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

02 June 2024
Volume 32 · Issue 6



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.


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.


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.


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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