The Relationship Between Coping, Stress, and Breastfeeding Outcomes

Background: Breastfeeding is the optimal form of nutrition for infants in their first year of life. While the benefits of breastfeeding are numerous, national rates remain below professional recommendations. Multiple barriers to breastfeeding have been identified, including various sociodemographic, psychosocial, and biomedical and health-carerelated barriers. Maternal stress may be another barrier, as it has been previously associated with breastfeeding outcomes. Coping strategies are used to manage the demands of a stressful environment and can be categorized as problem- or emotion-focused. Emotion regulation emerged from the coping literature, but describes a unique set of techniques that affect the emotion-generating process. Social support is another coping resource that has been associated with successful breastfeeding outcomes.

Objective: The objective of this study was to assess the cross-sectional relationships between emotion regulation, perceived stress, perceived social support, problem solving, and breastfeeding outcomes (i.e., initiation and full breastfeeding) among mothers with infants less than six months of age via an online survey.

Methods: A total of 180 mothers were recruited, via social networking websites and the Principle Investigator’s lab, to participate in an online survey that included the following measures: Difficulties in Emotion Regulation Scale (DERS), Perceived Stress Scale (PSS), Multidimensional Scale of Perceived Social Support (MSPSS), and Ways of Coping Questionnaire (WCQ). Independent t-tests, linear and logistic regressions, and Pearson’s r correlations were used for analysis.

Results: Cross-sectional data from 91 mothers were analyzed. Results demonstrate a significant negative relationship between perceived maternal stress and breastfeeding initiation. Additionally, less difficulty in emotion regulation and greater perceived social support were significantly associated with lower perceived stress.

Conclusion: Results from the present study suggest that perceived stress may be a barrier to breastfeeding initiation. Emotion regulation and perceived social support, both modifiable constructs, may be important target areas for reducing maternal stress and improving breastfeeding outcomes. Interventions using Dialectical Behavioral Therapy (DBT) or Acceptance and Commitment Therapy (ACT) may be effective in developing emotion regulation skills during the perinatal period.