Association between Breastfeeding Attitudes and Postpartum Depression among Mothers with Premature Infants during COVID-19 Pandemic.

Noor Fairuzi Suhana Yahya,Najwa Shafiee,Nur Islami Mohd Fahmi Teng,Norsham Juliana

doi:10.3390/ijerph182010915

Abstract

Breastfeeding is the best form of feeding for premature infants. However, mothers with premature delivery are frequently reported to be depressed, and this has been especially the case during the Coronavirus Disease-2019 (COVID-19) pandemic. We aimed to measure the level of breastfeeding attitude and its association with postpartum depression among mothers with premature infants in the Neonatal Intensive Care Unit (NICU) during the COVID-19 pandemic. A total of 248 mothers with a premature infant were observed in this cross-sectional study from the chosen NICUs of government hospitals in Selangor, Malaysia. The Iowa Infant Feeding Attitude Score (IIFAS) and the Edinburgh Postnatal Depression Scale, along with sociodemographic questionnaires, were used to obtain information on the mothers’ attitudes towards breastfeeding and the risk of postpartum depression. A higher percentage of mothers had a positive attitude towards breastfeeding (64.9%), with a mean IIFAS score of 66.30 ± 6.92. Meanwhile, about 27% of mothers with premature infants were reported to have high risk of depressive symptoms. Mothers with a high risk of depression were less likely to have a positive attitude towards breastfeeding (OR 0.37, 95% CI 0.199, 0.675) as compared to mothers with a low risk of depression (p < 0.01). We found that there is an association between the risk of depression and the attitude towards breastfeeding. Early identification of maternal mental health problems should be addressed to ensure the willingness of mothers to continue breastfeeding.

Highlights

Breast milk provides optimal nutrients to protect infants against various diseases such as upper and lower tract infections, as well as protecting against Type 1 diabetes and reducing asthma during infancy and beyond [1]
The infant characteristics showed that a majority of mothers had their infant in the late preterm period (52.8%) and underwent vaginal delivery during the process of giving birth (56.9%), and a majority of infants weighed more than 2500 g at birth (65.3%)
Research documenting breastfeeding attitudes has previously been published in various settings in Malaysia [10,11,12], to the best of our knowledge, this is the first study in Malaysia to employ a validated Iowa Infant Feeding Attitude Score (IIFAS) scale to measure the breastfeeding attitudes of mothers with premature infants in Neonatal Intensive Care Unit (NICU) during the COVID-19 pandemic

Summary

Introduction

Breast milk provides optimal nutrients to protect infants against various diseases such as upper and lower tract infections, as well as protecting against Type 1 diabetes and reducing asthma during infancy and beyond [1]. If the benefits for a full-term infant are enormous, a preterm infant may be entitled to far more benefits of breast milk. Managing nutritional needs among premature infants by encouraging breastfeeding is mandatory to ensure reductions in physiological problems, despite the beneficial pharmacokinetics of several available drugs [2]. Breastfeeding provides several advantages to mothers, including protection against breast and ovarian cancer, aid in postpartum recovery, and improved mother–infant bonding [1]. In Malaysia, the National Breastfeeding Policy has encouraged mothers to breastfeed their infants exclusively for the first six months and continue up

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