Women’s Mental Health as a Factor Associated with Exclusive Breastfeeding and Breastfeeding Duration: Data from a Longitudinal Study in Greece

Abstract

This study investigated the relationship between exclusive breastfeeding and breastfeeding duration, and maternal psychological well-being in the perinatal period. Methods: A longitudinal study involving a retrospective follow-up of a group of 1080 women from pregnancy to the 1st year postpartum, who gave birth during the 5-year period between January 2014 and January 2019 in Athens, Greece, was designed. Women’s history and two psychometric tools—the Edinburg Postpartum Depression Scale (EPDS) and the Patient Health Questionnaire-9 (PHQ-9) administered at 5-time points—were used for data collection. Logistic regression analysis and a series of multiple analysis of variance (MANOVA) tests were performed. Results: The chance for exclusive breastfeeding (giving only breast milk) appeared to decrease (a) with an increase of the scores for psychometric tools antenatally (PHQ-9, p = 0.030) or at the 6th week postpartum (EPDS, p < 0.001 and PHQ-9, p < 0.001), (b) with an increase in the number of psychotherapeutic sessions needed antenatally (p = 0.030), and (c) when the initiation of psychotherapy was necessary postpartum (p = 0.002). Additionally, a shorter duration of any breastfeeding (with or without formula or other types of food/drink) seems to be associated with (a) the occurrence of pathological mental health symptoms (p = 0.029), (b) increased PHQ-9 scores antenatally (p = 0.018), (c) increased EPDS scores at the 6th week (p = 0.004) and the 12th month postpartum (p = 0.031), (d) the initiation of psychotherapy postpartum (p = 0.040), and e) the need for more than 13 psychotherapeutic sessions (p = 0.020). Conclusions: This study demonstrates a negative relationship between exclusive breastfeeding and breastfeeding duration, and poor maternal mental health in the perinatal period.

Breastfeeding during a Pandemic

“…It is known that breastfeeding is a protective factor for the mother against postpartum stress and depression development. A recent study by Dagla et al [13] confirmed that breastfeeding and its duration could positively influence maternal mental health, demonstrating how a shorter duration of breastfeeding is related to symptoms of psychological distress, initiation of psychological therapy, and higher scores on the Edinburgh Postpartum Depression Scale. Previous studies have obtained similar results, confirming the association between breastfeeding and maternal mental health [14].…”

Remote provision of breastfeeding support and education: Systematic review and meta‐analysis

“…Perinatal mental health indicators encompass the spectrum of mental health indicators (including and not limited to adjustment disorders and distress, PTSD, mild to moderate depressive illness, severe depressive illness, chronic severe mental illness and postpartum psychosis). Such conditions are associated with adverse breastfeeding outcomes and women could benefit from targeted anticipatory guidance and additional support (Dagla et al, 2021). In addition as evidence demonstrates the benefits of breastfeeding with reduction in hospitalisations and mortality both in the UK and worldwide, it is important to understand if remote support has any impact on these (Payne & Quigley, 2017; Sankar et al, 2015).…”

Anxiety and its influence on maternal breastfeeding self-efficacy

“…Despite the diverse evidence indicating that high self-efficacy levels have the power to positively influence the maintenance of breastfeeding ( 14 ) , and that the presence of anxiety can negatively influence this practice ( 15 ) , studies that evaluate the relationship of those variables were not found in the scientific literature. That fact shows that important failures persist, which justifies the conduction of this study.…”