A randomised controlled trial evaluating the effect of a brief motivational intervention to promote breastfeeding in postpartum depression

C Franco-Antonio,S Cordovilla-Guardia,S Chimento-Díaz,E Santano-Mogena,P Sánchez-García

doi:10.1038/s41598-021-04338-w

C Franco-Antonio, S Cordovilla-Guardia + Show 3 more

Open Access

https://doi.org/10.1038/s41598-021-04338-w

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Journal: Scientific Reports	Publication Date: Jan 10, 2022
Citations: 8	License type: open-access

Affiliation: University of Extremadura

Abstract

Postpartum depression (PPD) is the most frequent psychiatric complication during the postnatal period. According to existing evidence, an association exists between the development of PPD and the maintenance of breastfeeding. A brief motivational intervention (bMI), based on the motivational interview, seems effective in promoting breastfeeding. The objective of this study was to analyse the impact of a bMI aiming to promote breastfeeding on the development of PPD and explore the mediating/moderating roles of breastfeeding and breastfeeding self-efficacy in the effect of the intervention on developing PPD. Eighty-eight women who gave birth by vaginal delivery and started breastfeeding during the immediate postpartum period were randomly assigned to the intervention group (bMI) or control group (breastfeeding education). Randomisation by minimisation was carried out. The breastfeeding duration was longer in the intervention group (11.06 (± 2.94) weeks vs 9.02 (± 4.44), p = 0.013). The bMI was associated with a lower score on the Edinburgh Postnatal Depression Scale, with a regression β coefficient of − 2.12 (95% CI − 3.82; − 0.41). A part of this effect was mediated by the effect of the intervention on the duration of breastfeeding (mediation/moderation index β = − 0.57 (95% CI − 1.30; − 0.04)). These findings suggest that a bMI aiming to promote breastfeeding has a positive impact preventing PPD mainly due to its effectiveness in increasing the duration of breastfeeding.

Highlights

Various approaches to PPD prevention have been implemented as follows: (i) interpersonal counselling interventions 33,34, (ii) cognitive-behavioural therapies 35,36, (iii) therapies to modify health habits 37–39, and (iv) postpartum support interventions 2,40–44
There were no differences in the baseline score on the Breastfeeding Self-Efficacy Scale Short-Form (BSES-SF) as follows: 59.14 (± 9.35) in the brief motivational intervention (bMI) group and 59.41 (± 8.45) in the control group (p = 0.886) (Table 2)
A bMI for the promotion of BF applied during the immediate postpartum period in women who initiate BF in the first hour of life of the newborn and reinforced by one telephone call per month is associated with a lower score on the Edinburgh Postnatal Depression Scale (EPDS) at the third postpartum month

Summary

Introduction

Various approaches to PPD prevention have been implemented as follows: (i) interpersonal counselling interventions 33,34, (ii) cognitive-behavioural therapies 35,36, (iii) therapies to modify health habits 37–39, and (iv) postpartum support interventions 2,40–44. A meta-analysis performed for the US Preventive Services Task Force[45] found that cognitive behavioural therapy and interpersonal therapy are effective interventions for preventing PPD. The brief motivational intervention (bMI) is based on the motivational interview, which could be defined as a collaborative communication style designed to increase personal motivation to achieve one’s goals while exploring the individual’s ambivalences to change within an atmosphere of acceptance[46]. This type of intervention has already been shown to be effective in increasing the duration of BF and the level of BSE47–53. Analysing whether an intervention that acts on BF and BSE has an impact on PPD and determining the causal relationships and the magnitude of the effect among these factors are relevant and pertinent

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