Postnatal Mental Health, Breastfeeding Beliefs, and Breastfeeding Practices in Rural China

Abstract

Background The importance of breastfeeding in low- and middle- income countries is well recognized, yet the importance of postnatal mental health on breastfeeding practices and beliefs in these settings has been understudied. This study investigates the associations between maternal mental health problems and breastfeeding beliefs as well as practices in rural China. Methods Cross-sectional data were collected from 742 mothers of infants under six months old in rural Sichuan Province, China. Surveys collected data on maternal mental health problems (depression, anxiety, and stress symptoms), breastfeeding beliefs (attitudes and self-efficacy), and breastfeeding practices. Ordinary least squares regression, multiple logistic regression and heterogeneous effect analyses were used to determine the associations between maternal mental health and breastfeeding outcomes. Results Among all respondents, 13% showed symptoms of depression, 16% anxiety, and 9% stress. The prevalence of full breastfeeding was 59.3%. Breastfeeding attitude was significantly associated with symptoms of depression (p = 0.023) and breastfeeding self-efficacy with symptoms of depression (p = 0.001) and symptoms of stress (p = 0.020). However, there were no significant associations between symptoms of mental health problems and full breastfeeding. The heterogeneous effects analyses revealed that full breastfeeding was negatively associated with stress symptoms when the infant was from a high-income family (p = 0.011). In addition, full breastfeeding was negatively associated with the father having a higher education level (p = 0.026, p = 0.048, and p = 0.020) and the infant being older than 2 months old (p = 0.000, p = 0.000, p = 0.00), regardless of maternal mental health problem symptoms. Conclusion Symptoms of maternal mental health problems are significantly associated with breastfeeding attitude and self-efficacy, yet has less of an association with breastfeeding practices. To improve breastfeeding practices, interventions need a multi-dimensional approach that should not only focus on improving maternal mental well-being but also consider demographic background characteristics.

Mental Health of Breastfeeding Mothers during COVID-19 Pandemic

“…Some of the impacts of poor mental health on breastfeeding women during the COVID-19 pandemic in this study include breastfeeding difficulties, low breastfeeding efficacy, stop breastfeeding, can't be exclusive breastfeeding and disturbed mother-infant bonding . The previous studies showed that breastfeeding beliefs, which have been found to be critical for breastfeeding practices, can also be exacerbated by postnatal mental health problems (Jiang et al, 2022;Ngo et al, 2019;Spatz et al, 2023;Sun et al, 2017;Tucker & O'Malley, 2022;Zubaran & Foresti, 2018). Existing global literature suggests that maternal depression affects breastfeeding beliefs such as self-efficacy (a mother's confidence in her ability to breastfeed her baby) and attitude (a mother's viewpoint and stance on breastfeeding).…”

“…Breastfeeding requires the mother's willingness and self efficacy to undergo the breastfeeding process (Hoff et al, 2019;Oliver et al, 2023). For mothers who are facing mental health problems, this process can be burdensome and in turn can discourage the desire to breastfeed (Gila-Díaz et al, 2020;Jeličić et al, 2022;Jiang et al, 2022). Studies have found that depressed mothers are less likely to breastfeed exclusively and are more likely to stop breastfeeding early.…”