母亲在怀孕期间和产后的信念和焦虑与母乳喂养的开始和早期停止的关联。
Associations of Maternal Beliefs and Distress in Pregnancy and Postpartum With Breastfeeding Initiation and Early Cessation.
机构信息
1 Department of Anthropology, Ohio State University, Columbus, OH, USA.
2 Department of Counseling and Human Development, University of Louisville, Louisville, KY, USA.
出版信息
J Hum Lact. 2019 Feb;35(1):49-58. doi: 10.1177/0890334418767832. Epub 2018 Jul 3.
BACKGROUND
: Breastfeeding plays an important role in both maternal and infant health and well-being. While researchers have examined the relationship between postpartum psychological distress and breastfeeding behaviors, few have investigated links between prenatal distress, postpartum distress, and breastfeeding behaviors over time.
RESEARCH AIM
: We aimed to determine if prenatal breastfeeding beliefs and psychological distress during and after pregnancy were associated with initiation and early cessation rates of breastfeeding.
METHODS
: In our secondary data analysis, a nonexperimental longitudinal one-group design was used. We assessed pregnant women ( N = 70) during four perinatal visits (early, mid, and late pregnancy and 7-10 weeks postpartum). Participants completed self-report surveys about psychological distress and depressive symptoms at each visit, breastfeeding beliefs during the third visit, and breastfeeding behaviors at the postpartum visit.
RESULTS
: Participants who breastfed for ⩾8 weeks had more positive beliefs about breastfeeding prior to delivery than participants with early cessation, who in turn had more positive beliefs than those who never initiated. Participants with early cessation reported heightened levels of pregnancy-specific distress in early pregnancy compared to those who continued breastfeeding or never initiated. Participants who continued breastfeeding for ⩾8 weeks reported less general anxiety and depressive symptoms in postpartum than those who discontinued or never initiated.
CONCLUSIONS
: Prenatal beliefs about breastfeeding, pregnancy-specific distress in early pregnancy, and general anxiety and depressive symptoms in postpartum are associated with breastfeeding initiation and continuation. Of clinical relevance, addressing prenatal and postpartum distress in the implementation of breastfeeding practice interventions could improve breastfeeding rates.
背景
母乳喂养对母婴健康和幸福都起着重要作用。虽然研究人员已经研究了产后心理困扰与母乳喂养行为之间的关系，但很少有研究调查产前困扰、产后困扰与随时间推移的母乳喂养行为之间的联系。
目的
我们旨在确定产前母乳喂养信念和怀孕前后的心理困扰是否与母乳喂养的开始和早期停止率有关。
方法
在我们的二次数据分析中，采用了非实验性的纵向单组设计。我们在四个围产期访视（早孕、中孕、晚孕和产后 7-10 周）期间评估了孕妇（N=70）。参与者在每次访视时完成关于心理困扰和抑郁症状的自我报告调查，在第三次访视时评估母乳喂养信念，在产后访视时评估母乳喂养行为。
结果
母乳喂养 ⩾8 周的参与者在分娩前对母乳喂养的信念比早期停止的参与者更积极，而早期停止的参与者又比从未开始母乳喂养的参与者更积极。与继续母乳喂养或从未开始的参与者相比，早期停止母乳喂养的参与者在早孕时报告了更高水平的妊娠特异性困扰。继续母乳喂养 ⩾8 周的参与者在产后报告的一般焦虑和抑郁症状少于停止或从未开始母乳喂养的参与者。
结论
产前对母乳喂养的信念、早孕时的妊娠特异性困扰以及产后的一般焦虑和抑郁症状与母乳喂养的开始和持续有关。从临床角度来看，在实施母乳喂养实践干预措施时解决产前和产后的困扰，可能会提高母乳喂养率。
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