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Carvalho Hilje C, Bauer NH, Reis D, Kapp C, Ostermann T, Vöhler F, Längler A. The role of breastfeeding and formula feeding regarding depressive symptoms and an impaired mother child bonding. Sci Rep 2024; 14:11417. [PMID: 38763963 PMCID: PMC11102907 DOI: 10.1038/s41598-024-62168-y] [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: 02/06/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024] Open
Abstract
Associations between depressive symptoms and breastfeeding are well documented. However, evidence is lacking for subdivisions of feeding styles, namely exclusive breastfeeding, exclusive formula feeding and a mixed feeding style (breastfeeding and formula feeding). In addition, studies examining associations between mother-child-bonding and breastfeeding have yielded mixed results. The aim of this study is to provide a more profound understanding of the different feeding styles and their associations with maternal mental health and mother-child-bonding. Data from 307 women were collected longitudinally in person (prenatally) and by telephone (3 months postnatally) using validated self-report measures, and analyzed using correlational analyses, unpaired group comparisons and regression analyses. Our results from a multinomial regression analysis revealed that impaired mother-child-bonding was positively associated with mixed feeding style (p = .003) and depressive symptoms prenatal were positively associated with exclusive formula feeding (p = .013). Further studies could investigate whether information about the underlying reasons we found for mixed feeding, such as insufficient weight gain of the child or the feeling that the child is unsatiated, could help prevent impaired mother-child-bonding. Overall, the results of this study have promising new implications for research and practice, regarding at-risk populations and implications for preventive measures regarding postpartum depression and an impaired mother-child-bonding.
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Affiliation(s)
- Clara Carvalho Hilje
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany
| | - Nicola H Bauer
- Institute of Midwifery Science, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Daniela Reis
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany.
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany.
| | - Claudia Kapp
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Franziska Vöhler
- Department of Obstetrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
| | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Witten, Germany
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Hanach N, Radwan H, Bani Issa W, Saqan R, de Vries N. The perceived mental health experiences and needs of postpartum mothers living in the United Arab Emirates : A focus group study. Midwifery 2024; 132:103977. [PMID: 38518436 DOI: 10.1016/j.midw.2024.103977] [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: 09/05/2023] [Revised: 02/06/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND After childbirth, mothers are particularly vulnerable to mental health problems including anxiety and depression, which often remain undetected and untreated. In the United Arab Emirates (UAE), recent figures revealed a substantial prevalence of postpartum depression. However, postpartum mental health remains largely understudied in the country's clinical and research settings. Therefore, given the paucity of literature in the UAE and building upon previous epidemiological findings, this study aimed to explore the perceived mental health experiences and needs of mothers during the postpartum period to guide the development of targeted interventions that address mothers' unique mental health challenges. METHODOLOGY Four focus groups were conducted, involving a total of 27 Emirati and multicultural expatriate mothers aged 32.47 ± 4.56 years old, living in the UAE and within their first year postpartum. Descriptive interpretive thematic analysis was employed to analyze the data. ANALYSIS Six themes were generated that capture the mothers postpartum experiences and mental health needs: (1) distinct postpartum experiences of primiparous and multiparous mothers, (2) experiences of emotional distress in the initial postpartum stage, (3) multifaceted challenges in breastfeeding, (4) multifactorial influences on postpartum mental health, (5) postpartum social support resources and providers, and (6) the need for formal and informal resources. CONCLUSIONS The findings highlight the importance of considering the unique cultural and societal factors that impact maternal mental health in the UAE, given its diverse population. A collaborative multidisciplinary approach, integrating culture sensitivity, is vital to address the mental health needs of postpartum mothers and to guide the development of tailored evidence-based interventions.
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Affiliation(s)
- Nivine Hanach
- Faculty of Health, Medicine, and Life Sciences, Care and Publica Health Research Institute, Maastricht University, Maastricht, the Netherlands.
| | - Hadia Radwan
- Clinical Nutrition and Dietetics Dept., College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Wegdan Bani Issa
- Nursing Dept., College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Roba Saqan
- Health Promotion Group, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Nanne de Vries
- Faculty of Health, Medicine, and Life Sciences, Care and Publica Health Research Institute, Maastricht University, Maastricht, the Netherlands
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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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Baker N, Bick D, Bamber L, Wilson CA, Howard LM, Bakolis I, Soukup T, Chang Y. A mixed methods systematic review exploring infant feeding experiences and support in women with severe mental illness. MATERNAL & CHILD NUTRITION 2023; 19:e13538. [PMID: 37276241 PMCID: PMC10483956 DOI: 10.1111/mcn.13538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/27/2023] [Accepted: 05/06/2023] [Indexed: 06/07/2023]
Abstract
There are many benefits of breastfeeding to women and their infants but meeting the recommended 6 months of exclusive breastfeeding is likely to be more challenging for women with severe mental illness (SMI). This is the first systematic review that aims to examine evidence of (a) infant feeding outcomes in women with SMI and the factors associated with this, (b) the experiences of infant feeding and infant feeding support for women with SMI, (c) interventions for supporting infant feeding among these women and (d) health care professionals' attitudes toward supporting infant feeding in women with SMI. Mixed methods systematic review was carried out using the principles of Joanna Briggs Institute's (JBI) 'convergent integrated' methodology. CINAHL, PsycINFO, Medline and MIDIRS were used to search literature between 1994 and 2022. The quality of selected articles was assessed using JBI critical appraisal tools and thematic synthesis was undertaken to obtain findings. Eighteen papers were included in the final review. Women with SMI were less likely to initiate and continue breastfeeding than women without SMI. Several challenges with breastfeeding were highlighted, and while these were often linked to women's mental health difficulties, inconsistent advice from health care professionals and poor support with breastfeeding further compounded these challenges. This review highlights that policy and practice need to take into account the individual challenges women with SMI face when planning, initiating and maintaining breastfeeding. Education and training for health care professionals are needed to enable them to provide tailored infant feeding support to women with SMI, which reflects their individual needs.
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Affiliation(s)
- Natasha Baker
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Debra Bick
- Warwick Clinical Trials Unit, Warwick Medical SchoolUniversity of WarwickCoventryUK
| | - Louise Bamber
- Child and Maternal Mental Health Team, South London and Maudsley NHS Foundation TrustLondonUK
| | - Claire A. Wilson
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- Child and Maternal Mental Health Team, South London and Maudsley NHS Foundation TrustLondonUK
| | - Louise M. Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics & Health Service and Population Research Department, School of Mental Health and Psychological Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Tayana Soukup
- Department of Surgery and CancerImperial College LondonLondonUK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Yan‐Shing Chang
- Methodologies Research Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College LondonLondonUK
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Scime NV, Brockway ML, Metcalfe A, Nettel-Aguirre A, Tough SC, Chaput KH. Association of illness perceptions and exclusive breastfeeding intentions among pregnant women with chronic conditions: A community-based pregnancy cohort study. J Psychosom Res 2023; 172:111418. [PMID: 37429127 DOI: 10.1016/j.jpsychores.2023.111418] [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: 07/08/2022] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE We examined whether changes in illness perceptions from preconception to pregnancy were associated with intentions to exclusively breastfeed to 6 months postpartum among women with chronic physical health conditions. METHODS We analyzed self-reported cross-sectional questionnaire data collected in the third trimester from 361 women with chronic conditions enrolled in a community-based cohort study (Alberta, Canada). For individual and total illness perceptions, measured with the Brief Illness Perception Questionnaire, women were classified using change scores (preconception minus pregnancy) into one of the following groups: "worsening," "improving," or "stable" in pregnancy. Intention to exclusively breastfeed was defined as plans to provide only breast milk for the recommended first 6 months after birth. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariable logistic regression modelling, with the "stable" group as the reference and controlling for demographic factors, chronic condition duration and medication, prenatal class attendance, and social support. RESULTS Overall, 61.8% of women planned to exclusively breastfeed to 6 months. Worsened total illness perceptions (adjusted OR 0.50, 95% CI 0.30-0.82) as well as perceptions of worsened identity (i.e., degree of symptoms; adjusted OR 0.49, 95% CI 0.28-0.85) or consequences (i.e., impact on functioning; adjusted OR 0.60, 95% CI 0.34-1.06) were associated with lower odds of intending to exclusively breastfeed to 6 months. CONCLUSIONS Women who perceive their illness experience to worsen during pregnancy are less likely to plan to exclusively breastfeed to 6 months in accordance with public health recommendations.
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Affiliation(s)
- Natalie V Scime
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
| | - Meredith L Brockway
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amy Metcalfe
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alberto Nettel-Aguirre
- Centre For Health and Social Analytics, National Institute for Applied Statistical Research, School of Mathematics and Statistics, University of Wollongong, NSW, Australia.; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Suzanne C Tough
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Kathleen H Chaput
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada
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Nurbaeti I, Lestari KB, Syafii M. Association between Islamic religiosity, social support, marriage satisfaction, and postpartum depression in teenage mothers in West Java, Indonesia: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:313-321. [PMID: 37645571 PMCID: PMC10461155 DOI: 10.33546/bnj.2661] [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: 04/08/2023] [Revised: 05/08/2023] [Accepted: 07/17/2023] [Indexed: 08/31/2023] Open
Abstract
Background Postpartum depression is a prevalent mental health issue among mothers after giving birth. Adolescent mothers are believed to have a higher rate of postpartum depression than adult mothers. However, research on postpartum depression among teenage mothers in Indonesia remains limited. This research gap emphasizes the need for more comprehensive studies to address the mental health and well-being of postpartum mothers in Indonesia, especially among adolescents. Objective This study aimed to investigate the correlations between Islamic religiosity, social support, marital satisfaction, and postpartum depression in teenage mothers in Indonesia. Methods A cross-sectional study was conducted involving 203 adolescent postpartum mothers selected through cluster sampling. Data were collected using validated questionnaires from July to August 2020 in Cianjur and Sukabumi districts, West Java Province, Indonesia. Descriptive statistics, chi-square, and multiple logistic regression were employed for data analysis. Results The study revealed that 35.96% of teenage mothers experienced symptoms of postpartum depression. Among the variables studied, marriage satisfaction (p = 0.002), education level (p = 0.012), family income (p = 0.003), number of children (p = 0.044), and baby weight at birth (p = 0.0001) were significantly associated with postpartum depression. However, social support (p = 0.688) and religiosity (p = 0.788) showed no significant association with postpartum depression. Multiple logistic regression analysis further confirmed that marriage satisfaction (p = 0.001; OR = 0.365; 95% CI 0.197 - 0.676), family income (p = 0.001; OR = 0.326; 95% CI = 0.165 - 0.644), and the number of children (p = 0.026; OR = 3.68; 95% CI = 1.173 - 11.547) were the most significant factors associated with postpartum depression. Conclusion The study highlighted a high prevalence of postpartum depression among adolescent mothers. Marital satisfaction, family income, and the number of children were identified as key factors associated with postpartum depression in this population. These findings emphasize the importance of considering these factors in nursing and midwifery practice to provide targeted support and interventions, ultimately improving the mental health outcomes for teenage mothers during the postpartum period.
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Affiliation(s)
- Irma Nurbaeti
- Nursing Program, Faculty of Health Sciences Universitas Islam Negeri Syarif Hidayatullah Jakarta, Indonesia
| | - Kustati Budi Lestari
- Nursing Program, Faculty of Health Sciences Universitas Islam Negeri Syarif Hidayatullah Jakarta, Indonesia
| | - Moch Syafii
- University of Al Zaytun, Indramayu, Indonesia
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Frawley T, McGuinness D. Dysphoric milk ejection reflex (D-MER) and its implications for mental health nursing. Int J Ment Health Nurs 2023; 32:620-626. [PMID: 36705232 DOI: 10.1111/inm.13115] [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] [Accepted: 12/28/2022] [Indexed: 01/28/2023]
Abstract
Dysphoric milk ejection reflect (D-MER) is a dysphoria which women may experience within seconds of commencing breastfeeding. It is only recently gaining recognition in the academic literature and may have important implications for breastfeeding continuation, differential diagnosis and perinatal mental health. This perspective piece introduces the topic, sets out the physiological processes underpinning the experience and outlines why increased awareness of D-MER is important for the profession of mental health nursing.
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Affiliation(s)
- Timothy Frawley
- Mental Health Nursing, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Denise McGuinness
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Aizlewood EG, Jones FW, Whatmough RM. Paediatric gastroesophageal reflux disease and parental mental health: Prevalence and predictors. Clin Child Psychol Psychiatry 2023:13591045231164866. [PMID: 36939301 DOI: 10.1177/13591045231164866] [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] [Indexed: 03/21/2023]
Abstract
OBJECTIVE The current study aimed to estimate the prevalence of common mental health difficulties in parents who have an infant with Gastroesophageal Reflux Disease (GORD), and to identify psychological predictors of parental anxiety, depression, and well-being, as a platform for subsequent intervention development. METHODS Parents of infants with GORD (N = 309) completed online psychometric measures of potential predictors (self-compassion, illness appraisals, and illness uncertainty), potential confounders (sleep quality, relationship satisfaction, social support, and infant feeding satisfaction), and mental health outcomes (anxiety, depression, and wellbeing). The outcome measures were repeated eight-weeks later (N = 103). RESULTS At the first time-point, 66% of participants exceed the clinical cut off for generalised anxiety disorder and 63% exceeded that for a depressive disorder. Both had significantly reduced eights-weeks later. Greater self-compassion predicted lower anxiety and depression, and better well-being, in both cross-sectional and longitudinal data, including when all confounders were controlled for. Illness uncertainty and illness appraisals were less consistent predictors. No robust differences were found between parents of infants with silent GORD and those with GORD with visible regurgitation. CONCLUSIONS Parents of infants with GORD showed high rates of anxiety and depression, which were elevated compared to those that have been found in perinatal and general population samples. Self-compassion was a consistent predictor of better mental health and has promise as a proximal intervention target. Future research could benefit from examining the efficacy of a compassion-focussed intervention in this population.
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Affiliation(s)
- Elizabeth Gm Aizlewood
- Salomons Institute for Applied Psychology, 2238Canterbury Christ Church University, Tunbridge Wells, UK
| | - Fergal W Jones
- Salomons Institute for Applied Psychology, 2238Canterbury Christ Church University, Tunbridge Wells, UK
| | - Rachel M Whatmough
- Salomons Institute for Applied Psychology, 2238Canterbury Christ Church University, Tunbridge Wells, UK
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Scime NV, Metcalfe A, Nettel-Aguirre A, Nerenberg K, Seow CH, Tough SC, Chaput KH. Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis. BMC Pregnancy Childbirth 2023; 23:90. [PMID: 36732799 PMCID: PMC9893695 DOI: 10.1186/s12884-023-05407-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Breastfeeding difficulties frequently exacerbate one another and are common reasons for curtailed breastfeeding. Women with chronic conditions are at high risk of early breastfeeding cessation, yet limited evidence exists on the breastfeeding difficulties that co-occur in these mothers. The objective of this study was to explore clusters of breastfeeding difficulties experienced up to 6 weeks postpartum among mothers with chronic conditions and to examine associations between chronic condition types and breastfeeding difficulty clusters. METHODS We analyzed 348 mothers with chronic conditions enrolled in a prospective, community-based pregnancy cohort study from Alberta, Canada. Data were collected through self-report questionnaires. We used latent class analysis to identify clusters of early breastfeeding difficulties and multinomial logistic regression to examine whether types of chronic conditions were associated with these clusters, adjusting for maternal and obstetric factors. RESULTS We identified three clusters of breastfeeding difficulties. The "physiologically expected" cluster (51.1% of women) was characterized by leaking breasts and engorgement (reference outcome group); the "low milk production" cluster (15.4%) was discerned by low milk supply and infant weight concerns; and the "ineffective latch" cluster (33.5%) involved latch problems, sore nipples, and difficulty with positioning. Endocrine (adjusted relative risk ratio [RRR] 2.34, 95% CI 1.10-5.00), cardiovascular (adjusted RRR 2.75, 95% CI 1.01-7.81), and gastrointestinal (adjusted RRR 2.51, 95% CI 1.11-5.69) conditions were associated with the low milk production cluster, and gastrointestinal (adjusted RRR 2.44, 95% CI 1.25-4.77) conditions were additionally associated with the ineffective latch cluster. CONCLUSION Half of women with chronic conditions experienced clusters of breastfeeding difficulties corresponding either to low milk production or to ineffective latch in the first 6 weeks postpartum. Associations with chronic condition types suggest that connections between lactation physiology and disease pathophysiology should be considered when providing breastfeeding support.
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Affiliation(s)
- Natalie V. Scime
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada
| | - Amy Metcalfe
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Medicine, University of Calgary, Calgary, AB Canada
| | - Alberto Nettel-Aguirre
- grid.1007.60000 0004 0486 528XCentre For Health and Social Analytics, School of Mathematics and Statistics, National Institute for Applied Statistical Research, University of Wollongong, Wollongong, NSW Australia ,grid.22072.350000 0004 1936 7697Department of Pediatrics, University of Calgary, Calgary, AB Canada
| | - Kara Nerenberg
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Division of General Internal Medicine, Department of Medicine, University of Calgary, Calgary, AB Canada
| | - Cynthia H. Seow
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Division of Gastroenterology & Hepatology, Department of Medicine, University of Calgary, Calgary, AB Canada
| | - Suzanne C. Tough
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Pediatrics, University of Calgary, Calgary, AB Canada
| | - Kathleen H. Chaput
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB Canada
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Chang Y, Li KMC, Chien L, Lee EY, Hong SA, Coca KP. Associations between breastfeeding intention, breastfeeding practices and post-natal depression during the COVID-19 pandemic: A multi-country cross-sectional study. MATERNAL & CHILD NUTRITION 2022; 19:e13450. [PMID: 36349949 PMCID: PMC9749603 DOI: 10.1111/mcn.13450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 09/14/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022]
Abstract
Associations between breastfeeding intention, duration and post-natal depression (PND) have been shown in pre-COVID-19 studies. However, studies during COVID-19 have not examined the associations between breastfeeding intention, breastfeeding practices, and PND in an international sample of post-natal women, taking into consideration COVID-19 related factors. This is the first study to address this gap as both PND and breastfeeding may be affected by COVID-19, and have important long-term effects on women's and infant's health. A cross-sectional internet-based survey was conducted with 3253 post-natal women from five countries: Brazil, South Korea, Taiwan, Thailand, and the United Kingdom from July to November 2021. The results showed that women who intended to breastfeed during pregnancy had lower odds of having PND than women who did not intend to. Women who had no breastfeeding intention but actually breastfed had greater odds (AOR 1.75) of having PND than women who intended to breastfeed and actually breastfed. While there was no statistical significance in expressed breast milk feeding in multivariable logistic regression models, women who had shorter duration of breastfeeding directly on breast than they planned had greater odds (AOR 1.58) of having PND than those who breastfed longer than they planned even after adjusting for covariates including COVID-19-related variables. These findings suggested the importance of working with women on their breastfeeding intention. Tailored support is required to ensure women's breastfeeding needs are met and at the same time care for maternal mental health during and beyond the pandemic.
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Affiliation(s)
- Yan‐Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative CareKing's College LondonLondonUK
| | - Kan M. C. Li
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative CareKing's College LondonLondonUK,Guy's and St. Thomas' NHS Foundation TrustEvelina London Children's HospitalLondonUK
| | - Li‐Yin Chien
- Institute of Community Health Care, National Yang Ming Chiao Tung UniversityYang‐Ming CampusTaipeiTaiwan
| | - Eun Y. Lee
- Department of NursingCatholic Kkottongnae UniversityCheongjuRepublic of Korea
| | - Seo A. Hong
- ASEAN Institute for Health DevelopmentMahidol UniversityNakhon PathomThailand,Institute for Health and SocietyHanyang UniversitySeoulRepublic of Korea
| | - Kelly P. Coca
- Department of Women's Health Nursing, Escola Paulista de EnfermagemUniversidade Federal de São PauloSão PauloBrazil
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11
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Christie H, Hiscox LV, Halligan SL, Creswell C. Examining harmful impacts of the COVID‐19 pandemic and school closures on parents and carers in the United Kingdom: A rapid review. JCPP ADVANCES 2022; 2:e12095. [PMID: 36247724 PMCID: PMC9537939 DOI: 10.1002/jcv2.12095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/23/2022] [Indexed: 11/07/2022] Open
Abstract
Background As a result of the COVID‐19 pandemic, school closures meant that for many households, home and school environments became intertwined. Parents and carers found themselves taking on the role as de‐facto educators, as well as balancing working from home and caring for additional members of the household. Understanding the full extent of the effects incurred by parents and carers during school closures is vital to identifying and supporting vulnerable families. This rapid review aimed to appraise the available evidence on the potential effects of the COVID‐19 pandemic on UK parents and carers. Methods Searches for academic literature were conducted using Proquest Central, Scopus, and Google Scholar between 21st and 28th April 2021 using search terms describing “parents and carers”, “COVID‐19” and the “UK”. Additional literature was identified on relevant parents and carers' organisations websites including charity reports. Results Thirty‐two articles were found relating to harms affecting parents and carers in the UK High levels of psychological distress, including anxiety and depression, were consistently identified in the general parent population, and especially in parents caring for a child with special educational needs and/or neurodevelopmental disorders (SEN/ND). Charity reports indicated that many parents, especially those from an ethnic minority background and kinship carers, were worse off financially and with food insecurities, whereas empirical evidence showed that mothers were more likely to initiate furlough for themselves compared with fathers or childless women. Domestic abuse support services also reported a sharp rise in demand during lockdown restrictions, and practitioners reported an increase in child and adolescent violence towards parents. Conclusions Given the known impacts of parental stress, mental health problems, domestic violence and financial hardship on children's development, it is critical that these findings are taken into account in case of future pandemics to minimise harms both to parents and their families.
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Affiliation(s)
- Hope Christie
- Department of Clinical Psychology University of Edinburgh Edinburgh UK
| | | | | | - Cathy Creswell
- Department of Experimental Psychology & Department of Psychiatry Oxford University Oxford UK
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Hielscher L, Ludlow A, Mengoni SE, Rogers S, Irvine K. The experiences of new mothers accessing feeding support for infants with down syndrome during the COVID-19 pandemic. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:469-478. [PMID: 38699493 PMCID: PMC11062264 DOI: 10.1080/20473869.2022.2109000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/26/2022] [Indexed: 05/05/2024]
Abstract
Infants with Down syndrome are more likely to experience feeding problems and mothers are likely to require more feeding support than mothers of typically developing infants. During the COVID-19 pandemic, many feeding support services changed from face-to-face to online, which impacted some maternal feeding experiences negatively, but no studies to date have explored the impact for mothers of infants with Down syndrome. Thematic analysis was conducted on semi-structured interviews from thirteen new mothers of infants (aged 8-17 months) with Down syndrome in the UK. Three superordinate themes were generated: (1) Every baby with Down syndrome has a unique journey, (2) There's no point asking, they won't know, (3) Lack of in-person support. Many mothers expressed frustrations over health professionals' lack of Down syndrome specific knowledge resulting in unmet needs, further magnified due to the nature of the virtual support being offered. Moreover, mothers struggled with reduced social support from other mothers when encountering feeding problems. These results hold real-world implications for health professionals who could provide more specialised face-to-face feeding support to mothers of infants with Down syndrome. This should be prioritised for children's overall development and mothers' wellbeing.
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Affiliation(s)
- L. Hielscher
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, UK
| | - A. Ludlow
- Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, UK
| | | | - S. Rogers
- University of Hertfordshire, Hatfield, Herts, UK
| | - K. Irvine
- University of Hertfordshire, Hatfield, Herts, UK
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13
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Singh J, Scime NV, Chaput KH. Association of Caesarean delivery and breastfeeding difficulties during the delivery hospitalization: a community-based cohort of women and full-term infants in Alberta, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 114:104-112. [PMID: 35902540 PMCID: PMC9849537 DOI: 10.17269/s41997-022-00666-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/20/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Breastfeeding difficulties are the most common reason for breastfeeding cessation, particularly in the early postpartum. Caesarean delivery is associated with earlier breastfeeding cessation than is the case with vaginal delivery, but differences in breastfeeding difficulties by mode of delivery have not been thoroughly examined. Our objective was to explore the association between Caesarean delivery and types of breastfeeding difficulties. METHODS We conducted a secondary analysis of data from a prospective cohort study of mothers who delivered full-term, singleton infants in Calgary, Alberta, Canada (N = 418). Women completed self-report questionnaires during the delivery hospitalization. Mode of delivery was defined as vaginal or Caesarean, and further classified as planned or unplanned Caesarean. Breastfeeding difficulties were measured using the Breastfeeding Experiences Scale and operationalized with binary variables for presence of various types of maternal (i.e. physical, supply, social) and infant (i.e. latch, behaviour/health) difficulties that were reported as moderate to unbearable. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS Overall, 37.1% of women had a Caesarean delivery and 80.9% experienced a breastfeeding difficulty during the delivery hospitalization. Of the difficulties studied, Caesarean delivery was significantly associated with low milk supply (AOR = 1.62, 95% CI = 1.16-2.28) and infant behaviour/health difficulties (AOR = 1.33, 95% CI = 1.01-1.75). The association with low milk supply persisted when examining both planned (AOR = 2.42, 95% CI = 1.19-4.92) and unplanned (AOR = 2.21, 95% CI = 1.16-4.22) Caesarean deliveries. CONCLUSION Mothers who deliver by Caesarean have higher odds of reporting low milk supply and infant behaviour/health difficulties than women who deliver vaginally.
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Affiliation(s)
- Joyce Singh
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Natalie V. Scime
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Kathleen H. Chaput
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada ,Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
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Kokkinaki T, Hatzidaki E. COVID-19 Pandemic-Related Restrictions: Factors That May Affect Perinatal Maternal Mental Health and Implications for Infant Development. Front Pediatr 2022; 10:846627. [PMID: 35633965 PMCID: PMC9133722 DOI: 10.3389/fped.2022.846627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/30/2022] [Indexed: 11/28/2022] Open
Abstract
This review aims to discuss the factors that may affect maternal mental health and infant development in COVID-19 pandemic condition. Toward this direction, the two objectives of this review are the following: (a) to discuss possible factors that may have affected negatively perinatal mental health through the pandemic-related restrictions; and (b) to present the implications of adversely affected maternal emotional wellbeing on infant development. We conclude that the pandemic may has affected maternal mental health with possible detrimental effects for the infants of the COVID-19 generation. We highlight the need for evidence-based interventions to be integrated within the health system for prenatal and postpartum care in an effort to promote maternal mental health and infant development.
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Affiliation(s)
- Theano Kokkinaki
- Child Development and Education Unit, Laboratory of Applied Psychology, Department of Psychology, University of Crete, Rethymno, Greece
| | - Eleftheria Hatzidaki
- Department of Neonatology, Neonatal Intensive Care Unit (NICU), School of Medicine, University of Crete, Rethymno, Greece
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Bruney TL, Scime NV, Madubueze A, Chaput KH. Systematic review of the evidence for resolution of common breastfeeding problems-Ankyloglossia (Tongue Tie). Acta Paediatr 2022; 111:940-947. [PMID: 35150472 DOI: 10.1111/apa.16289] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/02/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
Abstract
AIM Tongue tie is a common problem affecting breastfeeding due to poor infant latch and/or maternal pain. Evidence of whether treatment improves breastfeeding outcomes is conflicting. We conducted a systematic review and meta-analysis to examine the effectiveness of tongue-tie treatment on breastfeeding difficulties. METHODS We searched peer-reviewed and grey literature in MEDLINE (OVID), PubMed, CINAHL Plus, EMBASE and PsycINFO, from 01/1970 to 09/2019. INCLUSION randomised and non-randomised clinical trials, and quasi-experimental study designs, involving breastfeeding interventions for full-term singleton infants, using standardised measure of breastfeeding difficulty. EXCLUSION qualitative and purely observational studies, lacked operational definition of breastfeeding difficulty, lacked control/comparison group. We assessed risk of bias, summarised study quality and results and conducted meta-analysis using random effects modelling. RESULTS Six studies on tongue-tie division were included (4 randomised and 2 non-randomised). Meta-analysis of standardised mean differences in breastfeeding difficulty scores in four studies showed statistically significant differences in favour of frenotomy (Pooled SMD +2.12, CI:(0.17-4.08)p = 0.03). Similarly, a statistically significant difference in favour of frenotomy was observed for pain (Pooled SMD -1.68, 95% CI: (-2.87- -0.48). CONCLUSION Results support that infant frenotomy is effective for improving standardised scores on breastfeeding difficulty and maternal pain scales and could improve breastfeeding outcomes.
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Affiliation(s)
- Talitha L. Bruney
- Department of Obstetrics & Gynecology and Women’s Health Montefiore Medical Center The University Hospital of Albert Einstein College of Medicine Bronx NY USA
| | - Natalie V. Scime
- Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary Alberta Canada
| | - Ada Madubueze
- Department of Community Health Sciences Cumming School of Medicine University of Calgary Calgary Alberta Canada
| | - Kathleen H. Chaput
- Department of Obstetrics & Gynecology and Community Health Sciences Cumming School of Medicine University of Calgary Calgary Alberta Canada
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Gustafsson I, Spångby M, Arvidsdal A, Golsäter M, Palmér L. The Existential Breastfeeding Difficulty Scale’s influences on the caring dialogue—Child healthcare nurses’ lived experiences. Scand J Caring Sci 2022; 36:558-566. [PMID: 35224755 PMCID: PMC9306827 DOI: 10.1111/scs.13072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/13/2021] [Accepted: 02/12/2022] [Indexed: 11/28/2022]
Abstract
Breastfeeding is experienced as an existential journey, and breastfeeding difficulties put mothers in existentially vulnerable situations. For care to be caring, it must be based on the mother's breastfeeding story. Previous research show that healthcare professionals struggle to perform individualised breastfeeding care. The Existential Breastfeeding Difficulty Scale (ExBreastS) was developed to support an existential focus in caring dialogues and was introduced in child healthcare in Sweden. The aim of this study is to describe child healthcare nurses’ lived experience of how the Existential Breastfeeding Difficulty Scale (ExBreastS) influences the caring dialogue. Seventeen child healthcare nurses with experience in using ExBreastS as a basis for caring dialogues with breastfeeding mothers were interviewed, in groups, pairs or individually. The interviews were analysed using a thematic analysis based on descriptive phenomenology. The results show that the caring dialogue becomes re‐evaluated when using ExBreastS because existential aspects of breastfeeding is acknowledged. ExBreastS also visualises new perspectives of the mother's breastfeeding experiences. However, the use of ExBreastS also risks overshadowing the caring dialogue when the nurses focus too much on the instrument. The use of ExBreastS supports caring dialogues—and caring care—by highlighting the existential aspects of breastfeeding/breastfeeding difficulties and the uniqueness of every mothers’ breastfeeding experience. However, the instrument sometimes evokes a vulnerability in the nurses that calls for support from the care organisation.
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Affiliation(s)
- Ida Gustafsson
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Malin Spångby
- Child Health Services Region Jönköping County Jönköping Sweden
| | - Ann Arvidsdal
- Child Health Services Region Jönköping County Jönköping Sweden
| | - Marie Golsäter
- Child Health Services Region Jönköping County Jönköping Sweden
- CHILD‐research Group School of Health and Welfare Jönköping University Jönköping Sweden
- Department of Health, Medicine and Caring Linköping University Linköping Sweden
| | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
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Spannhake M, Jansen C, Görig T, Diehl K. "It Is a Very Emotional Topic for Me"-Managing Breastfeeding Problems among German Mothers: A Qualitative Approach. Healthcare (Basel) 2021; 9:healthcare9101352. [PMID: 34683032 PMCID: PMC8544576 DOI: 10.3390/healthcare9101352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/28/2021] [Accepted: 10/06/2021] [Indexed: 12/23/2022] Open
Abstract
Breastfeeding is associated with positive health outcomes for both child and mother. Nevertheless, some women experience breastfeeding problems which commonly lead to early cessation, or not starting breastfeeding at all. Our aim was to explore how women that have difficulties in breastfeeding perceive their situation and how they actively manage it. We conducted semi-structured interviews with 15 mothers living in Germany who had experienced breastfeeding problems. The interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis. Breastfeeding problems occurred due to different reasons and had a huge impact, as evidenced in the four main themes of the findings: individual situation, managing the situation, perceived consequences for relations, feelings, and potential future pregnancies, and perceived health consequences for the mother. They frequently experienced negative emotions, including psychological distress and mental health problems, with perceived negative consequences for the mother-infant-bonding. Trying to actively manage the situation and availability of social support seemed to have a relieving effect, whereas confrontation and lack of understanding worsened the situation. Breastfeeding problems and the inability to breastfeed can have a great influence on maternal well-being. These can affect different aspects of a mother's life, including the attachment to the child. Providing support for actively managing the situation and supporting the exchange of experience between mothers who perceive breastfeeding problems may help mothers to better deal with their situation. Our findings may help health professionals to understand what these mothers feel and how they can support these women in a sensitive way.
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Scime NV, Metcalfe A, Nettel-Aguirre A, Tough SC, Chaput KH. Association of prenatal medical risk with breastfeeding outcomes up to 12 months in the All Our Families community-based birth cohort. Int Breastfeed J 2021; 16:69. [PMID: 34526043 PMCID: PMC8442292 DOI: 10.1186/s13006-021-00413-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background Prenatal medical risk describes physical health issues or biological factors that predate or arise during pregnancy which heighten the risk of adverse outcomes, and often warrant specialized obstetric care. The influence of the nature and magnitude of prenatal risk on breastfeeding outcomes remains poorly understood. The objective of this study was to determine the association between prenatal medical risk and breastfeeding initiation and duration up to 1 year postpartum. Methods We analysed a subset of data from the All Our Families longitudinal cohort (n = 2706) of women in Calgary, Canada who delivered a liveborn infant between 2008 and 2010. Data were collected from self-report questionnaires and medical records. Women with complete data on prenatal medical risk factors and breastfeeding outcomes were included in this analysis. Prenatal medical risk was operationalized as one integer score of risk severity and four binary risk types capturing pre-pregnancy characteristics, past obstetric problems, current obstetric problems, and substance use. Outcomes were breastfeeding initiation defined as the infant ever receiving breast milk, and duration operationalized as still breastfeeding at 4 months, at 12 months, and time to breastfeeding cessation in weeks. We used logistic regression and Cox regression with right censoring at 52 weeks or attrition to calculate odds ratios (OR) and hazard ratios (HR), respectively, adjusting for sociodemographic vulnerability, parity, mode of delivery, and gestational age. Results Prenatal medical risk severity and type were not significantly associated with breastfeeding initiation, with the exception of pre-pregnancy risk type (OR 0.45; 95% CI 0.26, 0.77). Risk severity was associated with lower odds of breastfeeding to 4 months (OR 0.94; 95% CI 0.90, 0.99), 12 months (OR 0.93; 95% CI 0.87, 0.98), and earlier breastfeeding cessation (HR 1.05; 95% CI 1.02, 1.08). Associations with shorter breastfeeding length across the first postpartum year were observed for pre-pregnancy, current obstetric, and substance use risk types, but not past obstetric problems. Conclusion Prenatal medical risk is associated with shortened duration of breastfeeding. Women with prenatal medical risk may benefit from the proactive arrangement of lactation support before and following delivery to promote continued breastfeeding. Supplementary Information The online version contains supplementary material available at 10.1186/s13006-021-00413-0.
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Affiliation(s)
- Natalie V Scime
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Amy Metcalfe
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Alberto Nettel-Aguirre
- Centre for Health and Social Analytics, National Institute for Applied Statistical Research, School of Mathematics and Statistics, University of Wollongong, Wollongong, NSW, Australia
| | - Suzanne C Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kathleen H Chaput
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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19
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Consensus Bundle on Postpartum Care Basics: From Birth to the Comprehensive Postpartum Visit. Obstet Gynecol 2021; 137:33-40. [PMID: 33278281 DOI: 10.1097/aog.0000000000004206] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/09/2020] [Indexed: 01/31/2023]
Abstract
In the weeks after childbirth, a woman navigates multiple challenges. She must recover from birth, learn to care for herself and her newborn, and cope with fatigue and postpartum mood changes as well as chronic health conditions. Alongside these common morbidities, the number of maternal deaths in the United States continues to increase, and unacceptable racial inequities persist. One third of pregnancy-related deaths occur between 1 week and 1 year after delivery, with a growing proportion of these deaths due to cardiovascular disease; one fifth occur between 7 and 42 days postpartum. In addition, pregnancy-associated deaths due to self-harm or substance misuse are increasing at an alarming rate. Rising maternal mortality and morbidity rates, coupled with significant disparities in outcomes, highlight the need for tailored interventions to improve safety and well-being of families during the fourth trimester of pregnancy, which includes the period from birth to the comprehensive postpartum visit. Targeted support for growing families during this transition can improve health and well-being across generations.
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Mercan Y, Tari Selcuk K. Association between postpartum depression level, social support level and breastfeeding attitude and breastfeeding self-efficacy in early postpartum women. PLoS One 2021; 16:e0249538. [PMID: 33798229 PMCID: PMC8018654 DOI: 10.1371/journal.pone.0249538] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/21/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The study was aimed at investigating the association between postpartum women's breastfeeding self-efficacy levels and their depression levels, social support levels, and breastfeeding attitudes in early postpartum period. METHODS The cross-sectional study was carried out in Kirklareli in Turkey. The population of the study consisted of 398 women aged 15-49 in the first 42 days of the postpartum period who presented to eight family health centers. The study data were collected face-to-face using the Personal Information Form, Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS), and Breastfeeding Attitudes of the Evaluation Scale (BAES). RESULTS The mean age of the participants was 28.61±5.72 (Min:18, Max: 44), and the mean score they obtained from the BSES-SF was 55.13±8.39. Statistically significant differences were detected between the participants' BSES-SF scores and age groups, employment status, perceived income level, and the number of living children (p < 0.05). No statistically significant differences were detected between marital status, educational status and BSES-SF scores (p > 0.05). In the multivariate regression analysis adjusted according to the sociodemographic characteristics, BAES, EPDS and MSPSS accounted for 48.3% of the BSES-SF. A negative association was found between BSES-SF scores and EPDS scores (β = -0.178, 95% CI:-0.349, -0.006), and a positive relation between the BAES scores (β = 0.194, 95% CI: 0.163, 0.226) and the MSPSS scores (β = 0.114, 95% CI: 0.037, 0.191). CONCLUSION As the level of depression of women increases in the postpartum period, the level of breastfeeding self-efficacy decreases. The breastfeeding self-efficacy increases as the level of social support increases and as the attitudes that drive breastfeeding behavior change positively.
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Affiliation(s)
- Yeliz Mercan
- Department of Health Management, School of Health Kirklareli University, Kirklareli, Turkey
| | - Kevser Tari Selcuk
- Department of Nurition and Dietetics, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balikesir, Turkey
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21
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Postpartum depressive symptoms following implementation of the 10 steps to successful breastfeeding program in Kinshasa, Democratic Republic of Congo: A cohort study. PLoS Med 2021; 18:e1003465. [PMID: 33428617 PMCID: PMC7799755 DOI: 10.1371/journal.pmed.1003465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 12/16/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Social support and relevant skills training can reduce the risk of postpartum depression (PPD) by reducing the impact of stressors. The 10-step program to encourage exclusive breastfeeding that forms the basis of the Baby-Friendly Hospital Initiative (BFHI) provides both, suggesting it may lessen depressive symptoms directly or by reducing difficulties associated with infant feeding. Our objective was to quantify the association of implementing Steps 1-9 or Steps 1-10 on postpartum depressive symptoms and test whether this association was mediated by breastfeeding difficulties. METHODS AND FINDINGS We used data from a breastfeeding promotion trial of all women who gave birth to a healthy singleton between May 24 and August 25, 2012 in 1 of the 6 facilities comparing different BFHI implementations (Steps 1-9, Steps 1-10) to the standard of care (SOC) randomized by facility in Kinshasa, Democratic Republic of Congo. Depressive symptoms, a non-registered trial outcome, was assessed at 14 weeks via the Edinburgh Postnatal Depression Scale (EPDS). Inverse probability weighting (IPW) was used to estimate the association of BFHI implementations on depressive symptoms and the controlled direct association through breastfeeding difficulties at 10 weeks postpartum. A total of 903 mother-infant pairs were included in the analysis. Most women enrolled had previously given birth (76%) and exclusively breastfed at 10 weeks (55%). The median age was 27 (interquartile range (IQR): 23, 32 years). The proportion of women reporting breastfeeding difficulties at week 10 was higher in both Steps 1-9 (75%) and Steps 1-10 (91%) relative to the SOC (67%). However, the number of reported difficulties was similar between Steps 1-9 (median: 2; IQR: 0, 3) and SOC (2; IQR: 0, 3), with slightly more in Steps 1-10 (2; IQR: 1, 3). The prevalence of symptoms consistent with probable depression (EPDS score >13) was 18% for SOC, 11% for Steps 1-9 (prevalence difference [PD] = -0.08; 95% confidence interval (CI): -0.14 to -0.01, p = 0.019), and 8% for Steps 1-10 (PD = -0.11, -0.16 to -0.05; p < 0.001). We found mediation by breastfeeding difficulties. In the presence of any difficulties, the PD was reduced for both Steps 1-9 (-0.15; 95% confidence level (CL): -0.25, -0.06; p < 0.01) and Steps 1-10 (-0.16; 95% CL: -0.25, -0.06; p < 0.01). If no breastfeeding difficulties occurred in the population, there was no difference in the prevalence of probable depression for Steps 1-9 (0.21; 95% CL: -0.24, 0.66; p = 0.365) and Steps 1-10 (-0.03; 95% CL: -0.19, 0.13; p = 0.735). However, a limitation of the study is that the results are based on 2 hospitals randomized to each group. CONCLUSIONS In conclusion, in this cohort, the implementation of the BFHI steps was associated with a reduction in depressive symptoms in the groups implementing BFHI Steps 1-9 or 1-10 relative to the SOC, with the implementation of Steps 1-10 associated with the largest decrease. Specifically, the reduction in depressive symptoms was observed for women reporting breastfeeding difficulties. PPD has a negative impact on the mother, her partner, and the baby, with long-lasting consequences. This additional benefit of BFHI steps suggests that renewed effort to scale its implementation globally may be beneficial to mitigate the negative impacts of PPD on the mother, her partner, and the baby. TRIAL REGISTRATION ClinicalTrials.gov NCT01428232.
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22
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Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite 2021; 156:104985. [PMID: 33038477 PMCID: PMC7538871 DOI: 10.1016/j.appet.2020.104985] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/02/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 New Mum Study is recording maternal experiences and infant feeding during the UK lockdown. This report from week 1 of the survey describes and compares the delivery and post-natal experiences of women who delivered before (BL) versus during (DL) the lockdown. METHODS Women living in the UK aged ≥18 years with an infant ≤12 months of age completed an anonymous online survey (https://is.gd/covid19newmumstudy). Information/links are shared via websites, social media and existing contacts. RESULTS From 27.5.20-3.6.20, 1365 women provided data (94% white, 95% married/with partner, 66% degree/higher qualification, 86% living in house; 1049 (77%) delivered BL and 316 (23%) DL. Delivery mode, skin-to-skin contact and breastfeeding initiation did not differ between groups. DL women had shorter hospital stays (p < 0.001). 39% reported changes to their birth plan. Reflecting younger infant age, 59% of DL infants were exclusively breast-fed/mixed fed versus 39% of BL (p < 0.05). 13% reported a change in feeding; often related to lack of breastfeeding support, especially with practical problems. Important sources of feeding support were the partner (60%), health professional (50%) and online groups (47%). 45% of DL women reported insufficient feeding support. Among BL women, 57% and 69% reported decreased feeding support and childcare, respectively. 40% BL/45% DL women reported insufficient support with their own health, 8%/9% contacted a mental health professional; 11% reported their mental health was affected. 9% highlighted lack of contact/support from family and distress that they had missed seeing the baby. CONCLUSION Lockdown has impacted maternal experiences, resulting in distress for many women. Our findings suggest the need for better infant feeding support, especially 'face-to-face' support for practical issues; and recognising and supporting mothers who are struggling with mental health challenges or other aspects of their health. The effectiveness of online versus face-to-face contact is currently uncertain, and requires further evaluation.
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Affiliation(s)
- A Vazquez-Vazquez
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
| | - S Dib
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
| | - E Rougeaux
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
| | - J C Wells
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
| | - M S Fewtrell
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
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Rivi V, Petrilli G, Blom JMC. Mind the Mother When Considering Breastfeeding. Front Glob Womens Health 2020; 1:3. [PMID: 34816148 PMCID: PMC8593947 DOI: 10.3389/fgwh.2020.00003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/23/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Veronica Rivi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Greta Petrilli
- Unità di Psichiatria-Ambulatorio Varenna per la Salute Mentale Perinatale, ASST Papa Giovanni XXIII, Bergamo, Italy
- Area Perinatale SIPRe-Milano, Società Italiana di Psicoanalisi della Relazione, Milan, Italy
| | - Johanna M. C. Blom
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Centre of Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
- *Correspondence: Johanna M. C. Blom
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Kuswara K, Knight T, Campbell KJ, Hesketh KD, Zheng M, Bolton KA, Laws R. Breastfeeding and emerging motherhood identity: An interpretative phenomenological analysis of first time Chinese Australian mothers' breastfeeding experiences. Women Birth 2020; 34:e292-e301. [PMID: 32205077 DOI: 10.1016/j.wombi.2020.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Chinese Australian mothers are more likely than the general Australian mothers to introduce formula in the first month of age. A better understanding of the context of formula introduction in the early weeks of birth can provide a deeper insight into how Chinese Australian mothers can be supported to continue exclusive breastfeeding. METHODS An interpretative phenomenological analysis approach was used to examine the lived breastfeeding experiences of 11 first time Chinese mothers in Australia. The experiences of those who breastfed exclusively were compared to those who introduced formula in the first month after birth. FINDINGS An overarching theme across all participants' narratives was the meaning ascribed to breastfeeding in their emerging motherhood identity. Breastfeeding could be a pragmatic and a socially desirable method to nourish an infant but lacking personal identification to the mother. These mothers were more vulnerable to the early introduction of formula, especially when the support environment was lacking. Maternal identity conflict was common and negatively impacted exclusive breastfeeding and mothers' mental health. In contrast, mothers who identified closely with breastfeeding showed greater persistence and enjoyment in breastfeeding and were more likely to continue breastfeeding exclusively. Health professionals were perceived to have an important influence in strengthening maternal breastfeeding motivation and self-efficacy. CONCLUSION Breastfeeding support to Chinese Australian mothers needs to consider how breastfeeding can be better integrated with their motherhood identity. Health professionals are well-positioned to facilitate this process through a better understanding of mothers' cultural and social contexts around breastfeeding.
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Affiliation(s)
- Konsita Kuswara
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Tess Knight
- The Cairnmillar Institute, Hawthorn East, VIC, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; Centre for Research Excellence in the Early Prevention of Obesity in Childhood, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; Centre for Research Excellence in the Early Prevention of Obesity in Childhood, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; Centre for Research Excellence in the Early Prevention of Obesity in Childhood, Australia
| | - Kristy A Bolton
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; Centre for Research Excellence in the Early Prevention of Obesity in Childhood, Australia
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O'Brien C, Quinn E, Murphy M, Lehane E, O'Leary DP, Livingstone V, Paul Redmond H, Corrigan MA. Breast abscess: Not just a puerperal problem. Breast J 2019; 26:339-342. [PMID: 31544305 DOI: 10.1111/tbj.13586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 01/12/2023]
Affiliation(s)
- Carl O'Brien
- Department of Academic Surgery, Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - Edel Quinn
- Department of Academic Surgery, Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - Margaret Murphy
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Elaine Lehane
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Donal Peter O'Leary
- Department of Academic Surgery, Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - Vicki Livingstone
- Department of Academic Surgery, Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - Henry Paul Redmond
- Department of Academic Surgery, Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
| | - Mark Anthony Corrigan
- Department of Academic Surgery, Cork Breast Research Centre, Cork University Hospital, Cork, Ireland
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Palmér L. Previous breastfeeding difficulties: an existential breastfeeding trauma with two intertwined pathways for future breastfeeding-fear and longing. Int J Qual Stud Health Well-being 2019; 14:1588034. [PMID: 30893016 PMCID: PMC6442107 DOI: 10.1080/17482631.2019.1588034] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
PURPOSE Experiencing breastfeeding difficulties poses a risk for early cessation of breastfeeding and decreases the likelihood of breastfeeding a future child. To further understand breastfeeding outcomes, the aim of this study is to explain the phenomenon of breastfeeding difficulties in order to understand how women's previous experiences of breastfeeding difficulties relate to their decisions about future breastfeeding. METHODS A reflective lifeworld hermeneutical approach was adopted. The study consisted of 15 lifeworld interviews with eight women who had previously experienced difficulties with initial breastfeeding. RESULTS Previously experienced breastfeeding difficulties represent an existential breastfeeding trauma in an individual woman's life, from which there are two intertwined pathways for future breastfeeding: a fear of breastfeeding, which renders the idea of future breastfeeding unthinkable, and a longing for breastfeeding, which increases the likelihood of future breastfeeding. Fear and longing are intertwined in ambiguous ways in an individual woman's life. CONCLUSION Women with previous breastfeeding difficulties may bring negative breastfeeding experiences with them, which are etched into the woman's being as a mother as an embodied memory. A lifeworld-led caring science perspective as a foundation for care can contribute to the development of caring practices, which grasp the existential nature of the breastfeeding trauma.
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Affiliation(s)
- Lina Palmér
- a Faculty of Caring Science, Work Life and Social Welfare , University of Borås , Borås , Sweden
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Jackson JE, Hallam J. ‘I felt like I was doing something wrong’: A qualitative exploration of mothers' experiences of breastfeeding. ACTA ACUST UNITED AC 2019. [DOI: 10.12968/johv.2019.7.4.166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jessica Eve Jackson
- Research Nurse and Specialist Community Public Health Nurse (Health Visitor), Health and Social Care Research Centre, College of Health and Social Care, University of Derby
| | - Jenny Hallam
- Senior Lecturer in Psychology, College of Life and Natural Sciences, School of Human Sciences. University of Derby
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Development and psychometric testing of an instrument to assess existential aspects of mother's initial breastfeeding difficulties (ExBreastS). SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 19:88-94. [PMID: 30928141 DOI: 10.1016/j.srhc.2019.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 01/11/2019] [Accepted: 01/15/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Mothers who have negative breastfeeding experiences due to initial breastfeeding difficulties are in demanding existential situations. Therefore, it is important for healthcare professionals to identify and address such breastfeeding problems. The aim of this study was to develop an instrument designed to assess existential aspects of mothers' initial breastfeeding difficulties and evaluate its psychometric properties. METHODS This study reports on the development of a new instrument and was carried out in three steps: (1) a questionnaire about various existential aspects of initial breastfeeding difficulties, based on 66 items derived from two phenomenological studies, was developed; (2) information was collected using the questionnaire; (3) and the resulting data were statistically analysed. Spearman's correlation coefficient was used to assess comparative validity; exploratory factor analysis with principal axis factoring and varimax rotation were used to assess construct validity; and Cronbach's alfa was used to assess internal consistency and reliability. Three hundred and nine Swedish-speaking mothers aged 20-46 participated in the study. RESULTS Correlation and factor analysis of the 66 items revealed that 16 of the items were of psychometric value and valid. Factor analysis generated three factors that accounted for 62.9% of the total variance: Mother-Child Interdependency, Exposure and Vulnerability and Security and Trust. The instrument shows adequate sensitivity to identify existential aspects of mothers' initial breastfeeding difficulties. CONCLUSION The instrument satisfactorily assesses existential aspects of initial breastfeeding difficulties and can be used as a sensitive tool by healthcare professionals to screen for and identify mothers who have negative breastfeeding experiences.
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Association between psychosocial factors and postpartum depression in South Jakarta, Indonesia. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 20:72-76. [PMID: 31084823 DOI: 10.1016/j.srhc.2019.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 01/31/2019] [Accepted: 02/13/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To investigate the association between psychosocial factors and postpartum depression. METHODS A cross-sectional design was used. The sample consisted of 166 postpartum mothers recruited by cluster sampling from two public health centers in South Jakarta, Jakarta Province, Indonesia, during February to April 2016. Data collection was through home visits. Instruments employed were: the Edinburgh Postnatal Depression Scale (EPDS); the Childcare Stress Inventory; the Postpartum Support Questionnaire to measure social support; the Dyad Adjustment Scale to measure marital satisfaction; the Rosenberg Self-esteem Scale; and the modified Life Events Questionnaire to measure stressful life events. Data analysis consisted of linear regression. RESULTS The prevalence of postpartum depression was 19.88%. Childcare stress, marital satisfaction and stressful life events were associated with postpartum depression (R2 = 0.298, F = 16.794, p-value < 0.001). Stressful life events explained the most variance in EPDS scores (ß = 0.220, P-value < 0.001), followed by marital satisfaction (ß = -0.321, P-value < 0.01) and childcare stress (ß = 0.008, P-value < 0.01). CONCLUSION The results of this study can be used to inform the screening of vulnerable sub-groups for postpartum depression and to develop nursing interventions that might alleviate postpartum depression.
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Olson T, Bowen A, Smith-Fehr J, Ghosh S. Going home with baby: innovative and comprehensive support for new mothers. Prim Health Care Res Dev 2018; 20:e18. [PMID: 30587261 PMCID: PMC6476368 DOI: 10.1017/s1463423618000932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 09/10/2018] [Accepted: 11/12/2018] [Indexed: 11/23/2022] Open
Abstract
Shorter length of stay for postpartum mothers and their newborns necessitates careful community follow-up after hospital discharge. The vast amount of information given during the initial postpartum period can be overwhelming. New parents often need considerable support to understand the nuances of newborn care including newborn feeding. Primary health care and community services need to ensure there is a seamless continuum of care to support, empower, and educate new mothers and their families to prevent unnecessary hospital readmission and other negative health outcomes. The Healthy & Home postpartum community nursing program provides clinical communication and supports to bridge the gap between acute hospital and community follow-up care through home visits, a primary health care clinic, a breastfeeding center, a breastfeeding café, a postpartum anxiety and depression support group, bereavement support, and involvement in a Baby-Friendly Initiative™ coalition. Nurses working in the program have the acute care skills and resources to complete required health care assessments and screening tests. They are also international board-certified lactation consultants able to provide expert breastfeeding and lactation care. This paper describes how the Healthy & Home program has evolved over the past 25 years and offers suggestions to other organizations wanting to develop a postpartum program to meet the physical and mental health needs of postpartum families to promote maternal and infant wellbeing.
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Affiliation(s)
- Tonia Olson
- Clinical Coordinator, Healthy & Home, West Winds Primary Health Centre, Saskatchewan Health Authority, Saskatoon, SK, Canada
| | - Angela Bowen
- Professor, College of Nursing, University of Saskatchewan. Saskatoon, SK, Canada
| | - Julie Smith-Fehr
- Maternal Services Manager Healthy & Home/Prenatal Home Care/Baby-Friendly Initiative Coordinator, West Winds Primary Health Centre, Saskatchewan Health Authority, Saskatoon, SK, Canada
| | - Swagata Ghosh
- Research and Statistical Officer, Department of Health and Wellness, Government of Nova Scotia, Halifax, Canada
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Vieira EDS, Caldeira NT, Eugênio DS, Lucca MMD, Silva IA. Breastfeeding self-efficacy and postpartum depression: a cohort study. Rev Lat Am Enfermagem 2018; 26:e3035. [PMID: 30208158 PMCID: PMC6136553 DOI: 10.1590/1518-8345.2110.3035] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 05/20/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to evaluate breastfeeding self-efficacy, the presence of postpartum depression symptons and the association between breastfeeding self-efficacy and postpartum depression with cessation of exclusive breastfeeding. METHOD cohort study with 83 women. The instruments used were the Breastfeeding Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Statistical analysis was conducted using the log-rank tests, analysis of variance and the Cox survival model. RESULTS breastfeeding self-efficacy (p = 0.315) and postpartum depression (p = 0.0879) did not show any statistical difference over time. The chances of cessation of exclusive breastfeeding decreased by 48% when self-efficacy changed from low to medium and by 80% when it changed from medium to high. Postpartum women who scored ≥10 on the Edinburgh Postnatal Depression Scale interrupt exclusive breastfeeding, on average, 10 days earlier than those with a score ≤9, whose median breastfeeding duration was 38 days postpartum. CONCLUSION breastfeeding self-efficacy was proved to be a protective factor for exclusive breastfeeding, while postpartum depression is a risk factor.
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Affiliation(s)
- Erika de Sá Vieira
- PhD, Adjunct Professor, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Nathalia Torquato Caldeira
- Resident RN, Programa Multidisciplinar em Aleitamento Materno, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Daniella Soares Eugênio
- Prenatal Care Specialist, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Marina Moraes di Lucca
- Obstetrics and Gynecology Nursing Specialist, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, SP, Brazil
| | - Isília Aparecida Silva
- PhD, Full Professor, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
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Demirci J, Caplan E, Murray N, Cohen S. "I Just Want to Do Everything Right:" Primiparous Women's Accounts of Early Breastfeeding via an App-Based Diary. J Pediatr Health Care 2018; 32:163-172. [PMID: 29276003 PMCID: PMC5818309 DOI: 10.1016/j.pedhc.2017.09.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/15/2017] [Accepted: 09/03/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Our objective was to describe the early breastfeeding experience of primiparous women. METHODS Healthy, primiparous women intending to exclusively breastfeed downloaded a commercial infant feeding mobile application (app) during their postpartum hospitalization. Women free-texted breastfeeding thoughts and experiences through 8 weeks postpartum in the app's diary. Diary content was qualitatively coded. RESULTS Thirty-five participants completed diaries and were included in analyses. The overarching theme was Seeking sustainability and validation. Mothers felt overwhelmed, anxious, and frustrated with the intensity and unpredictability of breastfeeding and inconsistent professional breastfeeding support. The ability to exclusively breastfeed was seen as a bellwether of maternal competence. Breastfeeding progress was primarily measured through external feedback (e.g., weight checks) and managed through strict adherence to provider feeding plans. As breastfeeding problems and intensity abated, women exhibited optimism and assumed greater independence in feeding decisions. DISCUSSION The primiparous breastfeeding experience is fraught with internally imposed and externally reinforced pressure to produce and persevere despite inadequate breastfeeding support infrastructure.
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Affiliation(s)
- Jill Demirci
- Corresponding author: Assistant Professor, University of Pittsburgh School of Nursing, Department of Health Promotion & Development, 440 Victoria Building, Pittsburgh, PA 15261, , Telephone: +11 724-622-6371
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Nahirney M, Metcalfe A, Chaput KH. Administration of epidural labor analgesia is not associated with a decreased risk of postpartum depression in an urban Canadian population of mothers: a secondary analysis of prospective cohort data. Local Reg Anesth 2017; 10:99-104. [PMID: 29184440 PMCID: PMC5673041 DOI: 10.2147/lra.s141569] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a common complication of pregnancy, affecting approximately 13% of mothers internationally. Previous research has examined whether epidural analgesia used for pain control during labor and birth is associated with a lower risk of PPD, but reports conflicting results and may have suffered from methodological shortcomings. Our study aimed to prospectively assess whether epidural analgesia is associated with a lower risk of PPD (at either 6 weeks or 6 months postpartum) after attempting to adequately adjust for selection bias and confounding variables. METHODS We conducted a secondary analysis of a prospective cohort of urban Canadian mothers who were recruited at birth in Calgary, Canada, in 2010, for a primary study on predictors of PPD. Mothers with full-term, singleton infants who did not require neonatal intensive care unit admission of >24 hours were included, and filled out questionnaires at birth, 6 weeks and 6 months postpartum including demographics, birth data, maternal and infant physical health, lifestyle, breastfeeding and maternal mental health. Descriptive statistics were calculated for participant characteristics and to identify potential confounder variables. Multivariable logistic regression analysis was conducted to assess whether epidural analgesia is associated with PPD after controlling for available confounding variables. RESULTS Our study included 206 mothers who had vaginal deliveries and were free of depression at delivery. We found an incidence of PPD of 13.3% (n=27) and no statistically significant association between epidural use and PPD, regardless of adjustment for potential confounding variables (unadjusted odds ratio [OR] 0.86, 95% confidence interval [CI] 0.69-1.22; adjusted OR (for body mass index 1.04, 95% CI 0.40-2.77). CONCLUSION We did not observe a significant association between epidural use and PPD. While the CIs are wide, we do not believe that this masks a clinically relevant association, and as such, the risks and benefits of epidural analgesia communicated to women during labor and delivery should not be modified.
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Affiliation(s)
| | | | - Katie H Chaput
- Alberta Children’s Hospital Research Institute and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Silva FV, Dias F, Costa G, Campos MDG. Chamomile reveals to be a potent galactogogue: the unexpected effect. J Matern Fetal Neonatal Med 2017; 31:116-118. [PMID: 28000519 DOI: 10.1080/14767058.2016.1274300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Good habits of breastfeeding have been associated with many long-term health benefits. Nowadays, improvement is seen in the health of children and mothers who practice exclusive breastfeeding for the first six months of life. The search of new potent stimulants for milk production is important to promote lactation, mainly in cases where breastfeeding is a difficult task. This report presents a case of a woman who accidentally realized an abundant amount of milk and had high breast tension, a few hours after consuming chamomile. Although usual consumption of chamomile during pregnancy and lactation are documented for several purposes, the galactogogue effect was never reported. In this case report, we document for the first time the influence of chamomile in a lactating woman by increasing lactogenesis. This article also highlights the need of more research in this field to assure the safety of the intake, by women, of herbal product without the risk for them or the newborns.
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Affiliation(s)
- Fernando V Silva
- a Pharmacognosy , Faculdade de Farmácia Universidade de Coimbra , Coimbra , Portugal.,b Observatory of Herb-Drug Interactions/Faculty of Pharmacy & CQ - Centre of Chemistry - Coimbra , University of Coimbra, Polo III , Coimbra , Portugal
| | - Francisca Dias
- c Molecular Oncology & Viral Pathology Group , IPO-Porto Research Center (CI-IPOP), Portuguese Institute of Oncology of Porto (IPO-Porto) , Porto , Portugal.,d ICBAS, Abel Salazar Biomedical Sciences Institute, University of Porto , Porto , Portugal.,e Research Department , Portuguese League Against Cancer (NR Norte) , Porto , Portugal
| | - Gustavo Costa
- a Pharmacognosy , Faculdade de Farmácia Universidade de Coimbra , Coimbra , Portugal.,f Center for Neurosciences and cell Biology, University of Coimbra , Coimbra , Portugal
| | - Maria da Graça Campos
- a Pharmacognosy , Faculdade de Farmácia Universidade de Coimbra , Coimbra , Portugal.,b Observatory of Herb-Drug Interactions/Faculty of Pharmacy & CQ - Centre of Chemistry - Coimbra , University of Coimbra, Polo III , Coimbra , Portugal
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Sutherland S. Late-night breastfeeding advice. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2016; 62:579. [PMID: 27412213 PMCID: PMC4955089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Susan Sutherland
- Retired from public health in Halifax, NS. She is the mother of 4 grown children, all of whom were breastfed
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