Abstract
Background: Late preterm infants suffer from several problems after birth, and the key factor in fighting these problems is effective breastfeeding.
Objective: To determine breastfeeding self-efficacy and its relationship with perceived stress and assess breastfeeding performance in mothers with late preterm infants.
Methods: In this prospective study, 171 eligible nursing mothers with late preterm infants born in Alzahra Medical Center of Tabriz, Iran, were selected via convenience sampling. The Breastfeeding Self-Efficacy Scale-Short Form was employed to measure breastfeeding self-efficacy, and the 14-item Perceived Stress Scale was used to measure the perceived stress 24 hours after giving birth. When the child was 4 months old, breastfeeding performance was measured by the Standard Breastfeeding Performance Questionnaire. The data were analyzed by Pearson and Spearman’s correlation tests, independent t-test, one-way ANOVA, and multiple linear regression analysis.
Results: The mean (standard deviation) of breastfeeding self-efficacy was 50.0 (7.8) with scores ranging from 13 to 65, and the mean (standard deviation) of perceived stress was 26.5 (8.8) with scores ranging from 0 to 56. The median (25-75 percentiles) of breastfeeding performance score equaled 2.0 (1.0 to 3.0) with scores ranging from 0 to 6. Based on multiple linear regression analysis and after adjusting the personal-social characteristics, by increasing the score of breastfeeding self-efficacy, perceived stress was significantly decreased (B=-0.1, 95 %CI=-0.3 to 0.0). However, there was no statistically significant relationship between breastfeeding self-efficacy and breastfeeding performance (p = 0.418).
Conclusion: Due to the possibility of adjusting breastfeeding self-efficacy and its role in mothers’ perceived stress, developing proper strategies seems to be essential for enhancing breastfeeding self-efficacy.
Keywords: Preterm infant, breastfeeding, self-efficacy, perceived stress, performance, Iran.
Graphical Abstract
[1]
Abbott MB, Vlasses CH. Nelson textbook of pediatrics. JAMA 2011; 306(21): 2387-8.
[http://dx.doi.org/10.1001/jama.2011.1775]
[http://dx.doi.org/10.1001/jama.2011.1775]
[2]
Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding. In: Pickering LK, Morrow AL, Ruiz-Palacios GM, Schanler RJ, Eds. Protecting infants through human milk. Boston, MA: Springer 2004; pp. 63-77.
[http://dx.doi.org/10.1007/978-1-4757-4242-8_7]
[http://dx.doi.org/10.1007/978-1-4757-4242-8_7]
[3]
Horta BL, Loret de Mola C, Victora CG. Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: A systematic review and meta-analysis. Acta Paediatr 2015; 104(467): 30-7.
[http://dx.doi.org/10.1111/apa.13133] [PMID: 26192560]
[http://dx.doi.org/10.1111/apa.13133] [PMID: 26192560]
[4]
Horta B, Victora C. Short-term effects of breastfeeding: A systematic review on the benefits of breastfeeding on diarrhoea and pneumonia mortality. 2013.
[5]
Arenz S, Rückerl R, Koletzko B, von Kries R. Breast-feeding and childhood obesity-A systematic review. Int J Obes 2004; 28(10): 1247-56.
[http://dx.doi.org/10.1038/sj.ijo.0802758] [PMID: 15314625]
[http://dx.doi.org/10.1038/sj.ijo.0802758] [PMID: 15314625]
[6]
Pediatrics AAo. Breastfeeding and the use of human milk, Pediatrics(elektronik dergi). 2012; 129: 827-41. Available from: http://pediatrics aappublications org/content/115/2/496 full pdf+ html.
[7]
Mohammadi F, Kiani A, Gholamzadeh S, Asadi Noghabi F, Sadeghi T. The factors affecting Successful Breast-feeding (SBF). Iran J Neonatol 2018; 9(2): 73-82.
[8]
Ogunlesi TA. Maternal socio-demographic factors influencing the initiation and exclusivity of breastfeeding in a Nigerian semi-urban setting. Matern Child Health J 2010; 14(3): 459-65.
[http://dx.doi.org/10.1007/s10995-008-0440-3] [PMID: 19156508]
[http://dx.doi.org/10.1007/s10995-008-0440-3] [PMID: 19156508]
[9]
Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. Lancet 2012; 379(9832): 2162-72.
[http://dx.doi.org/10.1016/S0140-6736(12)60820-4] [PMID: 22682464]
[http://dx.doi.org/10.1016/S0140-6736(12)60820-4] [PMID: 22682464]
[10]
Ahmadzadeh N, Rezapour A, Ghanavatinejad Z, et al. Estimation of economic burden of preterm and premature births in Iran. Med J Islam Repub Iran 2017; 31: 78.
[http://dx.doi.org/10.14196/mjiri.31.78] [PMID: 29445706]
[http://dx.doi.org/10.14196/mjiri.31.78] [PMID: 29445706]
[11]
Sharifi N, Khazaeian S, Pakzad R, Fathnezhad Kazemi A, Chehreh H. Investigating the prevalence of preterm birth in Iranian population: A systematic review and meta-analysis. J Caring Sci 2017; 6(4): 371-80.
[http://dx.doi.org/10.15171/jcs.2017.035] [PMID: 29302576]
[http://dx.doi.org/10.15171/jcs.2017.035] [PMID: 29302576]
[12]
Natarajan G, Shankaran S. Short-and long-term outcomes of moderate and late preterm infants. Am J Perinatol 2016; 33(3): 305-17.
[http://dx.doi.org/10.1055/s-0035-1571150] [PMID: 26788789]
[http://dx.doi.org/10.1055/s-0035-1571150] [PMID: 26788789]
[13]
Escobar GJ, Clark RH, Greene JD. Short-term outcomes of infants born at 35 and 36 weeks gestation: We need to ask more questions. Semin Perinatol 2006; 30(1): 28-33.
[14]
Goyal NK, Attanasio LB, Kozhimannil KB. Hospital care and early breastfeeding outcomes among late preterm, early-term, and term infants. Birth 2014; 41(4): 330-8.
[http://dx.doi.org/10.1111/birt.12135] [PMID: 25294061]
[http://dx.doi.org/10.1111/birt.12135] [PMID: 25294061]
[15]
Henry BA, Nicolau AI, Américo CF, Ximenes LB, Bernheim RG, Oriá MO. Socio-cultural factors influencing breastfeeding practices among low-income women in Fortaleza-Ceará-Brazil: A Leininger’s sunrise model perspective. Enfermería Global 2010; 19: 1-13.
[16]
Uchendu U, Ikefuna A, Emodi I. Factors associated with exclusive breastfeeding among mothers seen at the University of Nigeria Teaching Hospital. SAJCH 2009; 3(1): 13-9.
[17]
Shariat M, Abedinia N, Noorbala AA, Zebardast J, Moradi S, Shahmohammadian N. Breastfeeding self-efficacy as a predictor of exclusive breastfeeding: A clinical trial. Iran J Neonatol 2018; 9(3): 26-34.
[18]
Bartle NC, Harvey K. Explaining infant feeding: The role of previous personal and vicarious experience on attitudes, subjective norms, self-efficacy, and breastfeeding outcomes. Br J Health Psychol 2017; 22(4): 763-85.
[http://dx.doi.org/10.1111/bjhp.12254] [PMID: 28646537]
[http://dx.doi.org/10.1111/bjhp.12254] [PMID: 28646537]
[19]
Gerhardsson E, Hildingsson I, Mattsson E, Funkquist EL. Prospective questionnaire study showed that higher self-efficacy predicted longer exclusive breastfeeding by the mothers of late preterm infants. Acta Paediatr 2018; 107(5): 799-805.
[http://dx.doi.org/10.1111/apa.14229] [PMID: 29352489]
[http://dx.doi.org/10.1111/apa.14229] [PMID: 29352489]
[20]
O’Brien K, Bracht M, Macdonell K, et al. A pilot cohort analytic study of family integrated care in a canadian neonatal intensive care unit. BMC Pregnancy Childbirth 2013; 13(S1)(Suppl. 1): S12.
[http://dx.doi.org/10.1186/1471-2393-13-S1-S12] [PMID: 23445639]
[http://dx.doi.org/10.1186/1471-2393-13-S1-S12] [PMID: 23445639]
[21]
Gellman MD, Turner JR. Encyclopedia of behavioral medicine. Springer 2013.
[http://dx.doi.org/10.1007/978-1-4419-1005-9]
[http://dx.doi.org/10.1007/978-1-4419-1005-9]
[22]
Miles MS, Funk SG, Kasper MA. The stress response of mothers and fathers of preterm infants. Res Nurs Health 1992; 15(4): 261-9.
[http://dx.doi.org/10.1002/nur.4770150405] [PMID: 1496151]
[http://dx.doi.org/10.1002/nur.4770150405] [PMID: 1496151]
[23]
Jubinville J, Newburn-Cook C, Hegadoren K, Lacaze-Masmonteil T. Symptoms of acute stress disorder in mothers of premature infants. Adv Neonatal Care 2012; 12(4): 246-53.
[http://dx.doi.org/10.1097/ANC.0b013e31826090ac] [PMID: 22864005]
[http://dx.doi.org/10.1097/ANC.0b013e31826090ac] [PMID: 22864005]
[24]
Giannì ML, Bezze E, Sannino P, et al. Facilitators and barriers of breastfeeding late preterm infants according to mothers’ experiences. BMC Pediatr 2016; 16(1): 179.
[http://dx.doi.org/10.1186/s12887-016-0722-7] [PMID: 27821185]
[http://dx.doi.org/10.1186/s12887-016-0722-7] [PMID: 27821185]
[25]
Mörelius E, Örtenstrand A, Theodorsson E, Frostell A. A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding. Early Hum Dev 2015; 91(1): 63-70.
[http://dx.doi.org/10.1016/j.earlhumdev.2014.12.005] [PMID: 25545453]
[http://dx.doi.org/10.1016/j.earlhumdev.2014.12.005] [PMID: 25545453]
[26]
Araban M, Karimian Z, Karimian Kakolaki Z, McQueen KA, Dennis C-L. Randomized controlled trial of a prenatal breastfeeding self-efficacy intervention in Primiparous women in Iran. J Obstet Gynecol Neonatal Nurs 2018; 47(2): 173-83.
[http://dx.doi.org/10.1016/j.jogn.2018.01.005] [PMID: 29406289]
[http://dx.doi.org/10.1016/j.jogn.2018.01.005] [PMID: 29406289]
[27]
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24(4): 385-96.
[http://dx.doi.org/10.2307/2136404] [PMID: 6668417]
[http://dx.doi.org/10.2307/2136404] [PMID: 6668417]
[28]
Maroufizadeh S, Zareiyan A, Sigari N. Reliability and validity of Persian version of Perceived Stress Scale (PSS-10) in adults with asthma. Arch Iran Med 2014; 17(5): 361-5.
[29]
Agunbiade OM, Ogunleye OV. Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: Implications for scaling up. Int Breastfeed J 2012; 7(1): 5.
[http://dx.doi.org/10.1186/1746-4358-7-5] [PMID: 22524566]
[http://dx.doi.org/10.1186/1746-4358-7-5] [PMID: 22524566]
[30]
Mirghafourvand M, Malakouti J, Mohammad-Alizadeh-Charandabi S, Faridvand F. Predictors of breastfeeding self-efficacy in Iranian women: A cross-sectional study. Int J Women’s Health Reprod Sci 2018; 6(3): 380-5.
[http://dx.doi.org/10.15296/ijwhr.2018.62]
[http://dx.doi.org/10.15296/ijwhr.2018.62]
[31]
Varaei S, Mehrdad N, Bahrani N. The relationship between self-efficacy and breastfeeding, Tehran, Iran. Hayat (Tihran) 2009; 15(3): 31-8.
[32]
Poorshaban F, Pakseresht S, Bostani Khalesi Z. KazemNejad Leili E. Factors associated with breastfeeding self-efficacy of mothers within 6 weeks of delivery. J Holist Nurs Midwifery 2017; 27(1): 27-34.
[http://dx.doi.org/10.18869/acadpub.hnmj.27.1.27]
[http://dx.doi.org/10.18869/acadpub.hnmj.27.1.27]
[33]
Karbandi S, Hosseini SM, Masoudi R, Mamori GA. The effect of relaxation training on breastfeeding self-efficacy of mothers with preterm infants: A randomized clinical trial. J Clin Nurs Midwifery 2014; 3(2): 37-45.
[34]
Ansari S, Abedi P, Hasanpoor S, Bani S. The effect of interventional program on breastfeeding self-efficacy and duration of exclusive breastfeeding in pregnant women in Ahvaz, Iran. Int Sch Res Notices 2014; 2014: 510793.
[35]
Azizi E, Maleki A, Mazloomzadeh S, Pirzeh R. Effect of stress management counseling on self-efficacy and continuity of exclusive breastfeeding. Breastfeed Med 2020; 15(8): 501-8.
[http://dx.doi.org/10.1089/bfm.2019.0251] [PMID: 32503365]
[http://dx.doi.org/10.1089/bfm.2019.0251] [PMID: 32503365]
[36]
Bastani F, Rahmatnejad L, Jahdi F, Haghani H. Breastfeeding self efficacy and perceived stress in primiparous mothers. Iran J Nurs 2008; 21(54): 9-24.
[37]
Didarloo A, Rahmatnezhad L, Sheikhi S, Khodai F. Relationship of spiritual health and perceived stress with breastfeeding self-efficacy: A survey on mothers with hospitalized neonates. Int J Pediatr 2017; 5(12): 6179-88.
[38]
Faridvand F, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Malakouti J. Breastfeeding performance in Iranian women. Int J Nurs Pract 2018; 24(4): e12659.
[http://dx.doi.org/10.1111/ijn.12659] [PMID: 29676039]
[http://dx.doi.org/10.1111/ijn.12659] [PMID: 29676039]
[39]
Moafi F, Asgari S, Yekefalah Z, Momeni M, Hajnasiri H. Assessment of breastfeeding self-efficacy and patterns and its predictors in mothers living in Qazvin province. Nurs Midwifery J 2018; 15(10): 777-87.
[40]
Zanardo V, Gambina I, Begley C, et al. Psychological distress and early lactation performance in mothers of late preterm infants. Early Hum Dev 2011; 87(4): 321-3.
[http://dx.doi.org/10.1016/j.earlhumdev.2011.01.035] [PMID: 21316877]
[http://dx.doi.org/10.1016/j.earlhumdev.2011.01.035] [PMID: 21316877]
[41]
Shiraishi M, Matsuzaki M, Kurihara S, Iwamoto M, Shimada M. Post-breastfeeding stress response and breastfeeding self-efficacy as modifiable predictors of exclusive breastfeeding at 3 months postpartum: A prospective cohort study. BMC Pregnancy Childbirth 2020; 20(1): 730.
[http://dx.doi.org/10.1186/s12884-020-03431-8] [PMID: 33238937]
[http://dx.doi.org/10.1186/s12884-020-03431-8] [PMID: 33238937]
[42]
De Roza JG, Fong MK, Ang BL, Sadon RB, Koh EYL, Teo SSH. Exclusive breastfeeding, breastfeeding self-efficacy and perception of milk supply among mothers in Singapore: A longitudinal study. Midwifery 2019; 79: 102532.
[http://dx.doi.org/10.1016/j.midw.2019.102532] [PMID: 31526969]
[http://dx.doi.org/10.1016/j.midw.2019.102532] [PMID: 31526969]
[43]
Ngo LTH, Chou H-F, Gau M-L, Liu C-Y. Breastfeeding self-efficacy and related factors in postpartum Vietnamese women. Midwifery 2019; 70: 84-91.
[http://dx.doi.org/10.1016/j.midw.2018.12.014] [PMID: 30594613]
[http://dx.doi.org/10.1016/j.midw.2018.12.014] [PMID: 30594613]
Article Metrics
23
1