physician. Arch Womens Ment Health 2024:10.1007/s00737-024-01448-y. [PMID: 38411866 DOI: 10.1007/s00737-024-01448-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE Maternity leave is a critical employee benefit that allows mothers to recover from the stress of pregnancy and childbirth and bond with their new baby. We aimed to examine the association between the extension of a maternity leave policy and maternal use of mental health services and prescription drugs in a universal public healthcare system. METHODS This study uses administrative medical records from 18,000 randomly selected women who gave birth three months before and after an extension of the maternity leave policy. More specifically, mothers who gave birth after January 1st 2001, were entitled to 50 weeks of paid maternity leave, while mothers who gave birth before that date were entitled to only 26 weeks of paid maternity leave. Medical records were analyzed over a seven-year period (i.e., from October 1998 to March 2006). We examined the number and costs of mothers' medical visits for mental health care in the five years following delivery, as well as maternal use of prescribed medication for mental health problems. RESULTS We found that mothers with extended maternity leave had - 0.12 (95%CI=-0.21; -0.02) fewer medical visits than mothers without a more generous maternity leave and that the cost of mental health services was Can$5 less expensive per women. These differences were found specifically during the extended maternity leave period. CONCLUSIONS The extra time away from work may help mothers to balance new family dynamics which may result in less demand on the healthcare system.
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Affiliation(s)
- Marie-Pier Larose
- INVEST Flagship Research Center, Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.
| | - Catherine Haeck
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
| | - Pierre Lefebvre
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
| | - Philip Merrigan
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
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Metin A, Baltacı N. The effects of video-assisted breastfeeding education given to primiparous pregnant women on breastfeeding self-efficacy: randomized control study. BMC Pregnancy Childbirth 2024; 24:142. [PMID: 38368316 PMCID: PMC10873982 DOI: 10.1186/s12884-024-06317-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/03/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Breastfeeding is vitally important for the health of the mother, baby, family and society. Especially the perception of breastfeeding self-efficacy of primiparous pregnant women is an important factor in breastfeeding. This study was conducted to determine the effects of online video-supported breastfeeding education on breastfeeding self-efficacy in primiparous pregnant women. METHODS This randomized controlled study was conducted with primiparous pregnant women admitted to a university hospital in northern Turkey. The study involved 80 pregnant women, with 40 assigned to the experimental group and 40 to the control group. Participants in the intervention group received online video-assisted education, which covered the first meeting of the mother and baby as well as the initial breastfeeding session. The data for the breastfeeding self-efficacy scale were gathered at the onset of the study and three weeks later. In data analysis, categorical variables were assessed using the chi-square test, continuous variables and intergroup comparisons were conducted through the independent sample t-test, and intragroup comparisons were performed using the paired sample t-test. RESULTS While the baseline breastfeeding self-efficacy levels of the primiparous pregnant women were similar between the groups, statistically significant differences were observed both within (p = 0.000) and between (p = 0.000) groups in the breastfeeding self-efficacy scores of pregnant women in the intervention group after the education intervention. CONCLUSION Breastfeeding self-efficacy levels in the education group showed a statistically significant increase compared to both the pre-education and control groups. This highlights the importance of nurses providing support to primiparous pregnant women through video-assisted education during pregnancy to enhance breastfeeding self-efficacy. TRIAL REGISTRATION ClinicalTrials.gov: NCT06121973 date of first registration (27/10/2023), retrospectively registered (08/11/2023).
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Affiliation(s)
- Ayşe Metin
- Faculty of Health Sciences, Department of Nursing, Erzurum Technical University, Erzurum, Turkey.
| | - Nazlı Baltacı
- Faculty of Health Sciences, Department of Nursing, Ondokuz Mayıs University, Samsun, Turkey
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Channell Doig A. Latina Mothers' Infant Feeding Experiences During the 2022 Formula Shortage. J Perinat Neonatal Nurs 2024; 38:37-45. [PMID: 38278643 DOI: 10.1097/jpn.0000000000000799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
BACKGROUND Mothers report feeling immense pressure to breastfeed their infants, and not doing so can be associated with stigma, shame, and judgment. Many Latina mothers struggle to meet their breastfeeding goals and substitute formula earlier than planned. During 2022, an infant formula recall caused a shortage and made acquiring formula difficult or impossible in many areas of the United States. This study explores Latina mothers' experiences with infant feeding during the time of the formula shortage. METHODS In-depth interviews (N = 7) were conducted with Latina mothers who formula-fed during the shortage. Interviews were analyzed using reflexive thematic analysis. Mean maternal age was 29.7 years, and mean infant age was 10.3 months. Three mothers were born in the United States, and 4 were immigrants. RESULTS Thematic analysis generated 3 themes: (1) Fighting to breastfeed; (2) Breastfeeding is not the only way to be a "good" mother; and (3) No formula on the shelves. Participants described their determination to continue breastfeeding despite challenges before realizing that it limited their ability to care for their children. They discussed the emotional toll of the formula shortage and strategies for finding formula. CONCLUSIONS The findings emphasize the need for additional structural support for infant feeding in the United States to prevent future formula shortages and for better lactation care and mental health support for mothers who want to breastfeed.
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Affiliation(s)
- Amara Channell Doig
- Department of Behavioral and Community Health, University of Maryland, College Park
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Fu Y, Lin X, Li Y, Zhang M, Chen WT, Huang F. Trajectories of cognitive reactivity and its predictive value on postpartum depression in Chinese women: a latent class growth modeling analysis. J Psychosom Obstet Gynaecol 2023; 44:2256470. [PMID: 37747284 DOI: 10.1080/0167482x.2023.2256470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023] Open
Abstract
Many women are experiencing postpartum depression (PPD) after giving birth. How to recognize and intervene in high-risk PPD women early and effectively remains unknown. Our objective is to describe the latent trajectory groups of cognitive reactivity (CR) in perinatal women, and their relationship to demographic and disease-related factors, as well as investigate the associations with PPD. Data from 321 perinatal women who were evaluated in urban tertiary hospitals in China at three-time points: 32-35 weeks of pregnancy, 1 week postpartum, and 6 weeks postpartum. Latent class growth modeling was used to identify the trajectory patterns of CR and logistic regression was used to explore the association between demographic and disease-related factors, CR trajectories, and depression. Three trajectory groups were identified: the continuing deterioration group (17.2%), the postpartum deterioration group (22.1%), and the consistent resilient group (60.7%). Participants with a bachelor's degree or higher and with gestational diabetes diagnosis were more likely to be in the continuing deterioration group. Those who were from only-child families were more likely to be in the postpartum deterioration group. Women in the continuing deterioration group and postpartum deterioration group were more likely to experience PPD. Targeted interventions should be developed based on trajectory group of CR.
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Affiliation(s)
- Yanqing Fu
- Fujian Medical University Union Hospital Department of Gynaecology and Obstetrics Nursing, Fuzhou, Fujian, China
| | - Xiujing Lin
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Yonglin Li
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Minfang Zhang
- Fujian Medical University Union Hospital Department of Gynaecology and Obstetrics Nursing, Fuzhou, Fujian, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
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Henshaw EJ. Breastfeeding and Postpartum Depression: A Review of Relationships and Potential Mechanisms. Curr Psychiatry Rep 2023; 25:803-808. [PMID: 37906349 DOI: 10.1007/s11920-023-01471-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE OF REVIEW Postpartum depression (PPD) and breastfeeding are important, interrelated health factors. It is established that women who breastfeed exclusively have lowered likelihood of developing significant PPD. Yet, many questions remain around what factors are involved. The purpose of this review is to provide updated information about the relationship between PPD and breastfeeding. RECENT FINDINGS Both psychological and physiological factors have emerged as important moderators and mechanisms of the relationship between postpartum depression and breastfeeding. Breastfeeding self-efficacy, self-compassion, and engagement with the infant during feeding all modify or mediate the relationship, and a complex dynamic relationship among cortisol, oxytocin, progesterone, and estrogen is involved. Importantly, recent intervention studies suggest psychosocial interventions may impact both breastfeeding and mood. Providers and researchers should recognize the interrelationship between the breastfeeding and PPD and apply this understanding to patient care through integrated education and care for both mood and breastfeeding enhancement.
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Affiliation(s)
- Erin J Henshaw
- Department of Psychology, Denison University, 100 West College Street, Granville, OH, 43023, USA.
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18
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Groff E, Steger F. The Ethics of Ancient Lactation and the Cult of the Perfect Breastfeeding Mother. Healthcare (Basel) 2023; 11:2941. [PMID: 37998433 PMCID: PMC10671742 DOI: 10.3390/healthcare11222941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/27/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
Breastfeeding is a key issue found in ancient sources that resonates with public debates today, affecting women in different parts of the world and of all social classes. The aim of this research was to identify breastfeeding narratives in ancient medical and philosophical texts from the 1st to the 6th century CE that address ethical issues in the medical management and social perception of new mothers. We examined 15 literary sources and one funerary inscription on lactation and critically evaluated the ancient idea of the perfect breastfeeding mother versus the non-breastfeeding mother. We then discussed our historical data in terms of objectivity and significance in relation to contemporary attitudes towards motherhood and lactation, e.g., (1) the cult of the perfect, breastfeeding mother in contemporary lactation education and (2) the onset of conditions which may affect normal breastfeeding, such as dysphoric milk ejection reflex (D-MER), breastfeeding aversion response (BAR) or post-partum depression. The analysis of the results showed that in both ancient and contemporary postnatal health care: (1) good mothering is associated with breastfeeding and (2) alternative feeding methods are acknowledged, but never as the best, natural option. Finally, our analysis shows that public health policies on breastfeeding and mothers' own knowledge of their bodies are contested between nursing theories, social expectations and economic factors.
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Affiliation(s)
- Elisa Groff
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, 89081 Ulm, Germany;
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19
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Descarpentrie A, Poquet D, Brugailleres P, Sauvegrain P, Frenoy P, Richard E, Bernard JY, de Lauzon-Guillain B, Vandentorren S, Lioret S. Is breastfeeding duration related to the health of migrant mother-child dyads experiencing homelessness? The ENFAMS cross-sectional survey. Eur J Public Health 2023; 33:796-802. [PMID: 37339520 PMCID: PMC10567129 DOI: 10.1093/eurpub/ckad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Literature from the general population shows a consensus about the health benefits associated with breastfeeding for both mothers and children. However, studies investigating these issues in the context of homelessness and migration are rare. This research aimed to examine the relations of any breastfeeding duration with health outcomes among migrant mother-child dyads experiencing homelessness. METHODS Data were collected among sheltered and mainly foreign-born mothers experiencing homelessness, and their children aged 6 months to 5 years, from the ENFAMS cross-sectional survey (n = 481, 2013-Great Paris area). Any breastfeeding duration, along with various health outcomes of both the mother and her child, was ascertained by face-to-face questionnaires administered by trained interviewers to mothers (perceived physical and emotional health and maternal depression) or by trained psychologists to children (adaptive behaviours). Nurses measured weight and height [thus allowing them to calculate body mass index (BMI)] and haemoglobin concentration (mother-child dyad) and maternal blood pressure. Multivariable linear and modified Poisson regression analyses were performed to examine outcome-wide associations between any breastfeeding duration ≥6 months and the various mother-child outcomes. RESULTS Any breastfeeding ≥6 months was associated with lower systolic blood pressure in mothers (B = -0.40, 95% confidence interval = -0.68 to -0.12). No association was observed with the other outcomes. CONCLUSIONS The relevance of supporting breastfeeding to improve mothers' physical health holds true in the context of migration and homelessness. It is therefore important to support breastfeeding in these settings. Moreover, given the documented social complexity of breastfeeding practices, interventions should take mothers' socio-cultural heritage and the structural barriers they face into account.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Delphine Poquet
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | | | - Priscille Sauvegrain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Sorbonne Université, Midwifery Unit, Paris, France
- Institut Convergences Migrations/CNRS, Aubervilliers, France
| | - Pauline Frenoy
- Université Paris Saclay, UVSQ, Université Paris-Sud, Inserm, Gustave Roussy, “Exposome and Heredity” Team, CESP, Villejuif, France
| | - Elodie Richard
- CIFRE Fnasat, Université Bordeaux, Inserm, UMR1219, Bordeaux, France
| | - Jonathan Y Bernard
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Blandine de Lauzon-Guillain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Stéphanie Vandentorren
- Université Bordeaux, Inserm, UMR1219, PHARes Team, Bordeaux, France
- Institut Convergences Migrations/CNRS, Aubervilliers, France
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Sandrine Lioret
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Dhaurali S, Dugat V, Whittler T, Shrestha S, Kiani M, Ruiz MG, Ali I, Enge C, Amutah-Onukagha N. Investigating Maternal Stress, Depression, and Breastfeeding: A Pregnancy Risk Assessment Monitoring System (2016-2019) Analysis. Healthcare (Basel) 2023; 11:1691. [PMID: 37372809 DOI: 10.3390/healthcare11121691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Breastfeeding is invaluable for postpartum physical healing and mental wellbeing, but psychosocial stress and depression impede such recovery processes. To inform future interventions and policies, associations between breastfeeding, maternal stress, and depression were examined. Data from the Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed (2016-2019). Logistic regression models were used to calculate adjusted odds ratios with 95% confidence intervals. Of the total sample (n = 95,820), approximately 88% of participants attempted breastfeeding. Our findings indicate that participants who experienced any form of stress had a slightly higher likelihood of breastfeeding compared to those without stress. Specifically, partner-related and financial-related stressors were significantly associated with increased odds of breastfeeding. However, no significant associations were observed trauma-related or emotional-related stressors and breastfeeding. Additionally, no significant association was found between depression at different stages (preconception, prenatal, and postpartum) and breastfeeding. A significant interaction effect was noted between having experienced any of the 13 stressors and Black race/ethnicity on breastfeeding odds. Similarly, significant interaction effects were observed between partner-related, trauma, financial, or emotional stressors and Black race/ethnicity. These findings emphasize the importance of considering various factors when promoting breastfeeding in diverse populations, and screening for psychosocial stress during postpartum visits. Our study recommends tailoring breastfeeding interventions to address the needs of Black mothers which could significantly improve maternal health and breastfeeding outcomes.
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Affiliation(s)
- Shubhecchha Dhaurali
- Department of Community Health, Tufts University, 419 Boston Avenue, Medford, MA 02155, USA
- Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
- Maternal Health Epidemiology and Data Synthesis Unit, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Vickie Dugat
- Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Tayler Whittler
- Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Shikhar Shrestha
- Maternal Health Epidemiology and Data Synthesis Unit, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Marwah Kiani
- Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Maria Gabriela Ruiz
- Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Iman Ali
- Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Courtney Enge
- Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
| | - Ndidiamaka Amutah-Onukagha
- Maternal Outcomes for Translational Health Equity Research (MOTHER) Lab, Center for Black Maternal Health and Reproductive Justice, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA
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Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 4. Obstet Gynecol 2023; 141:1232-1261. [PMID: 37486660 DOI: 10.1097/aog.0000000000005200] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
PURPOSE To review evidence on the current understanding of mental health conditions in pregnancy and postpartum, with a focus on mood and anxiety disorders, and to outline guidelines for screening and diagnosis that are consistent with best available scientific evidence. The conditions or symptoms reviewed include depression, anxiety and anxiety-related disorders, bipolar disorder, suicidality, and postpartum psychosis. For information on psychopharmacologic treatment and management, refer to American College of Obstetricians and Gynecologists (ACOG) Clinical Practice Guideline Number 5, "Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum" (1). TARGET POPULATION Pregnant or postpartum individuals with mental health conditions. Onset of these conditions may have predated the perinatal period or may have occurred for the first time in pregnancy or the first year postpartum or may have been exacerbated in that time. METHODS This guideline was developed using an a priori protocol in conjunction with a writing team consisting of one specialist in obstetrics and gynecology and one maternal-fetal medicine subspecialist appointed by the ACOG Committee on Clinical Practice Guidelines-Obstetrics and two external subject matter experts. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements. RECOMMENDATIONS This Clinical Practice Guideline includes recommendations on the screening and diagnosis of perinatal mental health conditions including depression, anxiety, bipolar disorder, acute postpartum psychosis, and the symptom of suicidality. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence.
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Ganho-Ávila A, Guiomar R, Sobral M, Pacheco F, Caparros-Gonzalez RA, Diaz-Louzao C, Motrico E, Domínguez-Salas S, Mesquita A, Costa R, Vousoura E, Hadjigeorgiou E, Bina R, Buhagiar R, Mateus V, Contreras-García Y, Wilson CA, Ajaz E, Hancheva C, Dikmen-Yildiz P, de la Torre-Luque A. The impact of COVID-19 on breastfeeding rates: An international cross-sectional study. Midwifery 2023; 120:103631. [PMID: 36822049 PMCID: PMC9922537 DOI: 10.1016/j.midw.2023.103631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 01/17/2023] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Breastfeeding promotes children's health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic. METHODS This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries' inequality levels) were studied by Generalized Linear Mixed-Effects Models. RESULTS A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child (β = -0.27), age of the child (β = -0.29), preterm birth (β = -0.52), admission to the neonatal/pediatric care (β = -0.44), lack of breastfeeding support (β = -0.18), current psychiatric treatment (β = -0.69) and inequality (β = -0.71) were negatively associated with breastfeeding (p < .001). Access to postnatal support groups was positively associated with breastfeeding (β = 0.59; p < .001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding (β = -0.16; p < .05) while access to maternity leave protected breastfeeding (β = 0.50; p < .001). DISCUSSION This study shows that mother's COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding.
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Affiliation(s)
- Ana Ganho-Ávila
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal.
| | - Raquel Guiomar
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal.
| | - Mónica Sobral
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Francisca Pacheco
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Rafael A Caparros-Gonzalez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; Instituto de Investigación Biosanitaria ibs. Granada, Spain; Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
| | - Carla Diaz-Louzao
- Research Methodology Group, University Clinical Hospital of Santiago (CHUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, 15706, Spain
| | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucia, Avenida de las Universidades s/n, Dos Hermanas (Sevilla), Spain
| | - Sara Domínguez-Salas
- Psychology Department, Universidad Loyola Andalucia, Avenida de las Universidades s/n, Dos Hermanas (Sevilla), Spain
| | - Ana Mesquita
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Raquel Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; HEI-Lab: Digital Human-environment Interaction. Lusófona University, Lisbon, Portugal
| | - Eleni Vousoura
- Department of Psychology, National and Kapodistrian University of Athens, Greece
| | - Eleni Hadjigeorgiou
- Nursing Department, School of Health Science, Cyprus University of Technology, Cyprus
| | - Rena Bina
- School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | | | - Vera Mateus
- Graduate Program on Developmental Disorders and Mackenzie Center for Research in Childhood and Adolescence, Center for Biological and Health Sciences, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Yolanda Contreras-García
- Departamento de Obstetricia y Puericultura. Facultad de Medicina. Universidad de Concepción, Chile
| | - Claire A Wilson
- Section of Women's Mental Health, King's College London and South London and Maudsley NHS Foundation Trust, UK
| | | | | | | | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid. Centre for Biomedical Research in Mental Health (CIBERSAM), 28040 Madrid, Spain
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