Postpartum Sleep and Breastfeeding Outcomes Among First-Time Mothers of Full-Term Newborns

Abstract

To examine the impact of impaired sleep and its related health consequences (fatigue, hormone disruption, and mood changes) on two breastfeeding outcomes: milk volume and discontinued breastfeeding during the early postpartum period. A descriptive, correlational design was used. Participants were recruited via childbirth classes held at a large community hospital in the southeastern United States. The sample included 29 healthy women who were first-time mothers (ages 22–35 years) and exclusively breastfeeding healthy, full-term newborns. A home visit was conducted at 2-weeks postpartum. Data were collected using a sleep diary, General Sleep Disturbance Scale (GSDS), 7-item Lee Fatigue Scale (LFS-7), Edinburgh Postnatal Depression Scale (EPDS), Perceived Stress Scale (PSS-10), and State-Trait Anxiety Index (STAI). A test weight was performed during the visit, immediately before and after breastfeeding, and was repeated for two consecutive feedings. A follow-up phone interview was conducted to determine breastfeeding status at 1-month postpartum. All women were exclusively breastfeeding at 2-weeks postpartum, and most (90%) were breastfeeding exclusively at 1 month. At 2 weeks, participants in this study were sleep disturbed (69.2%), fatigued (82.8%), experiencing symptoms of anxiety (27.6%), and expressing more symptoms of depression (27.6%) compared with low-risk postpartum women in the United States. Stress was a significant predictor of poor sleep quality (β = .597, p = .001). Poor sleep quality was a significant predictor for lower breast milk production during the 2nd postpartum week (β = –.695, p = .02). Findings highlight a need to develop stress-reduction interventions that might lead to improved sleep during the postpartum period. Improved sleep may have a positive impact on breast milk production. Appropriate screening for depression symptoms and anxiety are also needed for early detection and assistance for postpartum women who develop mood disorders.