Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo 2, 28029 Madrid, Spain.
Division of Neonatology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/ Profesor Martín Lagos s/n, 28040 Madrid, Spain.
Int J Environ Res Public Health. 2020 Sep 30;17(19):7153. doi: 10.3390/ijerph17197153.
Early breastfeeding cessation is a major public health problem. Several factors can affect breastfeeding pattern, and psychological aspects have been poorly explored. We hypothesize that psychological factors and breastfeeding pattern have a relationship. We have assessed in mothers during the first six months of lactation if breastfeeding pattern is associated with maternal stress, postpartum depression, and dispositional optimism, and if these psychological factors play a role on breastfeeding adherence. In total, 711 women participated, answering online the following questionnaires: sociodemographic, perceived stress scale, Edinburgh postpartum depression scale, life orientation test, and breastfeeding adherence score. Women were categorized according to infant feeding practices as exclusive breastfeeding (EBF) or mixed breastfeeding (MBF). The EBF group had a lower score of perceived stress compared to those giving MBF (first month: EBF = 1.5 [1.1; 1.9], MBF = 1.8 [1.5; 2.0]; -Value = 0.030; third month: EBF = 1.6 [1.2; 2.0], MBF = 1.8 [1.5; 2.4]; -Value = 0.038) and also had a lower score of postpartum depression (third month: EBF = 8.0 [6.0; 11.0], MBF = 11.0 [9.0; 15.0]; -Value = 0.001). The breastfeeding adherence score showed a positive correlation with maternal perceived stress (first month: ρ = 0.27; -Value = 0.018), and postpartum depression (third month: ρ = 0.30; -Value < 0.001), and a negative correlation with maternal dispositional optimism (second month: ρ = -0.20; -Value = 0.028). MBF was positively associated with breastfeeding adherence score (odd ratio (OR) = 1.4 [1.2-1.6]; -Value < 0.001) and with postpartum depression (OR = 1.1 [1.0; 1.1]; -Value = 0.020). In the third month of breastfeeding, women with MBF exhibited higher perceive stress and postpartum depression compared to those with EBF and no difference in dispositional optimism. The maternal psychological aspects are associated with breastfeeding pattern. Evaluation of maternal psychological concerns and providing support to lactating mothers may help improving breastfeeding adherence.
早期断奶是一个主要的公共卫生问题。有几个因素可以影响母乳喂养模式，而心理方面则研究得很少。我们假设心理因素和母乳喂养模式之间存在关系。我们在哺乳期的头 6 个月评估了母亲的情况，以了解母乳喂养模式是否与母亲的压力、产后抑郁和倾向性乐观有关，以及这些心理因素是否对母乳喂养的坚持起到作用。共有 711 名女性参与，在线回答了以下问卷：社会人口学、感知压力量表、爱丁堡产后抑郁量表、生活取向测验和母乳喂养坚持评分。根据婴儿喂养方式，女性被分为纯母乳喂养（EBF）或混合母乳喂养（MBF）。与给予 MBF 的女性相比，EBF 组的感知压力得分较低（第一个月：EBF = 1.5 [1.1；1.9]，MBF = 1.8 [1.5；2.0]；-值= 0.030；第三个月：EBF = 1.6 [1.2；2.0]，MBF = 1.8 [1.5；2.4]；-值= 0.038），产后抑郁得分也较低（第三个月：EBF = 8.0 [6.0；11.0]，MBF = 11.0 [9.0；15.0]；-值= 0.001）。母乳喂养坚持评分与母亲的感知压力呈正相关（第一个月：ρ= 0.27；-值= 0.018），与产后抑郁呈正相关（第三个月：ρ= 0.30；-值<0.001），与母亲的倾向性乐观呈负相关（第二个月：ρ= -0.20；-值= 0.028）。MBF 与母乳喂养坚持评分呈正相关（比值比（OR）= 1.4 [1.2-1.6]；-值<0.001），与产后抑郁呈正相关（OR = 1.1 [1.0；1.1]；-值= 0.020）。在第三个月的母乳喂养中，与 EBF 组相比，MBF 组的母亲感知压力和产后抑郁更高，而倾向性乐观则没有差异。母亲的心理方面与母乳喂养模式有关。评估母亲的心理问题并为哺乳期母亲提供支持，可能有助于提高母乳喂养的坚持率。
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