Timing of Breastfeeding Initiation Mediates the Association between Delivery Mode, Source of Breastfeeding Education, and Postpartum Depression Symptoms

Xinran Shen; Shunna Lin; Hui Li; Nubiya Amaerjiang; Wen Shu; Menglong Li; Huidi Xiao; Sofia Segura-Pérez; Rafael Pérez-Escamilla; Xin Fan; Yifei Hu

doi:10.3390/nu14142959

Nutrients (Jul 2022)

Timing of Breastfeeding Initiation Mediates the Association between Delivery Mode, Source of Breastfeeding Education, and Postpartum Depression Symptoms

Xinran Shen,
Shunna Lin,
Hui Li,
Nubiya Amaerjiang,
Wen Shu,
Menglong Li,
Huidi Xiao,
Sofia Segura-Pérez,
Rafael Pérez-Escamilla,
Xin Fan,
Yifei Hu

Affiliations

Xinran Shen: Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China
Shunna Lin: Department of Pediatrics, Tianhe District Maternal and Child Hospital of Guangzhou, Guangzhou 510620, China
Hui Li: Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China
Nubiya Amaerjiang: Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China
Wen Shu: Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China
Menglong Li: Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China
Huidi Xiao: Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China
Sofia Segura-Pérez: Chief Program Officer, Hispanic Health Council, 175 Main St., Hartford, CT 06106, USA
Rafael Pérez-Escamilla: Yale School of Public Health, Yale University, New Haven, CT 06510-3201, USA
Xin Fan: Department of Pediatrics, Women and Children’s Hospital of Chongqing Medical University, No. 120, Longshan Road, Yubei District, Chongqin 400042, China
Yifei Hu: Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China

DOI: https://doi.org/10.3390/nu14142959
Journal volume & issue: Vol. 14, no. 14
p. 2959

Abstract

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Background: Emergency cesarean section (EMCS) and breastfeeding difficulties increase the risk of postpartum depressive (PPD) symptoms. Early initiation of breastfeeding (EIBF) may not only alleviate PPD symptoms but also facilitate subsequent breastfeeding success. EMCS is a risk factor for not practicing EIBF. Therefore, it is important to understand the relationship between EMCS, EIBF, and PPD symptoms. Methods: We conducted a prospective cohort study in three areas of China. At baseline, a total of 965 mothers completed electronic questionnaires within 72 h postpartum. Women were screened for PPD symptoms using the Edinburgh Postpartum Depression Scale (EPDS). Multivariate logistic regression was used to identify the determinants of PPD symptoms. Mediation analysis was used to determine if EIBF mediated the relationship between delivery mode or breastfeeding education source and PPD symptoms. Results: The prevalence of EIBF was 40.6%; 14% of 965 mothers experienced EMCS, and 20.4% had PPD symptoms. The risk factors for developing PPD symptoms were excessive gestational weight gain (adjusted odds ratio [aOR] = 1.55, confidence interval [95% CI]: 1.03–2.33, p = 0.037) and EMCS (aOR = 2.05, 95% CI: 1.30–3.25, p = 0.002). The protective factors for developing PPD symptoms were monthly household income over CNY 10000 (aOR = 0.68, 95% CI: 0.47–0.97, p = 0.034), EIBF (aOR = 0.49, 95% CI: 0.34–0.72, p p = 0.001). EIBF indirectly affected PPD symptoms in patients who had undergone EMCS (percentage mediated [PM] = 16.69, 95% CI: 7.85–25.25, p PM = 17.29, 95% CI: 3.80–30.78, p = 0.012). Conclusion: The association between EMCS on PPD symptoms was mediated by EIBF. By providing breastfeeding education, nurses could also help alleviate PPD symptoms.

Published in Nutrients

ISSN: 2072-6643 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Technology: Home economics: Nutrition. Foods and food supply
Website: https://www.mdpi.com/journal/nutrients

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