Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
Matern Child Nutr. 2023 Apr;19(2):e13459. doi: 10.1111/mcn.13459. Epub 2022 Nov 21.
Exclusive breastfeeding is recommended for 6 months; however, many childbearing people wean their infants before 6 months. Psychosocial factors such as stress, social support and race are significant determinants of breastfeeding; however, few studies have longitudinally explored the effect of perceived stress and various forms of social support on exclusive breastfeeding. We used quantitative methodologies to examine exclusive breastfeeding, perceived stress and social support among 251 participants from the Postpartum Mothers Mobile Study. Participants between 18 and 44 years were recruited during pregnancy (irrespective of parity) and completed surveys in real-time via Ecological Momentary Assessment up to 12 months postpartum from December 2017 to August 2021. We measured perceived stress with the adapted Perceived Stress Scale and perceived social support with the Multi-dimensional Social Support Scale. Received social support was measured using a single question on breastfeeding support. We conducted a mixed-effects logistic regression to determine the effect of stress, race and social support on exclusive breastfeeding over 6 months. We examined the moderation effect of perceived social support and breastfeeding support in the relationship between perceived stress and exclusive breastfeeding. Black, compared with White, participants were less likely to breastfeed exclusively for 6 months. Participants who reported higher perceived stress were less likely to breastfeed exclusively for 6 months. Perceived social support moderated the relationship between perceived stress and exclusive breastfeeding (odds ratio: 0.01, 95% confidence interval: 0.001-0.072). However, breastfeeding support directly increased the likelihood of exclusive breastfeeding over 6 months. Perceived stress is negatively associated with exclusive breastfeeding. Birthing people who intend to breastfeed may benefit from perinatal support programs that include components to buffer stress.
建议纯母乳喂养 6 个月,但许多产妇在 6 个月前就给婴儿断奶。社会心理因素,如压力、社会支持和种族,是母乳喂养的重要决定因素;然而,很少有研究从纵向角度探讨感知压力和各种形式的社会支持对纯母乳喂养的影响。我们使用定量方法,从产后母亲移动研究中调查了 251 名参与者的纯母乳喂养、感知压力和社会支持情况。参与者年龄在 18 至 44 岁之间,在妊娠期间(无论产次如何)被招募,并在 2017 年 12 月至 2021 年 8 月期间通过生态瞬时评估实时完成调查,直到产后 12 个月。我们使用适应后的感知压力量表测量感知压力,使用多维社会支持量表测量感知社会支持。通过母乳喂养支持的一个问题来衡量收到的社会支持。我们进行了混合效应逻辑回归,以确定压力、种族和社会支持对 6 个月内纯母乳喂养的影响。我们还检验了感知社会支持和母乳喂养支持在感知压力与纯母乳喂养关系中的调节作用。与白人相比,黑人参与者更不可能在 6 个月内纯母乳喂养。报告感知压力较高的参与者更不可能在 6 个月内纯母乳喂养。感知社会支持调节了感知压力与纯母乳喂养之间的关系(优势比:0.01,95%置信区间:0.001-0.072)。然而,母乳喂养支持直接增加了 6 个月以上纯母乳喂养的可能性。感知压力与纯母乳喂养呈负相关。打算母乳喂养的产妇可能受益于围产期支持计划,该计划包括缓解压力的组成部分。