Postpartum Anxiety, Breastfeeding Self-Efficacy & Breastfeeding Outcomes

Abstract

Objectives: Postpartum anxiety is associated with failure to meet breastfeeding (BF) goals. While BF self-efficacy is a potential moderator of this relationship, the relationship between postpartum anxiety, BF self-efficacy, and exclusive breastfeeding (EBF) has not yet been assessed. The objective was to assess relationships between EBF, anxiety, depression, and BF self-efficacy scores. Methods: An online survey using the State-Trait Anxiety Inventory (STAI), Edinburgh Postnatal Depression Scale (EPDS), and Breastfeed-ing Self-Efficacy Scale (BSES) was conducted. Eligible mothers were ³ 18 years old, had infants 4-24 weeks old, and had provided breastmilk in the prior 2 weeks. Screening stratified by anxiety across 4 groups (no, low, moderate, high) using the Generalized Anxiety Disorder-7 (GAD) tool to ensure sample variability. Possible score ranges for each scale were: GAD (0-21), STAI (20-80), EPDS (0-30), and BSES (14-70). Full sample correlations assessed relationships between STAI, EPDS, and BSES scores. Independent t-tests assessed for differences in scale scores by EBF status. Results: Participants (n = 129) were primarily white (92.2%), non-Hispanic (90.7%), married (74.4%), and primiparous (62%). About half were low income and 56.6% reported EBF. Mean scale scores were as follows: GAD = 8.2 (+5.7); STAI = 24.6 (+12.9); EPDS = 9.7 (+4.6); and BSES = 56.8 (+11.4). STAI and EPDS scores were positively correlated (P < .001). BSES scores negatively correlated with STAI (P = .027) and EPDS (P < .001) scores. BSES scores were higher among those reporting EBF (60.0 vs. 53.3; P < .001). Conclusions: In this sample of mostly white, non-Hispanic, married women, preliminary findings indicate potentially important relationships between BF self-efficacy and anxiety and depression, and suggest these relationships may impact EBF. Future work, increasing our understanding of the relationship between postpartum anxiety and EBF, may provide important intervention pathways.