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Background: Only 50% of mothers in Japan exclusively breastfeed their infants during the postpartum period. To increase this rate, we aimed to examine modifiable factors at 1 month postpartum related to exclusive breastfeeding at 3 months postpartum by focusing on breastfeeding-related and psychosocial variables.
Methods: This prospective cohort study was a secondary analysis of a longitudinal study, which was conducted in a secondary medical care center in Osaka, Japan from 2017 to 2018. Demographic variables, infant feeding modality, breastfeeding-related variables, and psychosocial variables were obtained using questionnaires at 1 month postpartum. Daytime salivary cortisol levels before and after breastfeeding at 1 month postpartum were measured as a biological marker for stress responses associated with breastfeeding. Each infant’s feeding modality was re-assessed at 3 months postpartum. A multiple logistic regression analysis was performed to examine the factors affecting exclusive breastfeeding at 3 months postpartum.
Results: Of the 104 participants, 61 reported exclusive breastfeeding at 3 months postpartum. The following factors significantly affected exclusive breastfeeding at 3 months postpartum: multipara (adjusted odds ratio, 95% confidence interval: 11.128, 2.078–59.594), having a university degree (5.246, 1.037–26.526), no plan to return to work by 6 months postpartum (0.021, 0.001–0.460), exclusive breastfeeding at 1 month postpartum (42.841, 6.047–303.515), higher breastfeeding self-efficacy scale score at 1 month postpartum (1.070, 1.004–1.139), and lower cortisol level after breastfeeding at 1 month postpartum (0.000, 0.000–0.020).
Conclusions: Stress levels after breastfeeding and breastfeeding self-efficacy were identified as modifiable factors related to subsequent exclusive breastfeeding. Healthcare professionals need to develop effective approaches to reducing breastfeeding-related stress and improving breastfeeding self-efficacy to help women fulfill their antenatal breastfeeding intentions and increase exclusive breastfeeding practices.
Keywords
breastfeeding, postpartum period, self-efficacy, stress response
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CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
No community comments so far
Submission checks complete
On 18 Nov, 2020
Editorial decision: Accept
On 12 Nov, 2020
No comments provided
Editor assigned
On 07 Nov, 2020
Submission checks complete
On 07 Nov, 2020
Editor invited
On 07 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 23 Oct, 2020
Review #1 received
Received 21 Sep, 2020
Reviewer #1 agreed
On 23 Aug, 2020
Editor assigned
On 20 Aug, 2020
Reviewers invited
Invitations sent on 20 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
Version 1
Posted 31 Mar, 2020
No comments provided
Editorial decision: Major revision
On 06 Jul, 2020
Review #2 received
Received 06 Jun, 2020
Reviewer #2 agreed
On 15 May, 2020
Review #1 received
Received 28 Apr, 2020
Reviewer #1 agreed
On 17 Apr, 2020
Reviewers invited
Invitations sent on 09 Apr, 2020
First submitted
On 22 Mar, 2020
Editor assigned
On 22 Mar, 2020
Submission checks complete
On 21 Mar, 2020
Editor invited
On 21 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
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Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Pregnancy and Childbirth.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
No community comments so far
Submission checks complete
On 18 Nov, 2020
Editorial decision: Accept
On 12 Nov, 2020
No comments provided
Editor assigned
On 07 Nov, 2020
Submission checks complete
On 07 Nov, 2020
Editor invited
On 07 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 23 Oct, 2020
Review #1 received
Received 21 Sep, 2020
Reviewer #1 agreed
On 23 Aug, 2020
Editor assigned
On 20 Aug, 2020
Reviewers invited
Invitations sent on 20 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
Version 1
Posted 31 Mar, 2020
No comments provided
Editorial decision: Major revision
On 06 Jul, 2020
Review #2 received
Received 06 Jun, 2020
Reviewer #2 agreed
On 15 May, 2020
Review #1 received
Received 28 Apr, 2020
Reviewer #1 agreed
On 17 Apr, 2020
Reviewers invited
Invitations sent on 09 Apr, 2020
First submitted
On 22 Mar, 2020
Editor assigned
On 22 Mar, 2020
Submission checks complete
On 21 Mar, 2020
Editor invited
On 21 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pregnancy and Childbirth.
Background: Only 50% of mothers in Japan exclusively breastfeed their infants during the postpartum period. To increase this rate, we aimed to examine modifiable factors at 1 month postpartum related to exclusive breastfeeding at 3 months postpartum by focusing on breastfeeding-related and psychosocial variables.
Methods: This prospective cohort study was a secondary analysis of a longitudinal study, which was conducted in a secondary medical care center in Osaka, Japan from 2017 to 2018. Demographic variables, infant feeding modality, breastfeeding-related variables, and psychosocial variables were obtained using questionnaires at 1 month postpartum. Daytime salivary cortisol levels before and after breastfeeding at 1 month postpartum were measured as a biological marker for stress responses associated with breastfeeding. Each infant’s feeding modality was re-assessed at 3 months postpartum. A multiple logistic regression analysis was performed to examine the factors affecting exclusive breastfeeding at 3 months postpartum.
Results: Of the 104 participants, 61 reported exclusive breastfeeding at 3 months postpartum. The following factors significantly affected exclusive breastfeeding at 3 months postpartum: multipara (adjusted odds ratio, 95% confidence interval: 11.128, 2.078–59.594), having a university degree (5.246, 1.037–26.526), no plan to return to work by 6 months postpartum (0.021, 0.001–0.460), exclusive breastfeeding at 1 month postpartum (42.841, 6.047–303.515), higher breastfeeding self-efficacy scale score at 1 month postpartum (1.070, 1.004–1.139), and lower cortisol level after breastfeeding at 1 month postpartum (0.000, 0.000–0.020).
Conclusions: Stress levels after breastfeeding and breastfeeding self-efficacy were identified as modifiable factors related to subsequent exclusive breastfeeding. Healthcare professionals need to develop effective approaches to reducing breastfeeding-related stress and improving breastfeeding self-efficacy to help women fulfill their antenatal breastfeeding intentions and increase exclusive breastfeeding practices.
This is a list of supplementary files associated with this preprint. Click to download.
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