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.