Costin, Madalina Ruxandra, Taut, Diana, Baban, Adriana, Ionescu, Thea, Murray, Aja Louise, Lindsay, Carene, Secara, Eugen, Abbasi, Fahad, Acheampong, Isaac Sarfo, Katus, Laura, Thanh, Yen Luong, Hernandez, Sandra Concepcion Layla S., Radeny, Shobhavi, Du Toit, Stephanie, Valdebenito, Sara and Eisner, Manuel P. (2023) The role of maternal depression symptoms and maternal attachment in predicting exclusive breastfeeding: a multisite prospective study. Journal of Women's Health. ISSN 1540-9996 (Print), 1931-843X (Online) (doi:10.1089/jwh.2023.0076)

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Abstract

Background: Previous research shows that 61% of children younger than six months, coming from low- and middle-income countries (LMICs) are not exclusively breastfed. While data on the role of pre- and postnatal depression on breastfeeding exclusivity is mixed, foeto-maternal attachment might foster breastfeeding exclusivity. Thus, we tested the potential mediating role of foeto-maternal attachment and postnatal depression in the relationship between maternal prenatal depression and exclusive breastfeeding.
Methods: Data were collected as part of a prospective, cross-cultural project, the Evidence-for-Better-Lives Study, which enrolled N=1208 expectant mothers across right LMIC sites. Out of the whole sample, N= 1185 third-trimester pregnant women (Mage = 28.32, SD = 5.77) from eight LMICs, completed Computer-Aided-Personal-Interviews on prenatal depressive symptoms, foeto-maternal attachment and socio-economic status. N=1033 women provided follow-up data at 3-6 months after birth, about postnatal depressive symptoms, exclusive breastfeeding and infant health indicators. Path analysis was used to assess parallel mediation.
Results: In the whole sample, the effect of prenatal depression on breastfeeding exclusivity was totally mediated by postnatal depression, while foeto-maternal attachment did not mediate the relationship. The full mediation effect was replicated individually in Pakistan and Sri Lanka.
Conclusion: The study results indicate that prenatal maternal depression symptoms contributed to the development of depressive symptoms after birth, which in turn negatively affected the probability to exclusively breastfeed. Future research should consider this in early prevention interventions, increasing the chances of healthy child development in LMICs. Considering the mixed results around the eight countries, it is important to better understand the intricate relationship between maternal depression, foeto-maternal attachment and breastfeeding behavior through each country’s socio-cultural context.

Item Type:	Article
Additional Information:	An earlier version of the article (preprint) has been published as open access (CC-By Attribution 4.0 International) by PsyArXiv Preprints service [https://doi.org/10.31234/osf.io/vtp3u]. -MP
Uncontrolled Keywords:	prenatal depression; postnatal depression; foeto-maternal attachment; child development; low- and middle-income countries
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RG Gynecology and obstetrics
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	12 Dec 2023 11:39
URI:	http://gala.gre.ac.uk/id/eprint/43730

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