Promoting optimum breastfeeding for infants and reducing maternal and childhood mortalities have remained a significant interest for the international community for decades. According to the World Health Organisation (WHO), it is recommended that a mother should initiate breastfeeding within the first hour after birth, exclusive breastfeeding for the first six months, and continued breastfeeding for two years or more (WHO, 2015). Breastfeeding is of major importance with long term health and economic benefits, it protects both mother and child from various illnesses especially infections. Consequently, breastfeeding is paramount to mother-baby relationship and the mental health of both baby and mother (UNICEF, 2011).
Psychological changes are experienced by women during and after pregnancy which brings about distinctive changes and outcome. High-risk pregnancies and/or complications of pregnancy such as preterm labour, hypertension, prolonged labour or fetal abnormality can be attributed to anxiety (Huizink et al 2004). Nursing mothers are susceptible to heightened levels of stress and some anxiety which may interfere with oxytocin; a hormone which stimulates the release of milk and this in turn affects breastfeeding experiences (Adedinsewo et al., 2014). Breastfeeding difficulties may vary according to lack of breastfeeding initiation and breastfeeding cessation due to nipple pains, lack of milk expulsion and some other factors.
Postpartum depression is the primary complication of pregnancy, affecting 15%−20% of new mothers in developed countries. The condition has adverse effects on both maternal and child health, including impaired parenting relationships . A considerable number of research on maternal mental health are mostly on maternal depression associated with breastfeeding continuation with quite a few recognized are on maternal anxiety and breastfeeding practises. Most times symptoms of anxiety tend to be subsumed within the diagnosis of depression, hence the need to examine anxiety as a separate maternal mental health condition.
Psychological problems during and after pregnancy continues to remain on the rise, it is imperative to give a better understanding of how maternal anxiety can be a likely predictor of breastfeeding difficulties among mothers in order to develop interventions that would promote positive breastfeeding practises as well as tackle maternal anxiety during the onset of pregnancy and beyond.
Due to the high prevalence of psychological problems faced by women during and after pregnancy, these are the following specific objectives of this proposed study:
- To investigate whether there is an association between maternal anxiety and breastfeeding practices
- To examine if anxious mothers more likely to have breastfeeding difficulties than less anxious mothers.
- To explore the breastfeeding difficulties if any, that are common among those who are anxious during pregnancy?
This study will adopt a prospective cohort study from June to October 2010 of pregnant women age 18 years and older from 3 health-care centres providing maternity care in Calgary, Canada. Inclusion criteria will be full single term infants, intention to breastfeed, and fluency in English and the exclusion criteria will be non-intention to breastfeed, chronic illness, infants with anomalies and inability to speak English. Data collection will take place between 12-26 weeks of gestation with follow up at 3, 6 and 12 months postpartum using maternal self-reports.
Using the information, this study will be able to determine if there is a relationship between maternal anxiety and breastfeeding difficulties and the outcomes, also what are the likely difficulties that may occur, if any. This research will ensure to achieve enhanced validity and reliability by the way of cross-referencing and reducing likely bias within the data analysis.
Contributions to ResearchThis research will be able to the determine whether maternal anxiety is a likely predictor of breastfeeding difficulties among nursing mothers while identifying the kinds of breastfeeding difficulties. This will enable the recommendation of screening for psychological problems not limited to postpartum depression but maternal anxiety and stress through early detection to know the mothers that are at risk of developing breastfeeding difficulties .
The impact of the relationship between maternal anxiety and breastfeeding difficulties would give a justification to study, develop and implement novel and appropriate interventions that will tackle breastfeeding difficulties.
Despite few studies in the research of maternal anxiety and breastfeeding difficulties, this proposed study will give lay a strong foundation through increasing knowledge for future studies to further build well on.