References

Al-Sahab B, Lanes A, Feldman M, Tamim H Prevalence and predictors of 6-month exclusive breastfeeding among Canadian women: a national survey. BMC Pediatr. 2010; 10:(1) https://doi.org/10.1186/1471-2431-10-20

Azizi E, Maleki A, Mazloomzadeh S, Pirzeh R Effect of stress management counselling on self-efficacy and continuity of exclusive breastfeeding. Breastfeed Med. 2020; 15:(8)501-508 https://doi.org/10.1089/bfm.2019.0251

Bacon AM, Charlesford JJ Investigating the association between fantasy proneness and emotional distress: the mediating role of cognitive coping strategies. Pers Individ Dif. 2018; 135:157-165 https://doi.org/10.1016/j.paid.2018.07.003

Bacon AM, White L, Norman A Coping with fibromyalgia during the COVID-19 pandemic: adjustment and wellbeing. Psychol Health. 2023; 38:(10)1345-1360 https://doi.org/10.1080/08870446.2021.2013484

Bai YK, Middlestadt SE, Joanne Peng CY, Fly AD Psychosocial factors underlying the mother's decision to continue exclusive breastfeeding for 6 months: an elicitation study. J Hum Nutr Diet. 2009; 22:(2)134-140 https://doi.org/10.1111/j.1365-277X.2009.00950.x

Borders A, Lai JS, Kim KY 470: an optimized measure of maternal stress is associated with biologic markers of stress and pregnancy outcome. Am J Obstet Gynecol. 2013; 208:(1) https://doi.org/10.1016/j.ajog.2012.10.636

Brown A Maternal trait personality and breastfeeding duration: the importance of confidence and social support. J Adv Nurs. 2014; 70:(3)587-598 https://doi.org/10.1111/jan.12219

Carver CS You want to measure coping but your protocol’ too long: consider the brief cope. Int J Behav Med. 1997; 4:(1)92-100 https://doi.org/10.1207/s15327558ijbm0401_6

Carver CS, Connor-Smith J Personality and coping. Ann Rev Psychol. 2010; 61:679-704 https://doi.org/10.1146/annurev.psych.093008.100352

Colville GA, Smith JG, Brierley J Coping with staff burnout and work-related posttraumatic stress in intensive care. Pediatr Crit Care Med. 2017; 18:(7)e267-e273 https://doi.org/10.1097/PCC.0000000000001179

Cruz JP, Cabrera DNC, Hufana OD, Alquwez N, Almazan J Optimism, proactive coping and quality of life among nurses: a cross-sectional study. J Clin Nurs. 2018; 27:(9-10)2098-2108 https://doi.org/10.1111/jocn.14363

Feenstra MM, Jørgine Kirkeby M, Thygesen M, Danbjørg DB, Kronborg H Early breastfeeding problems: a mixed method study of mothers' experiences. Sex Reprod Healthc. 2018; 16:167-174 https://doi.org/10.1016/j.srhc.2018.04.003

Feliu-Soler A, Reche-Camba E, Borràs X Psychometric properties of the Cognitive Emotion Regulation Questionnaire (CERQ) in patients with fibromyalgia syndrome. Front Psychol. 2017; 8 https://doi.org/10.3389/fpsyg.2017.02075

Garnefski N, Kraaij V Effects of a cognitive behavioral self-help program on emotional problems for people with acquired hearing loss: a randomized controlled trial. J Deaf Stud Deaf Educ. 2012; 17:(1)75-84 https://doi.org/10.1093/deafed/enr020

Garnefski N, Kraaij V, Spinhoven P Negative life events, cognitive emotion regulation and emotional problems. Pers Individ Dif. 2001; 30:(8)1311-1327 https://doi.org/10.1016/S0191-8869(00)00113-6

Garnefski N, Kraaij V, Benoist M, Bout Z, Karels E, Smit A Effect of a cognitive behavioral self-help intervention on depression, anxiety, and coping self-efficacy in people with rheumatic disease. Arthritis Care Res (Hoboken). 2013; 65:(7)1077-1084 https://doi.org/10.1002/acr.21936

Gila-Díaz A, Carrillo GH, López de Pablo ÁL Arribas SM, Ramiro-Cortijo D Association between maternal postpartum depression, stress, optimism, and breastfeeding pattern in the first six months. Int J Environ Res Public Health. 2020; 17:(19)7153-1766 https://doi.org/10.3390/ijerph17197153

Hauck YL, Fenwick J, Dhaliwal SS, Butt J A Western Australian survey of breastfeeding initiation, prevalence and early cessation patterns. Matern Child Health J. 2011; 15:(2)260-268 https://doi.org/10.1007/s10995-009-0554-2

Horta BL, Loret de Mola C, Victora CG Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta-analysis. Acta Paediatr. 2015; 104 S467:30-37 https://doi.org/10.1111/apa.13133

Ip S, Chung M, Raman G Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep). 2007; 153:1-186

Keevash J, Norman A, Forrest H, Mortimer S What influences women to stop or continue breastfeeding? A thematic analysis. Br J Midwifery. 2018; 26:(10)651-658 https://doi.org/10.12968/bjom.2018.26.10.651

Kraaij V, Garnefski N Cognitive, behavioral and goal adjustment coping and depressive symptoms in young people with diabetes: a search for intervention targets for coping skills training. J Clin Psychol Med Settings. 2015; 22:(1)45-53 https://doi.org/10.1007/s10880-015-9417-8

Kraaij V, van der Veek SM, Garnefski N, Schroevers M, Witlox R, Maes S Coping, goal adjustment, and psychological well-being in HIV-infected men who have sex with men. AIDS Patient Care STDs. 2008; 22:(5)395-402 https://doi.org/10.1089/apc.2007.0145

Krol KM, Grossmann T Psychological effects of breastfeeding on children and mothers. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018; 61:(8)977-985 https://doi.org/10.1007/s00103-018-2769-0

Lazarus RS, Folkman S Stress, appraisal, and coping.New York: Springer; 1984

Liersch U Chronic pain acceptance does not equal accepting chronic pain. Psychologist. 2020; 12:42-45

Luo T, Cheng X, Xiong Y Relationship among resilience, coping style and mental health of newly recruited workers born after 1990 in manufacturing industry of Shenzhen City. Wei Sheng Yan Jiu. 2015; 44:(2)252-256

Martin RC, Dahlen ER Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger. Pers Individ Dif. 2005; 39:(7)1249-1260 https://doi.org/10.1016/j.paid.2005.06.004

National Institute for Health and Care Excellence. Antenatal and postnatal mental health: clinical management and service guidance (NICE clinical guideline 45). 2014. https//www.nice.org.uk/guidance/cg192 (accessed 9 May 2024)

Naushad VA, Bierens JJLM, Nishan KP A systematic review of the impact of disaster on the mental health of medical responders. Prehosp Disaster Med. 2019; 34:(6)632-643 https://doi.org/10.1017/S1049023X19004874

Breastfeeding celebration week – supporting mothers who breastfeed. 2021. https//ukhsa.blog.gov.uk/2021/06/25/breastfeeding-celebration-week-supporting-mothers-who-breastfeed/ (accessed 20 November 2023)

Norman A, Mortimer S, Ferrario H, Baptie G Breastfeeding experiences and support: identifying factors influencing breastfeeding behaviour. Br J Midwifery. 2022; 30:(4)190-201 https://doi.org/10.12968/bjom.2022.30.4.190

Oakley LL, Henderson J, Redshaw M, Quigley MA The role of support and other factors in early breastfeeding cessation: an analysis of data from a maternity survey in England. BMC Pregnancy Childbirth. 2014; 14:(1) https://doi.org/10.1186/1471-2393-14-88

O'Brien ML, Buikstra E, Fallon T, Hegney D Strategies for success: a toolbox of coping strategies used by breastfeeding women. J Clin Nurs. 2009; 18:(11)1574-1582 https://doi.org/10.1111/j.1365-2702.2008.02667.x

O'Brien M, Buikstra E, Hegney D The influence of psychological factors on breastfeeding duration. J Adv Nurs. 2008; 63:(4)397-408 https://doi.org/10.1111/j.1365-2648.2008.04722.x

Odar Stough C, Khalsa AS, Nabors LA, Merianos AL, Peugh J Predictors of exclusive breastfeeding for 6 months in a national sample of US children. Am J Health Promot. 2019; 33:(1)48-56 https://doi.org/10.1177/0890117118774208

Ogbuanu CA, Probst J, Laditka SB, Liu J, Baek J, Glover S Reasons why women do not initiate breastfeeding: a southeastern state study. Womens Health Issues. 2009; 19:(4)268-278 https://doi.org/10.1016/j.whi.2009.03.005

Phillips KF, DePue L, Mullen S The effect of postpartum fatigue on exclusive breastfeeding rates at discharge: a comparison of birth methods. J Comprehen Nurs Res Care. 2020; 5:(1) https://doi.org/10.33790/jcnrc1100158

Preventing disease and saving resources: the potential contribution of increasing breastfeeding rates in the UK. 2012. https//www.unicef.org.uk/wp-content/uploads/sites/2/2012/11/Preventing_disease_saving_resources.pdf (accessed 9 May 2024)

Rodríguez-Rey R, Palacios A, Alonso-Tapia J Burnout and posttraumatic stress in paediatric critical care personnel: prediction from resilience and coping styles. Aust Crit Care. 2019; 32:(1)46-53 https://doi.org/10.1016/j.aucc.2018.02.003

Scarborough J, Norman A, Cooper L The bidirectional relationship between breastfeeding and mental health. Br J Midwifery. 2022; 30:(10)554-562 https://doi.org/10.12968/bjom.2022.30.10.554

Scheier MF, Carver CS, Bridges MW Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the life orientation test. J Pers Soc Psychol. 1994; 67:(6)1063-1078 https://doi.org/10.1037/0022-3514.67.6.1063

Skafida V The relative importance of social class and maternal education for breast-feeding initiation. Public Health Nutr. 2009; 12:(12)2285-2292 https://doi.org/10.1017/S1368980009004947

Smith AJ, Harney KF, Chien AT Does maternal mental health affect initiation, exclusivity, and duration of breastfeeding?. Obstet Gynecol. 2015; 125 https://doi.org/10.1097/01.AOG.0000463101.44298.db

Swanson V, Keely A, Denison FC Does body image influence the relationship between body weight and breastfeeding maintenance in new mothers?. Br J Health Psychol. 2017; 22:(3)557-576 https://doi.org/10.1111/bjhp.12246

Theodorah DZ, Mc'Deline RN “The kind of support that matters to exclusive breastfeeding” a qualitative study. BMC Pregnancy Childbirth. 2021; 21:(1) https://doi.org/10.1186/s12884-021-03590-2

Thurgood SL, Clark-Carter D, Dean SE An online questionnaire study investigating the impact of psychosocial factors on the duration of breastfeeding. Midwifery. 2022; 109 https://doi.org/10.1016/j.midw.2022.103314

Victora CG, Bahl R, Barros AJD Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387:(10017)475-490 https://doi.org/10.1016/S0140-6736(15)01024-7

Wagner CL, Wagner MT, Ebeling M The role of personality and other factors in a mother's decision to initiate breastfeeding. J Hum Lactation. 2006; 22:(1)16-26 https://doi.org/10.1177/0890334405283624

World Health Organization. Implementation guidance: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: the revised baby-friendly hospital initiative. 2018. https//iris.who.int/bitstream/handle/10665/272943/9789241513807-eng.pdf?sequence=19 (accessed 9 May 2024)

World Health Organization, UNICEF. Global strategy for infant and young child feeding. 2003. http//www.who.int/nutrition/topics/global_strategy/en/ (accessed 9 May 2024)

Zigmond AS, Snaith RP The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67:(6)361-370 https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

Maternal mental health and breastfeeding duration: the role of optimism and coping strategies

02 June 2024
Volume 32 · Issue 6

Abstract

Background/Aims

Mental health can influence the likelihood that a woman will initiate and continue breastfeeding behaviour that is associated with improved infant and maternal health. Mental health outcomes are associated with variables such as optimism and coping. The aim of this study was to explore the relationship between coping, optimism and mental health, and their impact on breastfeeding duration.

Methods

A total of 612 women who had breastfed completed an online questionnaire comprising the hospital anxiety and depression scale, cognitive emotional regulation questionnaire, brief coping orientation to problems experienced inventory and life orientation test. Data were analysed using correlations, ordinal linear regression and mediation analysis.

Results

There was a direct relationship between breastfeeding duration and depression but no direct relationship between duration and anxiety. A mediation analysis showed no mediating between breastfeeding duration and depression. Optimism did mediate the relationship between anxiety and duration, with optimism being associated with reduced anxiety and increased duration.

Conclusions

The findings highlight the importance of support for mothers while breastfeeding to improve mental health outcomes and foster coping strategies, such as optimism.

The World Health Organization (WHO) and UNICEF (2003) recommend exclusive breastfeeding for 6 months, ideally continuing for at least 2 years alongside foods. It is widely documented that breastfeeding has many benefits to both child and mother (Ip et al, 2007; Horta et al, 2015; Victora et al, 2016; WHO, 2018). Successful breastfeeding can also enhance infant–mother attachment relationships (Krol and Grossmann, 2018).

Despite these benefits, the rate of breastfeeding in the UK is still relatively low compared with other countries around the world, with the only exception being the USA (Renfrew et al, 2012; Nicholson and Hayward, 2021). While 74% of mothers in the UK initiate breastfeeding, the rate of continued breastfeeding drops to 44% at 6 weeks and then to 36% at 6 months (Renfrew et al, 2012; Nicholson and Hayward, 2021). Only 1% of babies are exclusively breastfed at 6 months despite WHO guidelines (Renfrew et al, 2012), lower than many other developed countries (Al-Sahab et al, 2010; Odar Stough et al, 2019).

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