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Background: The rate of exclusive breastfeeding at 3 months postpartum is only 50% in Japan. In order to increase this rate, we aimed to examine modifiable factors related to exclusive breastfeeding at 3 months postpartum by focusing on breastfeeding-related and psychosocial variables at 1 month postpartum.
Methods: This prospective cohort study was conducted at a secondary medical care center in Osaka, Japan from February 2017 to October 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. Multiple logistic regression analyses were performed to examine factors affecting exclusive breastfeeding at 3 months postpartum.
Results: Of the 104 participants, 61 reported exclusive breastfeeding at 3 months postpartum. The following factors were significantly associated with exclusive breastfeeding at 3 months postpartum: multiparity (adjusted odds ratio, 95% confidence interval: 11.13, 2.08–59.59), having a university degree (5.25, 1.04–26.53), no plan to return to work by 6 months postpartum (0.02, 0.00–0.46), and exclusive breastfeeding (42.84, 6.05–303.52), lower cortisol level after breastfeeding (0.00, 0.00–0.02), and higher breastfeeding self-efficacy scale score (1.07, 1.00–1.14) at 1 month postpartum. In parity-specific analyses, exclusive breastfeeding (25.33, 4.75–134.98) and lower cortisol level after breastfeeding (0.00, 0.00–0.21) at 1 month postpartum in primiparous women, and lower cortisol level after breastfeeding (0.00, 0.00–0.94), higher breastfeeding self-efficacy score (1.18, 1.05–1.32), and absence of breast complications (0.09, 0.01-0.82) at 1 month postpartum in multiparous women were associated with exclusive breastfeeding at 3 months postpartum.
Conclusions: Stress levels after breastfeeding, breastfeeding self-efficacy, and the presence of breast complications could be modifiable factors associated with subsequent exclusive breastfeeding. Further research is needed to examine whether approaches to reducing breastfeeding-related stress, improving breastfeeding self-efficacy, and preventing breast complications during lactation are effective to 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.
Version 4
Posted 19 Nov, 2020
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
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
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Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
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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.
Version 4
Posted 19 Nov, 2020
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
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: The rate of exclusive breastfeeding at 3 months postpartum is only 50% in Japan. In order to increase this rate, we aimed to examine modifiable factors related to exclusive breastfeeding at 3 months postpartum by focusing on breastfeeding-related and psychosocial variables at 1 month postpartum.
Methods: This prospective cohort study was conducted at a secondary medical care center in Osaka, Japan from February 2017 to October 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. Multiple logistic regression analyses were performed to examine factors affecting exclusive breastfeeding at 3 months postpartum.
Results: Of the 104 participants, 61 reported exclusive breastfeeding at 3 months postpartum. The following factors were significantly associated with exclusive breastfeeding at 3 months postpartum: multiparity (adjusted odds ratio, 95% confidence interval: 11.13, 2.08–59.59), having a university degree (5.25, 1.04–26.53), no plan to return to work by 6 months postpartum (0.02, 0.00–0.46), and exclusive breastfeeding (42.84, 6.05–303.52), lower cortisol level after breastfeeding (0.00, 0.00–0.02), and higher breastfeeding self-efficacy scale score (1.07, 1.00–1.14) at 1 month postpartum. In parity-specific analyses, exclusive breastfeeding (25.33, 4.75–134.98) and lower cortisol level after breastfeeding (0.00, 0.00–0.21) at 1 month postpartum in primiparous women, and lower cortisol level after breastfeeding (0.00, 0.00–0.94), higher breastfeeding self-efficacy score (1.18, 1.05–1.32), and absence of breast complications (0.09, 0.01-0.82) at 1 month postpartum in multiparous women were associated with exclusive breastfeeding at 3 months postpartum.
Conclusions: Stress levels after breastfeeding, breastfeeding self-efficacy, and the presence of breast complications could be modifiable factors associated with subsequent exclusive breastfeeding. Further research is needed to examine whether approaches to reducing breastfeeding-related stress, improving breastfeeding self-efficacy, and preventing breast complications during lactation are effective to increase exclusive breastfeeding practices.
This is a list of supplementary files associated with this preprint. Click to download.
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