What promotes and hinders success in breastfeeding in hospital care? – the role of social support and anxiety
More details
Hide details
Submission date: 2017-05-10
Final revision date: 2017-06-20
Acceptance date: 2017-07-05
Online publication date: 2018-02-01
Publication date: 2018-02-01
Health Psychology Report 2018;6(3):252–260
Hospital stay is associated with difficult circumstances, which may be accompanied by anxiety. Difficulty with initiation and continuation of breastfeeding may be commonly experienced in the hospital. Observed difficulties can be modified by sharing knowledge and involvement of midwives in the care of mothers and newborns. Breastfeeding is considered to be the ideal choice of nutrition and infant’s feeding, providing many benefits both for infants and their mothers. The aim of the study is to explore the role of the quality of breastfeeding assistance during delivery hospitalization and maternal anxiety for overall breastfeeding duration.

Participants and procedure:
The study included 858 women after labor from intentionally selected hospitals of Pomerania, discharged from hospital up to 15 days after birth. We used a questionnaire to collect data on the nursing assistance and the process of breastfeeding during patients’ stay in a hospital. In addition, we applied the State-Trait Anxiety Inventory (STAI) to measure the levels of state and trait anxiety.

The results showed a significant relationship between the level of maternal postpartum anxiety and duration of breastfeeding. Mothers (mostly after physiological labor) reported a significantly lower level of state anxiety in hospitals titled Baby Friendly. Additionally, a significant difference in breastfeeding duration depending on the hospital and mothers’ perception of receiving support from midwives was found.

It is reasonable to continue the activities increasing standards of medical personnel support and raising the midwives’ and mothers’ awareness of the importance of anxiety for breastfeeding duration.

Adedinsewo, D. A., Fleming, A. S., Steiner, M., Meaney, M. J., & Girard, A. W.; MAVAN team. (2014). Maternal Anxiety and Breastfeeding: Findings from the MAVAN (Maternal Adversity, Vulnerability and Neurodevelopment) Study. Journal of Human Lactation, 30, 102–109.
Bidzan, M. (2013). Nastoletnie rodzicielstwo. Perspektywa psychologiczna [Teenage Parenthood. Psychological perspective]. Gdańsk: Harmonia Universalis.
Bielawska-Batorowicz, E. (2006). Psychologiczne aspekty prokreacji [Psychological aspects of procreation]. Katowice: „Śląsk” Wydawnictwo Naukowe.
Bigelow, A. E., Power, M., Gillis, D. E., Maclellan-Peters, J., Alex, M., & McDonald, C. (2014). Breastfeeding, skin-to-skin contact, and mother-infant interactions over infants’ first three months. Infant Mental Health Journal, 35, 51–62.
Bystrova, K., Matthiesen, A. S., Widstrom, A. M., Ransjö-Arvidson, A. B., Welles-Nyström, B., Vorontsov, I., & Uvnäs-Moberg, K. (2007). The effect of Russian maternity home routines on breastfeeding and neonatal weight loss with special reference to swaddling. Early Human Development, 83, 29–39.
Cai, X., Wardlaw, T., & Brown, D. W. (2012). Global trends in exclusive breastfeeding. International Breastfeeding Journal, 7, 12.
Chantry, C. J., Eglash, A., & Labbok, M. (2005). ABM Position on Breastfeeding – Revised. Breastfeeding Medicine, 10, 407–411.
Dragan, W. Ł. (2014). Temperament w pierwszym roku życia. Uwarunkowania genetyczne i środowiskowe [Temperament in the first year of life. Genetic and environmental determinants]. Warszawa: Wydawnictwo Naukowe Scholar.
Dunn, R., Kalich, K. A., Henning, M. J., & Fedrizzi, R. (2015). Engaging Field-Based Professionals in a Qualitative Assessment of Barriers and Positive Contributors to Breastfeeding Using the Social Ecological Model. Maternal and Child Health Journal, 19, 6–16.
Eidelman, A. I. (2012). Breastfeeding and the use of human milk: an analysis of the American Academy of Pediatrics 2012 Breastfeeding Policy Statement. Breastfeeding Medicine, 7, 323–324.
Flaherman, V. J., Beiler, J. S., Cabana, M. D., & Paul, I. M. (2016). Relationship of newborn weight loss to milk supply concern and anxiety: the impact on breastfeeding duration. Maternal & Child Nutrition, 12, 463–472.
Gartner, L. M., Morton, J., Lawrence, R. A., Naylor, A. J., O’Hare, D., Schanler, R. J., & Eidelman, A. I. (2005). American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics, 115, 496–506.
Golańska, Ż. (1994). Karmienie ekologiczne – potrzeba wsparcia [Ecological feeding – the need to suport]. In Z. Kawczyńska-Butrym (ed.), Wsparcie społeczne w zdrowiu i chorobie [Social support in health and disease] (pp. 53–59). Warszawa: Centrum Doskonalenia Nauczycieli Średniego Szkolnictwa Medycznego.
Grassley, J. S., & Nelms, T. P. (2008). Understanding Maternal Breastfeeding Confidence: A Gadamerian Hermeneutic Analysis of Women’s Stories. Health Care for Women International, 29, 841–862.
Haider, S. J., Chang, L. V., Bolton, T. A., Gold, J. G., & Olson, B. H. (2014). An Evaluation of the Effects of a Breastfeeding Support Program on Health Outcomes. Health Services Research Journal, 49, 2017–2034.
Haroon, S., Das, J. K., Salam, R. A., Imdad, A., & Bhutta, Z. A. (2013). Breastfeeding promotion interventions and breastfeeding practices: a systematic review. BMC Public Health, 13(Suppl 3), p. 20.
Hauck, Y., & Irurita, V. (2003). Incompatible expectations: The dilemma of breastfeeding mothers. Health Care for Women International, 24, 62–78.
Janiuk, E. (2006). Dlaczego karmienie noworodków przysparza problemów [Why feeding newborns causes problems]. Magazyn Pielęgniarki i Położnej, 3, 34.
Jansen, J., de Weerth, C., & Riksen-Walraven, J. M. (2008). Breastfeeding and the mother-infant relationship – A review. Developmental Review, 28, 503–521.
Jonas, W., Atkinson, L., Steiner, M., Meaney, M. J., Wazana, A., & Fleming, A. S.; the MAVAN research team. (2015). Breastfeeding and maternal sensitivity predict early infant temperament. Acta Paediatrica, 104, 678–686.
Karlström, A., Engström-Olofsson, R., Norbergh, K. G., Sjöling, M., & Hildingsson, I. (2007). Postoperative pain after cesarean birth affects breastfeeding and infant care. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 36, 430–440.
Kaźmierczak, M. (2015). Oblicza empatii w procesie adaptacji do rodzicielstwa [Faces of empathy in the process of adaptation to parenthood]. Warszawa: Scholar.
Kaźmierczak, M., Kiełbratowska, B., Lewandowska-Walter, A., Michałek, J., & Błażek, M. (2012). Charakter więzi rodzinnych oraz uwarunkowania ich kształtowania się w sytuacji okołoporodowej [Exploring bonds and its determinants within families with newborn infants]. Psychologia Rozwojowa, 17, 23–39.
Kaźmierczak, M., Kiełbratowska, B., Pastwa-Wojciechowska, B., & Preis, K. (2013). Couvade Syndrome among Polish expectant fathers. Medical Science Monitor, 19, 132–138.
Kielbratowska, B., Kazmierczak, M., Michalek, J., & Preis, K. (2015). Temperament and the mother-infant dyad: Associations with breastfeeding and formula feeding with a bottle. Infant Mental Health Journal, 36, 1–8.
Kowalewski, W. (1993). Karmienie piersią-wybór czy obowiązek? [Breastfeeding – choice or obligation?]. Łódź: Pro-med.
Kushnir, J., Friedman, A., Ehrenfeld, M., & Kushnir, T. (2012). Coping with Preoperative Anxiety in Cesarean Section: Physiological, Cognitive, and Emotional Effects of Listening to Favorite Music. Birth, 39, 121–127.
Mathews, M. E., Leerkes, E. M., Lovelady, C. A., & Labban, J. D. (2014). Psychosocial Predictors of Primiparous Breastfeeding Initiation and Duration. Journal of Human Lactation, 30, 480–487.
Mikiel-Kostyra, K. (2003). Odległe skutki zdrowotne sposobu żywienia niemowląt [The distant health effects of infant feeding method]. Medycyna Wieku Rozwojowego, 4, 605–615.
Nehring-Gugulska, M., & Żukowska-Rubik, M. (2006). Karmienie piersią. Podręcznik [Breastfeeding. Handbook]. Warszawa: National Breastfeeding Committee.
Nissen, E., Uvnas-Moberg, K., Svensson, K., Stock, S., Widström, A. M., & Winberg, J. (1996). Different patterns of oxytocin, prolactin but not cortisol release during breastfeeding in women delivered by caesarean section or by the vaginal route. Early Human Development, 45, 103–118.
Norris-Grant, D. M., & Jaggers, C. E. (2014) A Multidisciplinary Approach to Improving Skin-to-Skin Contact Immediately After Birth. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 43, 29.
Phillips, R. (2013). The Sacred Hour: Uninterrupted Skin-to-Skin Contact Immediately After Birth. Newborn and Infant Nursing Reviews, 13, 67–72.
Podolska, M. Z., Bidzan, M., Majkowicz, M., Podolski, J., Sipak-Szmigiel, O., & Ronin-Walknowska, E. (2010). Personality traits assessed by the NEO Five-Factor Inventory (NEO-FFI) as part of the perinatal depression screening program. Medical Science Monitor Basic Research, 16: PH77-PH81.
Pugh, L. C., Milligan, R. A., & Brown, L. P. (2001). The breastfeeding support team for low-income predominantly-minority women: a pilot intervention study. Health Care for Women International, 22, 501–515.
Rowu, E. (1995). Emocjonalne zmiany w okresie okołoporodowym – typowe problemy [Emotional changes during the perinatal period – common problems]. In Najlepszy start dla twojego dziecka. Materiały z Konferencji zorganizowanej przez Stowarzyszenie na Rzecz Naturalnego Rodzenia i Karmienia w Jachrance [The best start for your child. Materials from a conference organized by the Association for Natural Birthing and Feeding in Jachranka]. Warszawa.
Sęk, H., Ścigała, I., Beisert, M., & Bleja, A. (1992). Subiektywne koncepcje zdrowia. Wybrane uwarunkowania [Subjective concepts of health. Selected determinants]. Przegląd Psychologiczny, 35, 351–363.
Sosnowski, T. (1977). Lęk jako stan i cecha w ujęciu Charlesa D. Spielbergera [Anxiety as a state and trait in terms of Charles D. Spielberger]. Przegląd Psychologiczny, 20, 349–359.
Spatz, D. L., Kim, G. S., & Froh, E. B. (2014). Outcomes of a Hospital-Based Employee Lactation Program. Breastfeeding Medicine, 9, 510–514.
Spiby, H., McCormick, F., Wallace, L., Renfrew, M. J., D’Souza, L., & Dyson, L. (2009). A systematic review of education and evidence-based practice interventions with health professionals and breast feeding counsellors on duration of breast feeding. Midwifery, 25, 50–61.
Spielberger, C. D., Gorsuch, R. L., & Lushene, R. E. (1970). The State-Trait Anxiety Inventory manual. Palo Alto, CA: Consulting Psychologists Press.
Stuebe, A. M., & Schwarz E. B. (2010). The risks and benefits of infant feeding practices for women and their children. Journal of Perinatology, 30, 155–162.
Taki, M., Mizuno, K., Murase, M., Nishida, Y., Itabashi, K., & Mukai, Y. (2010). Maturational changes in the feeding behaviour of infants – A comparison between breast-feeding and bottle-feeding. Acta Paediatrica, 99, 61–67.
Tambelli, R., Odorisio, F., & Lucarelli, L. (2014). Prenatal and postnatal maternal representations in nonrisk and at-risk parenting: exploring the influences on mother-infant feeding interactions. Infant Mental Health Journal, 35, 376–388.
Tsai, T. I., Huang, S. H., & Lee, S. Y. (2015). Maternal and Hospital Factors Associated with First-Time Mothers’ Breastfeeding Practice: A Prospective Study. Breastfeeding Medicine, 10, 334–340.
Wen, L. M., Simpson, J. M., Rissel, C., & Baur, L. A. (2012). Awareness of Breastfeeding Recommendations and Duration of Breastfeeding: Findings from the Healthy Beginnings Trial. Breastfeeding Medicine, 7, 223–229.
World Health Organization (WHO) & United Nations Children’s Emergency Fund (UNICEF). (1989). Protecting, Promoting and Supporting Breastfeeding: The Special Role of Maternity Services. Switzerland: Genewa.
World Health Organization (WHO) & United Nations Children’s Emergency Fund (UNICEF). (1992). Baby Friendly Hospital Initiative Part II: Hospital Level Implementation. Switzerland: Genewa.
World Health Organization (WHO). Switzerland: Genewa. (2015). Infant and young child feeding. Fact sheet N°342. Switzerland: Genewa.
Wrześniewski, K., Sosnowski, T., & Matusik, D. (2002). Inwentarz stanu i cechy lęku STAI. Polska adaptacja STAI [STAI. State-trait anxiety inventory. Polish adaptation]. Warszawa: Psychological Test Laboratory of the Polish Psychological Association.