Socio-demographic and psychological determinants of exclusive breastfeeding after six months postpartum — a Polish case-cohort study
Abstract
Objectives: The purpose of this study was to explore the socio-demographic and psychological factors connected with exclusive breastfeeding after 6 months postpartum.
Material and methods: A total of 251 women filled in questionnaires in the first week postpartum, then again after 3 and 6 months. The questionnaires included socio-demographic and medical questions, as well as psychological tools: the NEO-FFI Personality Inventory, the Berlin Social Support Scales (BSSS), and the Edinburgh Postnatal Depression Scale (EPDS). Further detailed questions concerning breastfeeding were relevant to this study.
Results: The rate of exclusive breastfeeding after 6 months was 39.68%. It was found that exclusive breastfeeding was most strongly connected with attending prenatal classes (ORa = 2.84, CI 1.18–6.87, p = 0.01), formula supplementation after 3 months (ORa = 0.01, CI 0.002-0.08, p < 0.001) and the mother’s subjective satisfaction with feeding the infant after 3 months (ORa = 1.44, CI 1.01–2.06, p = 0.04). No other psychological (as far as personality, social support or risk of postpartum depression are concerned), demographic or medical factors were significant. Only factors pertaining to breastfeeding were significant.
Conclusions: The prevalence of exclusive breastfeeding in Poland is unsatisfactory. Women should have easy access to prenatal classes with the most up-to-date knowledge on lactation and be advised against supplementing with formula, whenever possible. This could lead to higher satisfaction with breastfeeding.
Keywords: breastfeedingpersonalitypostpartum depressionsocial support
References
- World Health Organization. Global strategy for infant and young child feeding [Internet]. Geneva; 2003. http://apps.who.int/iris/bitstream/10665/42590/1/9241562218.pdf?ua=1&ua=1 (access 2017.08.27).
- Szajewska H, Socha P, Horvath A, et al. Zasady żywienia zdrowych niemowląt. Zalecenia Polskiego Towarzystwa Gastroenterologii, Hepatologii i Żywienia Dzieci [Nutrition of healthy term infants. Recommendations of the Polish Society for Paediatric Gastroenterology, Hepatology and Nutrition]. Stand Med Pediatr. 2014; 11: 321–338.
- Cattaneo A, Yngve A, Koletzko B, et al. Promotion of Breastfeeding in Europe project. Protection, promotion and support of breast-feeding in Europe: current situation. Public Health Nutr. 2005; 8(1): 39–46.
- Piekarzewska M, Wieczorkowski R, Zajenkowska-Kozłowska A. Health status population in Poland in 2014 [Internet]. 2016. http://stat.gov.pl/obszary-tematyczne/zdrowie/zdrowie/stan-zdrowia-ludnosci-polski-w-2014-r-,6,6.html (access 2017.08.28).
- Zagórecka E, Motkowski R, Stolarczyk A, et al. Karmienie naturalne w żywieniu niemowląt z wybranych miast Polski Centralnej i Wschodniej. Pediatr Pol. 2007; 82(7): 538–549.
- Bernatowicz-Łojko U, Wesołowska A, Wilińska M. Udział pokarmu kobiecego w żywieniu dzieci do 2 r. ż. w Polsce na przykładzie wojewódzwta kujawsko-pomorskiego [Share of human milk in feeding children to the second year oflife on the example of Kuyavian-Pomoerianin Voivodeship]in Polish. Stand Med Pediatr. 2012; 9: 285–292.
- Hobbs AJ, Mannion CA, McDonald SW, et al. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth. 2016; 16: 90.
- Li R, Fein SB, Chen J, et al. Why mothers stop breastfeeding: mothers' self-reported reasons for stopping during the first year. Pediatrics. 2008; 122 Suppl 2: S69–S76.
- İsik Y, Dag ZO, Tulmac OB, et al. Early postpartum lactation effects of cesarean and vaginal birth. Ginekol Pol. 2016; 87(6): 426–430.
- Keller N, Medved V, Armano G. The Influence of Maternal Personality and Risk Factors for Impaired Mother-Infant Bonding on Breastfeeding Duration. Breastfeed Med. 2016; 11: 532–537.
- Wagner CL, Wagner MT, Ebeling M, et al. The role of personality and other factors in a mother's decision to initiate breastfeeding. J Hum Lact. 2006; 22(1): 16–26.
- Brown A. Maternal trait personality and breastfeeding duration: the importance of confidence and social support. J Adv Nurs. 2014; 70(3): 587–598.
- Britton C, McCormick FM, Renfrew MJ, et al. Support for breastfeeding mothers. Cochrane Database Syst Rev. 2007(1): CD001141.
- Kaźmierczak M, Kiełbratowska B, Karasiewicz K. The other side of the mirror-the role of partner’s empathy in transition to parenthood. Heal Psychol Rep. 2015; 3(2): 150–157.
- Schmied V, Beake S, Sheehan A, et al. Women's perceptions and experiences of breastfeeding support: a metasynthesis. Birth. 2011; 38(1): 49–60.
- Dias CC, Figueiredo B. Breastfeeding and depression: a systematic review of the literature. J Affect Disord. 2015; 171: 142–154.
- Figueiredo B, Dias CC, Brandão S, et al. Breastfeeding and postpartum depression: state of the art review. J Pediatr (Rio J). 2013; 89(4): 332–338.
- Dennis CL, McQueen K. The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review. Pediatrics. 2009; 123(4): e736–e751.
- Zawadzki B, Strelau J, Szczepaniak P. NEOFFI – Inwentarz Osobowości NEOFFI. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego, Warszawa 1998.
- Łuszczyńska A, Mazurkiewicz M, Kowalska M, et al. Berlińskie Skale Wsparcia Społecznego (BSSS): Wyniki wstępnych badań nad adaptacją skal i ich własnościami psychometrycznymi. Stud Psychol. 2006; 44(3): 17–27.
- O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013; 9: 379–407.
- Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987; 150: 782–786.
- Dennis CL. Can we identify mothers at risk for postpartum depression in the immediate postpartum period using the Edinburgh Postnatal Depression Scale? J Affect Disord. 2004; 78(2): 163–169.
- Cattaneo A, Burmaz T, Arendt M, et al. 'Promotion of Breastfeeding in Europe: Pilot Testing the Blueprint for Action' Project. Protection, promotion and support of breast-feeding in Europe: progress from 2002 to 2007. Public Health Nutr. 2010; 13(6): 751–759.
- McFadden A, Gavine A, Renfrew MJ, et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2017; 2: CD001141.
- Wallenborn JT, Ihongbe T, Rozario S, et al. Knowledge of Breastfeeding Recommendations and Breastfeeding Duration: A Survival Analysis on Infant Feeding Practices II. Breastfeed Med. 2017; 12: 156–162.
- Smith HA, Becker GE. Early additional food and fluids for healthy breastfed full-term infants. Cochrane Database Syst Rev. 2016(8): CD006462.
- Żukowska-Rubik M. Dokarmianie dzieci karmionych piersią – kiedy, czym i jak? [Supplementation for breastfed infants - what to give, when and how? Stand Med Pediatr. 2013; 11: 189–199.
- Pope CJ, Mazmanian D, Bédard M, et al. Breastfeeding and postpartum depression: Assessing the influence of breastfeeding intention and other risk factors. J Affect Disord. 2016; 200: 45–50.
- Imširagić AS, Begić D, Sarajlić I, et al. Predictors of Exclusive Breastfeeding 6-9 Weeks After Delivery: a Prospective Cohort Study. Public Mental Health Perspective. Psychiatr Danub. 2016; 28(4): 395–403.
- World Health Organization, United Nations International Children’s Emergency Fund. Background and implementation. Baby-friendly Hospital Initiative: Revised, updated and expanded for integrated care. In: The Global Criteria for BFHI Geneva, 2009.
- Stuart AL, Pasco JA, Jacka FN, et al. Comparison of self-report and structured clinical interview in the identification of depression. Compr Psychiatry. 2014; 55(4): 866–869.