Relationships between Postpartum Anxiety, Breastfeeding Self-Efficacy, and Breastfeeding Exclusivity

Background

Though several important barriers to exclusive breastfeeding (EBF) have been identified, the relationship between postpartum anxiety and EBF remains inadequately explored.

Objective

The objective of this study was to determine if there was a significant relationship between postpartum anxiety and EBF and, if so, determine if breastfeeding self-efficacy moderated this relationship.

Methods

This was a cross-sectional, online survey. Eligibility criteria: mothers (at least 18 years of age), with an infant (aged 4-24 weeks), and who had provided breastmilk at least once in the previous two weeks. The survey instrument included demographic questions and three scales: the EPDS (Edinburgh Postpartum Depression Scale; score range: 0-30), the STAI (State Trait Anxiety Inventory; score range: 0-60), and the BSES-SF (Breastfeeding Self-Efficacy Scale, short form; score range: 14-70).

Results

The final sample size was 123. The majority reported being white (91.0%; n=112), non-Hispanic (91.0%; n=112), married (75.6%; n=93) and EBF at survey completion (61%; n=75). Mean scale scores: STAI, 26.1 (+/-13.10), EPDS, 10.3 (+/-4.30), and BSES-SF, 56.4 (+/-11.25). Anxiety (STAI) was significantly negatively related to breastfeeding self-efficacy (p=0.047) but not EBF (p=0.357). Path analysis showed an indirect effect of anxiety on EBF via direct impact on breastfeeding self-efficacy (p=0.025; model: p

Conclusion

In this largely homogeneous sample, results indicated the relationship between postpartum anxiety and breastfeeding self-efficacy may have been affecting EBF. Strengthening breastfeeding self-efficacy among women experiencing postpartum anxiety may be a potential strategy to support EBF. Future research should explore these concepts in a more heterogeneous sample.