Anxious Mothers Breastfeed Less

Main Category: Pediatrics / Children's Health
Also Included In: Women's Health / Gynecology;  Anxiety / Stress;  Depression
Article Date: 15 Jan 2008 - 1:00 PST

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Anxiety and depressive thoughts can lead breastfeeding women to worry about whether their baby is eating enough. They are likely to stop breastfeeding or supplement their own milk with infant formula or baby porridge. New results from the Mother and Child Cohort Study at the Norwegian Institute of Public Health indicate that personality traits can affect breastfeeding habits.

Researchers analysed data from nearly 28 000 women who completed questionnaires during pregnancy and six months post-partum.

One in seven exclusively breastfeeds

Norwegian health authorities recommend that babies are breastfed exclusively until six months old. However, the study shows that only 15 percent of mothers, or just one in seven, solely breastfed for so long. Amongst the participants, 85 percent still breastfed at six months - 15 percent of these only gave breast milk whilst the others supplemented with infant formula or porridge. The remaining 15 percent had ceased to breastfeed.

Affected by worries

Negative feelings and personality traits had an obvious effect on breastfeeding. Anxious women who had little confidence in their breastfeeding ability appeared to do so less than other women in the cohort. This conclusion was drawn from responses about negative feelings such as anxiety, self-confidence and melancholy. A high score for anxiety gave a 30 percent increased chance that a woman would stop breastfeeding before six months, or that she would supplement breast milk with baby porridge or infant formula.

- It could be that these women worry more easily that their babies aren't gaining weight. Therefore they may drop breastfeeding or choose to give supplements, says researcher Eivind Ystrøm at the Division of Mental Health, Norwegian Institute of Public Health.

During pregnancy, researchers also measured how women perceived their ability to cope with their new situation. Among the women who believed they could cope well, more breastfed exclusively for six months after birth compared to the group who believed they couldn't cope.

In addition to personality, researchers could confirm results from other studies - that a mother's smoking habits can affect breastfeeding. By six months, 5 percent of smoking mothers were exclusively breastfeeding but nearly 30 percent had stopped.

Many women who had a Caesarean section or were first-time mothers had also ceased to breastfeed or supplemented with infant formula by six months.

Become easily stressed

Earlier research also shows that people with negative emotions (affectivity) are easily stressed and worry about their health. Anxious women can find the demands of full breastfeeding more stressful than others so they begin to avoid it. Increased stress levels can even restrict the biological mechanisms that steer milk production and milk ejection (let-down) reflex in the breast.

- When women with negative emotions find breastfeeding difficult they will have a greater tendency to avoid it, says Ystrøm.

May require alternative guidance

- What can health professionals do to help these women?

- Health professionals should be alert when they meet anxious, pregnant women, or those with depressive thoughts. These women may need another form of guidance, addressing concerns about breastfeeding instead of focusing on pure health information. A dialogue with a health nurse can help them to be conscious of the anxious feelings, says Ystrøm.
The women in the study were on average 29.8 years old when they gave birth. Almost half were first-time mothers. Nearly 5 percent gave birth too early, 13 percent had a Caesarean section and 11 percent smoked after birth.

The study is published in the Journal of Pediatrics.

Related links

The Impact of Maternal Negative Affectivity and General Self-Efficacy on Breastfeeding: The Norwegian Mother and Child Cohort Study (Abstract from Journal of Pediatrics)

About the Norwegian Institute of Public Health

Our goal is to improve public health through promotion of good health and prevention of disease. The Norwegian Institute of Public Health is a national center of excellence in the areas of epidemiology, mental health, infectious disease control, environmental medicine, forensic toxicology and drug abuse. Our vision: A healthier society. Our motto: Knowledge for better public health.

Norwegian Institute of Public Health