Factors Associated with Maternal Wellbeing at Four Months Post-Partum in Ireland

Annemarie E Bennett, John M Kearney, Annemarie E Bennett, John M Kearney

Abstract

This study aimed to examine factors associated with maternal wellbeing at four months post-partum in the Irish context. Socio-demographic, health behaviour and infant feeding data were collected in pregnancy, at birth and at 17 weeks post-partum. Maternal distress, body image and resilience were measured at 17 weeks post-partum. Binary logistic regression predicted maternal distress and statistical significance was taken at p < 0.05. One hundred and seventy-two women were followed-up in pregnancy, at birth and at 17 weeks post-partum. Three in five (61.6%, n106) initiated breastfeeding. At 17 weeks post-partum, 23.8% (n41) were exclusively or partially breastfeeding and over a third (36.0%, n62) of all mothers were at risk of distress. In multivariate analyses, independent predictors of distress included: low maternal resilience (p < 0.01, odds ratio (OR): 7.22 (95% confidence interval [CI]: 2.49⁻20.95)); unsatisfactory partner support (p = 0.02, OR: 3.89 (95% CI: 1.20⁻12.65)); older age (p = 0.02, OR: 1.11 (95% CI: 1.02⁻1.21)); and breastfeeding (p = 0.01, OR: 2.89 (95% CI: 1.29⁻6.47)). Routine assessment of emotional wellbeing and targeted interventions are needed to promote a more healthful transition to motherhood among women in Ireland.

Keywords: Ireland; breastfeeding support; infant; maternal distress; maternal wellbeing; partner support; paternal role; post-partum distress.

Conflict of interest statement

The authors declare no conflict of interest. The commercial funder had no role in the design of the study; in the collection, analyses, and interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

References

    1. Coates R., Ayers S., de Visser R. Women’s experiences of postnatal distress: A qualitative study. BMC Pregnancy Childbirth. 2014;14:359. doi: 10.1186/1471-2393-14-359.
    1. Coates R., de Visser R., Ayers S. Not identifying with postnatal depression: A qualitative study of women’s postnatal symptoms of distress and need for support. J. Psychosom. Obstet. Gynaecol. 2015;36:114–121. doi: 10.3109/0167482X.2015.1059418.
    1. Cooke M., Schmied V., Sheehan A. An exploration of the relationship between postnatal distress and maternal role attainment, breast feeding problems and breast feeding cessation in Australia. Midwifery. 2007;23:66–76. doi: 10.1016/j.midw.2005.12.003.
    1. Thomson G., Ebisch-Burton K., Flacking R. Shame if you do—Shame if you don’t: Women’s experiences of infant feeding. Matern. Child Nutr. 2015;11:33–46. doi: 10.1111/mcn.12148.
    1. Goyal D., Gay C., Lee K. Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Arch. Womens Ment. Health. 2009;12:229–237. doi: 10.1007/s00737-009-0070-9.
    1. Goodman J.H., Guarino A., Chenausky K., Klein L., Prager J., Peterson R., Forget A., Freeman M. CALM Pregnancy: Results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Arch. Womens Ment. Health. 2014;17:373–387. doi: 10.1007/s00737-013-0402-7.
    1. Brick A., Nolan A. Explaining the increase in breastfeeding at hospital discharge in Ireland, 2004–2010. Irish J. Med. Sci. 2014;183:333–339. doi: 10.1007/s11845-013-1012-0.
    1. Gallagher L., Begley C., Clarke M. Determinants of breastfeeding initiation in Ireland. Irish J. Med. Sci. 2016;185:663–668. doi: 10.1007/s11845-015-1333-2.
    1. Tarrant R.C., Younger K.M., Sheridan-Pereira M., White M.J., Kearney J.M. The prevalence and determinants of breast-feeding initiation and duration in a sample of women in Ireland. Public Health Nutr. 2010;13:760–770. doi: 10.1017/S1368980009991522.
    1. Nolan A., Layte R. The ‘healthy immigrant effect’: Breastfeeding behaviour in Ireland. Eur. J. Public Health. 2015;25:626–631. doi: 10.1093/eurpub/cku177.
    1. Leahy-Warren P., Creedon M., O’Mahony A., Mulcahy H. Normalising breastfeeding within a formula feeding culture: An Irish qualitative study. Women Birth. 2017;30:e103–e110. doi: 10.1016/j.wombi.2016.10.002.
    1. McInnes R.J., Chambers J.A. Supporting breastfeeding mothers: Qualitative synthesis. J. Adv. Nurs. 2008;62:407–427. doi: 10.1111/j.1365-2648.2008.04618.x.
    1. Perez-Blasco J., Viguer P., Rodrigo M.F. Effects of a mindfulness-based intervention on psychological distress, well-being, and maternal self-efficacy in breast-feeding mothers: Results of a pilot study. Arch. Womens Ment. Health. 2013;16:227–236. doi: 10.1007/s00737-013-0337-z.
    1. Pop V.J., Pommer A.M., Pop-Purceleanu M., Wijnen H.A., Bergink V., Pouwer F. Development of the Tilburg Pregnancy Distress Scale: The TPDS. BMC Pregnancy Childbirth. 2011;11:80. doi: 10.1186/1471-2393-11-80.
    1. Kramer M.S., Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst. Rev. 2012;8:Cd003517. doi: 10.1002/14651858.CD003517.pub2.
    1. Hoivik M.S., Burkeland N.A., Linaker O.M., Berg-Nielsen T.S. The Mother and Baby Interaction Scale: A valid broadband instrument for efficient screening of postpartum interaction? A preliminary validation in a Norwegian community sample. Scand. J. Caring Sci. 2013;27:733–739. doi: 10.1111/j.1471-6712.2012.01060.x.
    1. Evans C., Dolan B. Body Shape Questionnaire: Derivation of shortened “alternate forms”. Int. J. Eat. Disord. 1993;13:315–321. doi: 10.1002/1098-108X(199304)13:3<315::AID-EAT2260130310>;2-3.
    1. Wagnild G.M., Young H.M. Development and psychometric evaluation of the Resilience Scale. J. Nurs. Meas. 1993;1:165–178.
    1. McKeating A., Farren M., Cawley S., Daly N., McCartney D., Turner M.J. Maternal folic acid supplementation trends 2009–2013. Acta Obstet. Gynecol. Scand. 2015;94:727–733. doi: 10.1111/aogs.12656.
    1. Carroll M., Gallagher L., Clarke M., Millar S., Begley C. Artificial milk-feeding women’s views of their feeding choice in Ireland. Midwifery. 2015;31:640–646. doi: 10.1016/j.midw.2015.03.002.
    1. Bennett A.E., McCartney D., Kearney J.M. Views of fathers in Ireland on the experience and challenges of having a breast-feeding partner. Midwifery. 2016;40:169–176. doi: 10.1016/j.midw.2016.07.004.
    1. Shortt E., McGorrian C., Kelleher C. A qualitative study of infant feeding decisions among low-income women in the Republic of Ireland. Midwifery. 2013;29:453–460. doi: 10.1016/j.midw.2012.03.001.
    1. Whelan B., Kearney J.M. Breast-feeding support in Ireland: A qualitative study of health-care professionals’ and women’s views. Public Health Nutr. 2015;18:2274–2282. doi: 10.1017/S1368980014002626.
    1. Meedya S., Fahy K., Kable A. Factors that positively influence breastfeeding duration to 6 months: A literature review. Women Birth. 2010;23:135–145. doi: 10.1016/j.wombi.2010.02.002.
    1. Salonen A.H., Kaunonen M., Astedt-Kurki P., Järvenpää A.L., Isoaho H., Tarkka M.T. Parenting self-efficacy after childbirth. J. Adv. Nurs. 2009;65:2324–2336. doi: 10.1111/j.1365-2648.2009.05113.x.
    1. O'Brien M., Buikstra E., Hegney D. The influence of psychological factors on breastfeeding duration. J. Adv. Nurs. 2008;63:397–408. doi: 10.1111/j.1365-2648.2008.04722.x.
    1. Fox R., McMullen S., Newburn M. UK women’s experiences of breastfeeding and additional breastfeeding support: A qualitative study of Baby Café services. BMC Pregnancy Childbirth. 2015;15:147. doi: 10.1186/s12884-015-0581-5.
    1. Ingram J., Johnson D., Greenwood R. Breastfeeding in Bristol: Teaching good positioning, and support from fathers and families. Midwifery. 2002;18:87–101. doi: 10.1054/midw.2002.0308.
    1. National Committee of the Baby Friendly Health Initiative The National Committee of the Baby Friendly Health Initiative in Ireland Announce It Is Ceasing Its Activities. [(accessed on 21 November 2017)];2017 Media Report. Available online: .
    1. Institute of Public Health in Ireland . Review and Evaluation of “Breastfeeding in Ireland—A 5-Year Strategic Action Plan 2005–2010”. Institute of Public Health in Ireland; Dublin, Ireland: 2014. [(accessed on 23 January 2018)]. Available online: .
    1. Thomson G., Balaam M.C., Hymers K. Building social capital through breastfeeding peer support: Insights from an evaluation of a voluntary breastfeeding peer support service in North-West England. Int. Breastfeed. J. 2015;10:15. doi: 10.1186/s13006-015-0039-4.
    1. Lovera D., Sanderson M., Bogle M.L., Vela Acosta M.S. Evaluation of a breastfeeding peer support program for fathers of Hispanic participants in a Texas special supplemental nutrition program for women, infants, and children. J. Am. Diet. Assoc. 2010;110:1696–1702. doi: 10.1016/j.jada.2010.08.001.
    1. Pisacane A., Continisio G.I., Aldinucci M., D’Amora S., Continisio P. A controlled trial of the father’s role in breastfeeding promotion. Pediatrics. 2005;116:e494–e498. doi: 10.1542/peds.2005-0479.
    1. Tohotoa J., Maycock B., Hauck Y., Howat P., Burns S., Binns C. Supporting mothers to breastfeed: The development and process evaluation of a father inclusive perinatal education support program in Perth, Western Australia. Health Promot. Int. 2011;26:351–361. doi: 10.1093/heapro/daq077.
    1. Tohotoa J., Maycock B., Hauck Y.L., Howat P., Burns S., Binns C.W. Dads make a difference: An exploratory study of paternal support for breastfeeding in Perth, Western Australia. Int. Breastfeed. J. 2009;4:15. doi: 10.1186/1746-4358-4-15.
    1. Dimidjian S., Goodman S.H., Felder J.N., Gallop R., Brown A.P., Beck A. An open trial of mindfulness-based cognitive therapy for the prevention of perinatal depressive relapse/recurrence. Arch. Womens Ment. Health. 2015;18:85–94. doi: 10.1007/s00737-014-0468-x.
    1. Dimidjian S., Goodman S.H., Felder J.N., Gallop R., Brown A.P., Beck A. Staying well during pregnancy and the postpartum: A pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence. J. Consult. Clin. Psychol. 2016;84:134–145. doi: 10.1037/ccp0000068.
    1. Dunn C., Hanieh E., Roberts R., Powrie R. Mindful pregnancy and childbirth: Effects of a mindfulness-based intervention on women’s psychological distress and well-being in the perinatal period. Arch. Womens Ment. Health. 2012;15:139–143. doi: 10.1007/s00737-012-0264-4.
    1. Schmied V., Sheehan A., Barclay L. Contemporary breast-feeding policy and practice: Implications for midwives. Midwifery. 2001;17:44–54. doi: 10.1054/midw.2000.0234.
    1. Cruise S.M., Layte R., Stevenson M., O’Reilly D. Prevalence and factors associated with depression and depression-related healthcare access in mothers of 9-month-old infants in the Republic of Ireland. Epidemiol. Psychiatr. Sci. 2017 doi: 10.1017/S2045796017000026.
    1. Bennett A.E., Kearney J.M. Predictors of vitamin D supplementation amongst infants in Ireland throughout the first year of life. J. Public Health. 2018 doi: 10.1007/s10389-017-0891-3.

Source: PubMed

3
구독하다