Evaluation of Mother's Stress during Hospitalization Can Influence the Breastfeeding Rate. Experience in Intensive and Non Intensive Departments

S Foligno, A Finocchi, G Brindisi, A Pace, P Amadio, I Dall'Oglio, A Portanova, P Rossi, A Dotta, G Salvatori, S Foligno, A Finocchi, G Brindisi, A Pace, P Amadio, I Dall'Oglio, A Portanova, P Rossi, A Dotta, G Salvatori

Abstract

A mother's milk offers several benefits to infant's health, but, some factors may lead to a reduction in the duration of breastfeeding, such as maternal stress. The objective of our study is to determine if the rate of breastfeeding can be influenced by stress induced by infants' hospitalization. A preliminary observational non-randomized study was carried out in Bambino Gesù Children's Hospital between October 2016 and January 2017, in order to elucidate a possible relationship between breastfeeding and maternal stress, linked to hospitalization. We modeled the modified version of the PSS NICU (Parental Stressor Scale-neonatal intensive care unit) questionnaire, which investigated parental stress during hospitalization. This included 33 items with a score from 0 to 5. The overall score, high stress, was established at 85 points or higher. The principal statistically significant correlation was between 'high PSS score' and reduced breastfeeding during hospitalization (p-value: 0.048; OR: 2.865, 95%; CI: 1.008-8.146). This relation was not influenced by other descriptive characteristics of the mother. The PSS questionnaire can be an instrument to evaluate the influence of stress in breastfeeding and to monitor the rate and success of lactation. Our study highlights that the stress from hospitalization could influence the success of breastfeeding, mostly in intensive settings and during long hospitalizations.

Keywords: breastfeeding; hospitalization; stress.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Percentage of diagnostic causes of admission of the general population.
Figure 2
Figure 2
Percentage of population divided in the different departments.

References

    1. Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care. World Health Organization; Geneva, Switzerland: 2009. WHO Guidelines Approved by the Guidelines Review Committee.
    1. Section on B. Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827–e841. doi: 10.1542/peds.2011-3552.
    1. Committee Opinion No. 570: Breastfeeding in underserved women: Increasing initiation and continuation of breastfeeding. Pt 1Obstet. Gynecol. 2013;122:423–428.
    1. Unmarried_Women.pdf CTDBBtUWIoCaYAawcowcuBt. [(accessed on 3 December 2015)]; Available online: .
    1. Kenny L.C., Lavender T., McNamee R., O’Neill S.M., Mills T., Khashan A.S. Advanced maternal age and adverse pregnancy outcome: Evidence from a large contemporary cohort. PLoS ONE. 2013;8:e56583. doi: 10.1371/journal.pone.0056583.
    1. Lau C. Effects of stress on lactation. Pediatr. Clin. N. Am. 2001;48:221–234. doi: 10.1016/S0031-3955(05)70296-0.
    1. Salvatori G., Foligno S., Occasi F., Pannone V., Valentini G.B., Dall’Oglio I., Bagolan P., Dotta A. Human milk and breastfeeding in surgical infants. Breastfeed. Med. Off. J. Acad. Breastfeed. Med. 2014;9:491–493. doi: 10.1089/bfm.2014.0097.
    1. Khasawneh W., Khasawneh A.A. Predictors and barriers to breastfeeding in north of Jordan: Could we do better? Int. Breastfeed. J. 2017;12:49. doi: 10.1186/s13006-017-0140-y.
    1. Mattsson E., Funkquist E.L., Wickstrom M., Nyqvist K.H., Volgsten H. Healthy late preterm infants and supplementary artificial milk feeds: Effects on breast feeding and associated clinical parameters. Midwifery. 2015;31:426–431. doi: 10.1016/j.midw.2014.12.004.
    1. Alakaam A., Lemacks J., Yadrick K., Connell C., Choi H.W., Newman R.G. Breastfeeding Practices and Barriers to Implementing the Ten Steps to Successful Breastfeeding in Mississippi Hospitals. J. Hum. Lact. 2018;34:322–330. doi: 10.1177/0890334417737294.
    1. Bystrova K., Widström A.M., Matthiesen A.S., Ransjö-Arvidson A.B., Welles-Nyström B., Wassberg C., Vorontsov I., Uvnäs-Moberg K. Skin-to-skin contact may reduce negative consequences of “the stress of being born”: A study on temperature in newborn infants, subjected to different ward routines in St. Petersburg. Acta Paediatr. 2003;92:320–326. doi: 10.1111/j.1651-2227.2003.tb00553.x.
    1. Zanardo S., Nicolussi F., Favaro D., Faggian M., Plebani F., Marzari F., Freato V. Effect of postpartum anxiety on the colostral milk beta-endorphin concentrations of breastfeeding mothers. J. Obstet. Gynaecol. J. Inst. Obstet. Gynaecol. 2001;21:130–134. doi: 10.1080/01443610020026001.
    1. Giovannini M., Banderali G., Radaelli G., Carmine V., Riva E., Agostoni C. Monitoring breastfeeding rates in Italy: National surveys 1995 and 1999. Acta Paediatr. 2003;92:357–363. doi: 10.1111/j.1651-2227.2003.tb00559.x.
    1. Dall’Oglio I., Salvatori G., Stendardi M.C., Bonci E., D’Agostino G. Breastfeeding in neonatal intensive care: Description of a change. Assist. Inferm. Ric. Air. 2004;23:221–227.
    1. Agazio J.B., Buckley K.M. Revision of a Parental Stress Scale for use on a pediatric general care unit. Pediatr. Nurs. 2012;38:82–87.
    1. Miles M.S., Brunssen S.H. Psychometric properties of the parental stressor scale: Infant hospitalization. Adv. Neonatal Care Off. J. Natl. Assoc. Neonatal Nurses. 2003;3:189–196. doi: 10.1016/S1536-0903(03)00138-3.
    1. Samra H.A., Dutcher J., McGrath J.M., Foster M., Klein L., Djira G., Hansen J., Wallenburg D., Dowling D. Effect of Skin-to-Skin Holding on Stress in Mothers of Late-Preterm Infants: A Randomized Controlled Trial. Adv. Neonatal Care Off. J. Natl. Assoc. Neonatal Nurses. 2015;15:354–364. doi: 10.1097/ANC.0000000000000223.
    1. Carter M.C., Miles M.S., Buford T.H., Hassanein R.S. Parental environmental stress in pediatric intensive care units. Dimens. Crit. Care Nurs. Dccn. 1985;4:180–188. doi: 10.1097/00003465-198505000-00009.
    1. Miles M.S., Carter M.C. Sources of parental stress in pediatric intensive care units. Child. Health Care J. Assoc. Care Child. Health. 1983;11:65–69. doi: 10.1207/s15326888chc1102_4.
    1. Miles M.S., Funk S.G., Carlson J. Parental Stressor Scale: Neonatal intensive care unit. Nurs. Res. 1993;42:148–152. doi: 10.1097/00006199-199305000-00005.
    1. Miles M.S. Parental Stress Scale: Neonatal Intensive Care Unit 2002. [(accessed on 17 February 2020)]; doi: 10.1080/02646830601117258. Available online:
    1. Reid T., Bramwell R. Using the Parental Stressor Scale: NICU with a British sample of mothers of moderate risk preterm infants. J. Reprod. Infant. Psychol. 2003;21:279–291. doi: 10.1080/02646830310001622114.
    1. Miles M.S., Carlson J., Brunssen S. The nurse parent support tool. J. Pediatr. Nurs. 1999;14:44–50. doi: 10.1016/S0882-5963(99)80059-1.
    1. Milsum J.H. A model of the eustress system for health/illness. Behav. Sci. 1985;30:179–186. doi: 10.1002/bs.3830300402.
    1. Dimitraki M., Tsikouras P., Manav B., Gioka T., Koutlaki N., Zervoudis S., Galazios G. Evaluation of the effect of natural and emotional stress of labor on lactation and breast-feeding. Arch. Gynecol. Obstet. 2016;293:317–328. doi: 10.1007/s00404-015-3783-1.
    1. Buckley S.J. Executive Summary of Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies, and Maternity Care. J. Perinat. Educ. 2015;24:145–153. doi: 10.1891/1058-1243.24.3.145.
    1. Zanardo V., Nicolussi S., Carlo G., Marzari F., Faggian D., Favaro F., Plebani M. Beta endorphin concentrations in human milk. J. Pediatr. Gastroenterol. Nutr. 2001;33:160–164. doi: 10.1097/00005176-200108000-00012.
    1. Yang L., Zhao Y., Wang Y., Liu L., Zhang X., Li B., Cui R. The Effects of Psychological Stress on Depression. Curr. Neuropharmacol. 2015;13:494–504. doi: 10.2174/1570159X1304150831150507.
    1. Taj R., Sikander K.S. Effects of maternal depression on breast-feeding. JPMA J. Pak. Med. Assoc. 2003;53:8–11.
    1. Pippins J.R., Brawarsky P., Jackson R.A., Fuentes-Afflick E., Haas J.S. Association of breastfeeding with maternal depressive symptoms. J. Women’s Health. 2006;15:754–762. doi: 10.1089/jwh.2006.15.754.
    1. Insaf T.Z., Fortner R.T., Pekow P., Dole N., Markenson G., Chasan-Taber L. Prenatal stress, anxiety, and depressive symptoms as predictors of intention to breastfeed among Hispanic women. J. Women’s Health. 2011;20:1183–1192. doi: 10.1089/jwh.2010.2276.
    1. Chourasia N., Surianarayanan P., Adhisivam B., Vishnu Bhat B. NICU admissions and maternal stress levels. Indian J. Pediatr. 2013;80:380–384. doi: 10.1007/s12098-012-0921-7.
    1. Holmes A.V. Establishing successful breastfeeding in the newborn period. Pediatr. Clin. N. Am. 2013;60:147–168. doi: 10.1016/j.pcl.2012.09.013.
    1. Brett J., Staniszewska S., Newburn M., Jones N., Taylor L. A systematic mapping review of effective interventions for communicating with, supporting and providing information to parents of preterm infants. BMJ Open. 2011;1:e000023. doi: 10.1136/bmjopen-2010-000023.
    1. Turner M., Chur-Hansen A., Winefield H., Stanners M. The assessment of parental stress and support in the neonatal intensive care unit using the Parent Stress Scale-Neonatal Intensive Care Unit. Women Birth. 2015;28:252–258. doi: 10.1016/j.wombi.2015.04.001.

Source: PubMed

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