Impact of Maternal Anxiety on Breastfeeding Outcomes: A Systematic Review

Abstract

Prenatal and postpartum anxiety may impair maternal functioning and disrupt mother–infant behaviors including breastfeeding. The objective of this narrative review is to examine the association between maternal anxiety from pregnancy to 12 mo postpartum and breastfeeding initiation, duration, and exclusivity. Using a combination of Medical Subject Headings terms and text words, relevant studies were identified through PubMed and PsycINFO. Studies that were conducted in high-income countries, assessed anxiety during gestation and/or postpartum through a standardized measure, and evaluated the impact of anxiety on any of the primary outcomes were included. Sixteen studies met the eligibility criteria although they varied greatly in methodological rigor. A negative association between postpartum anxiety and breastfeeding initiation, duration, and exclusivity was suggested. No associations were found between prenatal anxiety and breastfeeding initiation or exclusivity. Evidence is mixed regarding the association between prenatal anxiety and breastfeeding duration. All studies included in the review were of low or very low quality. Although there was consistency in the association between maternal anxiety and breastfeeding outcomes in the included studies, future studies with greater methodological rigor are needed to determine the extent of the relation between prenatal and/or postpartum anxiety and breastfeeding outcomes.

Correlation between Kind of Cesarean Section and Posttraumatic Stress Disorder in Greek Women

“…In this investigation, the lack of breastfeeding played a determining role in the development of the trauma caused to the mother by the CS, with rates of 95% in the first 24-h nursing mothers without PTSD and 4.5% in nursing mothers with PTSD. These findings are consistent with the research of Hoff et al, which maintains that the lack of breastfeeding influences the development of mother-child attachment, and contributes to the intensity of the distress of the mother and developing postpartum PTSD [47]. Additionally, the maintenance of prolactin at high levels through breastfeeding is an effective way of reducing maternal stress [48].…”

Development of a Psychological Intervention to Address Anxiety During Pregnancy in a Low-Income Country

“…It is also associated with adverse birth outcomes including spontaneous abortion, preeclampsia, preterm delivery, low birth weight (15), and decreased birth length (16). Anxiety during pregnancy impairs mother-child bonding in the early postpartum period (17), lowers the odds of exclusive breastfeeding (18,19), and results in poor child development trajectories (20).…”

The Effect of Psychological Factors on the Quality of Life in Iranian Lactating Women During the COVID-19 Pandemic: A Path Analysis

“…Mother anxiety has an adverse physiological effect on breastfeeding due to maternal anxiety and stress can interfere with oxytocin releasing and milk ejection re ex. On the other hand anxiety with diminishing self-esteem, and mother-infant interactions have negative effects on breastfeeding (22). Worsening of mother-infant bonding one month after childbirth was reported after the COVID-19 pandemic (24).…”

“…Our results revealed that anxiety, depression, and CDAS have a negative impact on breastfeeding. The result of one systematic review shows that postpartum anxiety has negative impacts on breastfeeding initiation, duration, and exclusivity (22). Transmission of covid-19 as a respiratory virus via breast milk is not common even for mothers who tested positive (23).…”