Breastfeeding practices in mothers of high-respiratory-risk NICU infants: impact of depressive symptoms and smoking

May 16, 2013The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

Breastfeeding in mothers of high-risk newborns: links to depression and smoking

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Abstract

Fifty-five (52.9%) mothers of high-respiratory-risk NICU infants reported breastfeeding.

Thirty-seven and a half percent of mothers showed depressive symptoms based on the CES-D scale.
Breastfeeding rates were lower among mothers with depressive symptoms (38.5%) compared to those without (61.5%).
There was no significant association between smoking status and breastfeeding rates.
Mothers of HRR infants with significant depressive symptoms who smoke had breastfeeding rates of 21%, while those who are not depressed and do not smoke had rates of 65%.
These findings suggest a need for targeted interventions addressing both depression and smoking to support breastfeeding.

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AIM: Mothers of infants in the neonatal intensive care unit (NICU) have very low breastfeeding rates and these high-respiratory-risk (HRR) NICU infants may benefit from breastfeeding through decreased risk for respiratory illnesses. This population's increased risk for maternal depression and high rates (22%) of maternal smoking may negatively affect breastfeeding.

OBJECTIVE: This exploratory study investigated associations of breastfeeding with depressive symptoms and maternal smoking in mothers of HRR NICU infants (i.e. presence of one household smoker and birth weight <1500 g or mechanical ventilation ≥12 h).

METHODS: Breastfeeding, depression and smoking data were collected from 104 mothers in the NICU following delivery.

RESULTS: Fifty-five (52.9%) mothers reported breastfeeding, 39 (37.5%) had a Center for Epidemiological Studies Depression Scale (CES-D) score (≥16) suggestive of depression, and 36 (34.6%) reported smoking. Mothers with CES-D scores ≥16 were less likely to breastfeed compared to those with scores <16 (38.5% versus 61.5%; p = 0.02). Breastfeeding and smoking were not significantly associated (p < 0.10). Mothers of HRR infants with significant depressive symptoms who smoke have significantly lower breastfeeding rates (21%) than mothers who are not depressed and do not smoke (65%).

CONCLUSIONS: Interventions to improve breastfeeding initiation and continuation that target depression and smoking are necessary.

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Breastfeeding practices in mothers of high-respiratory-risk NICU infants: impact of depressive symptoms and smoking

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