Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
Midwifery. 2023 Sep;124:103770. doi: 10.1016/j.midw.2023.103770. Epub 2023 Jun 30.
The WHO recommends breastfeeding for at least six months as breastfeeding has many benefits for both infant and mother. The association of breastfeeding continuation with trait mindfulness during pregnancy and trajectories of postpartum depressive symptoms has not been examined yet. The current study aimed to assess this association using cox regression analysis.
DESIGN, SETTING AND PARTICIPANTS: The current research is part of a large longitudinal prospective cohort study following women from 12 weeks of pregnancy onwards in the South-East part of the Netherlands.
A total of 698 participants filled out the Three Facet Mindfulness Questionnaire-Short Form (TFMQ-SF) at 22 weeks of pregnancy and completed both the Edinburgh Postnatal Depression Scale (EPDS) and questions on breastfeeding continuation one week, six weeks, four months, and eight months postpartum. Breastfeeding continuation was defined as exclusive breastfeeding or both breastfeeding and formula. The assessment eight months postpartum was used as a proxy for the WHO recommendation to continue breastfeeding for at least six months.
Two trajectories (classes) of EPDS scores were determined using growth mixture modeling: 1) low stable (N = 631, 90.4%), and 2) increasing (N = 67, 9.6%). Cox regression analysis showed that the trait mindfulness facet non-reacting was significantly and inversely associated with the risk of breastfeeding discontinuation (HR = 0.96, 95% CI [0.94, 0.99], p = .002), while no significant association was found for belonging to the increasing EPDS class versus belonging to the low stable class (p = .735), adjusted for confounders.
This study is the first to show that higher trait mindfulness non-reacting scores, but not persistently low levels of postpartum depressive symptoms, increase the likelihood of breastfeeding continuation.
Improving non-reacting in perinatal women by meditation practice as part of a mindfulness-based intervention may lead to better breastfeeding continuation outcomes. Several mindfulness-based programs may be suitable.
世界卫生组织（WHO）建议至少母乳喂养 6 个月，因为母乳喂养对婴儿和母亲都有很多好处。然而，母乳喂养的持续时间与孕妇特质正念之间的关联以及产后抑郁症状的轨迹尚未得到研究。本研究旨在使用 Cox 回归分析评估这种关联。
设计、地点和参与者：本研究是一项大型纵向前瞻性队列研究的一部分，该研究从荷兰东南部招募了从怀孕 12 周开始的女性。
共有 698 名参与者在怀孕 22 周时填写了三因素正念问卷-短式（TFMQ-SF），并在产后一周、六周、四个月和八个月时完成了爱丁堡产后抑郁量表（EPDS）和母乳喂养持续时间的问题。母乳喂养的持续时间被定义为纯母乳喂养或母乳喂养和配方奶喂养。八个月时的评估被用作继续母乳喂养至少六个月的世界卫生组织建议的代表。
使用增长混合建模确定了 EPDS 评分的两个轨迹（类别）：1）低稳定（N=631，90.4%），2）增加（N=67，9.6%）。Cox 回归分析表明，特质正念非反应维度与母乳喂养中断的风险呈显著负相关（HR=0.96，95%CI[0.94，0.99]，p=0.002），而属于 EPDS 增加类别与属于低稳定类别之间没有显著关联（p=0.735），调整了混杂因素。
本研究首次表明，较高的特质正念非反应评分而非持续的产后低抑郁水平，增加了母乳喂养持续的可能性。
通过冥想练习将非反应性纳入围产期女性的正念中，可能会导致更好的母乳喂养持续时间。一些基于正念的方案可能是合适的。
