Maternal Anxiety and Breastfeeding

Sep 26, 2013Journal of human lactation : official journal of International Lactation Consultant Association

Links Between Mothers' Anxiety and Breastfeeding in the MAVAN Study

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Abstract

A single point increase in postpartum anxiety scores is associated with a 4% to 11% reduction in the odds of successful breastfeeding outcomes.

Prenatal anxiety was not linked to breastfeeding initiation or continuation.
An increase of 1 point in postpartum Hamilton Anxiety Scale scores correlates with an 11% decrease in the likelihood of exclusive breastfeeding at 6 months.
Higher State Anxiety scores at 3 months postpartum are associated with a 4% reduction in the odds of any breastfeeding at 12 months.
Increased Trait Anxiety scores at 3 months postpartum correlate with a 7% decrease in the odds of any breastfeeding at 12 months.
The results indicate a potential connection between maternal anxiety and breastfeeding practices that may warrant further attention.

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BACKGROUND: Maternal anxiety and depression may impair maternal intention, motivation, and self-efficacy in multiple domains associated with child health including breastfeeding.

OBJECTIVE: We tested the hypothesis that mothers who experience substantial anxiety during pregnancy or the postpartum period are at increased risk for reduced initiation, exclusivity, and continuation of breastfeeding.

METHODS: We obtained data on 255 Canadian pregnant women from the Maternal Adversity, Vulnerability and Neurodevelopment (MAVAN) study recruited between June 2004 and February 2009. We utilized data collected from 18 to 23 weeks gestation through 12 months postpartum. Multivariate logistic regression was used to assess whether scores on the Hamilton Anxiety Scale (HAM-A) and State-Trait Anxiety Inventory (STAI) were associated with initiation, exclusivity, and continuation of breastfeeding.

RESULTS: Prenatal anxiety was not associated with breastfeeding outcomes. In adjusted models, a single point increase in HAM-A scores at 3 months postpartum was associated with an 11% reduction in the odds of exclusive breastfeeding at 6 months (adjusted odds ratio [aOR] = 0.89; 95% CI, 0.80-0.99). A single point increase in STAI State and STAI Trait scores at 3 months postpartum was associated with a 4% (aOR = 0.96; 95% CI, 0.92-0.99) and 7% (aOR = 0.93; 95% CI, 0.86-1.00) reduction, respectively, in the odds of any breastfeeding at 12 months.

CONCLUSION: Our findings suggest a relationship between maternal anxiety and reduced exclusivity and continuation of breastfeeding. Maternal anxiety should be actively monitored and managed appropriately in the postpartum period to support optimal breastfeeding practices.

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Maternal Anxiety and Breastfeeding

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