1
|
Odabaş RK, Demir R. The relationship between body image, depression, and breastfeeding attitudes in women with 0-24-month-old infants: a cross-sectional study. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2025; 71:e20241372. [PMID: 40172397 PMCID: PMC11964324 DOI: 10.1590/1806-9282.20241372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/11/2024] [Accepted: 11/03/2024] [Indexed: 04/04/2025]
Abstract
OBJECTIVE The aim of this study was to determine the relationship between body image, depression, and breastfeeding attitudes in women who had infants aged 0-24 months. METHODS The study was cross-sectional and correlational in nature, conducted in Turkey between November 2023 and July 2024, with 282 women who had infants aged 0-24 months (n=282). RESULTS Of the women who participated in the study, 46.1% received breastfeeding training during the postpartum period, and 46.2% received breastfeeding training between 7 and 12 months. It was determined that women stopped breastfeeding between months, with the main reason being the perception of insufficient milk (51.2%). The total mean score of the Women's Breastfeeding Attitude Evaluation Scale was found to be 99.53±13.48, the Body Perception Scale was 132.19±28.84, and the Beck Depression Scale was 16.19±10.97. Additionally, if there was a high-level, positive linear relationship between the Breastfeeding Attitude Evaluation Scale and the Body Image Scale total scores (r=0.340, p<0.01), then there was a high-level, negative relationship between the Breastfeeding Attitude Evaluation Scale and the Beck Depression Inventory total score (r=-0.503, p<0.01), and a highly negative relationship was found between the Body Image Scale and the Beck Depression Scale (r=-0.526, p<0.01). CONCLUSION It has been concluded that low body image and depression in women who had infants aged 0-24 months negatively affect breastfeeding attitudes. It is recommended to investigate the factors affecting breastfeeding attitudes in postpartum women and to provide support and training that can positively affect breastfeeding attitudes.
Collapse
Affiliation(s)
- Resmiye Kaya Odabaş
- Kocaeli University, Faculty of Health Sciences, Department of Midwifery – Kocaeli, Turkey
| | - Rukiye Demir
- Çanakkale Onsekiz Mart University, Faculty of Health Sciences, Department of Midwifery – Çanakkale, Turkey
| |
Collapse
|
2
|
Kalli A, Iliadou M, Palaska E, Louverdi S, Dagla C, Orovou E, Dagla M. Mothers' Body Appreciation and Postpartum Self-Esteem in Relation to Body Changes and Breastfeeding Difficulties: A Cross-Sectional Survey in Cyprus. NURSING REPORTS 2025; 15:76. [PMID: 40137649 PMCID: PMC11944591 DOI: 10.3390/nursrep15030076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Revised: 02/16/2025] [Accepted: 02/21/2025] [Indexed: 03/29/2025] Open
Abstract
Objectives: This study explores the effect of pregnancy weight gain, acceptance of body changes, and breastfeeding difficulties on mothers' self-esteem and body appreciation during the postpartum period. Methods: A cross-sectional survey was conducted among 100 puerperae (at 2nd day postpartum), during August 2022-March 2023 in Paralimni/Cyprus, with exclusion criteria being the presence of postpartum depression. The Body Appreciation Scale-BAS-was administrated in order to investigate the level of body appreciation, and the Rosenberg Self-Esteem Scale-RSES-10-was used for assessing self-esteem. Results: Findings indicated that the higher the pregnancy weight gain (r = -0.293), the lower the measured levels of the mothers' self-esteem and body appreciation are (r = -0.292). Mothers whose level of acceptance of body changes was low to moderate appeared to demonstrate lower self-esteem (p = 0.027) and lower body appreciation (p < 0.001) at two days postpartum. Also, mothers who had breastfeeding difficulties at two days postpartum seem to demonstrate lower self-esteem (p = 0.032), and increased support from their husbands in terms of breastfeeding is associated with higher levels of mothers' self-esteem (r = 0.235). Additionally, greater support for breastfeeding, both in the clinic (r = 0.314) and from their husbands (r = 0.290), appears to be linked to higher levels of body appreciation. The psychological influence of pregnancy weight gain (β = -0.236, p = 0.04) and breastfeeding difficulties (β = -0.284, p = 0.008) appeared to be predictors of mothers' self-esteem at two days postpartum. Conclusions: The findings highlight the need for further research in areas including mothers' body image and self-esteem and breastfeeding difficulties and further longitudinal studies to determine the exact nature of the pathways involved.
Collapse
Affiliation(s)
- Anastasia Kalli
- Laboratory of Midwifery Care During Antenatal and Post Natal Period—Breastfeeding, Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (A.K.); (M.I.); (E.P.); (S.L.); (C.D.)
| | - Maria Iliadou
- Laboratory of Midwifery Care During Antenatal and Post Natal Period—Breastfeeding, Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (A.K.); (M.I.); (E.P.); (S.L.); (C.D.)
| | - Ermioni Palaska
- Laboratory of Midwifery Care During Antenatal and Post Natal Period—Breastfeeding, Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (A.K.); (M.I.); (E.P.); (S.L.); (C.D.)
| | - Sevasti Louverdi
- Laboratory of Midwifery Care During Antenatal and Post Natal Period—Breastfeeding, Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (A.K.); (M.I.); (E.P.); (S.L.); (C.D.)
| | - Calliope Dagla
- Laboratory of Midwifery Care During Antenatal and Post Natal Period—Breastfeeding, Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (A.K.); (M.I.); (E.P.); (S.L.); (C.D.)
| | - Eirini Orovou
- Department of Midwifery, School of Health and Care Sciences, University of Western Macedonia, 54636 Kozani, Greece;
| | - Maria Dagla
- Laboratory of Midwifery Care During Antenatal and Post Natal Period—Breastfeeding, Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (A.K.); (M.I.); (E.P.); (S.L.); (C.D.)
| |
Collapse
|
3
|
Bülbül H, Menekşe D. Breastfeeding self-efficacy in mothers: The body image and emotional intelligence perspective. Midwifery 2024; 139:104199. [PMID: 39342906 DOI: 10.1016/j.midw.2024.104199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 09/23/2024] [Accepted: 09/25/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Breastfeeding is a dynamic and complex process. Due to its complex nature, many reasons affect one another. Recent studies have focused on breastfeeding rates and factors that affect the early termination of breastfeeding. However, studies evaluating the relationship of body image and emotional intelligence concepts with breastfeeding self-efficacy have remained limited to date, resulting in a significant gap in the literature. AIM The present study was carried out to determine the relationship between breastfeeding self-efficacy, body image, and emotional intelligence of postpartum mothers. METHODS The descriptive and cross-sectional study was conducted with 400 mothers. The data were collected using the Descriptive Information Form, the Body Image Scale (BIS), Schutte Emotional Intelligence Scale (SEIS), and the Breastfeeding Self-Efficacy Scale (BSES). The data were evaluated with the SPSS program, using percentages, mean values, independent t-test,One-Way ANOVA, and Pearson's correlation and regression. RESULTS The mothers' mean age was 29.99±5.46 years. The mean total scores that mothers obtained from the scales were found to be 123.47±23.45 for the BIS, 144.46±13.11 for the SEIS, 51.81±9.46 for the BSES-SF. In the correlation analysis results, there was no correlation between the BSES-SF and SEIS. A statistically significant positive correlation was determined between the BIS and BSES-SF. Considering the regression analysis, it is seen that 7.4% of the change in mothers' breastfeeding self-efficacy is explained by body image (R^2 = 0.074) CONCLUSION: The study found that positive body image increases breastfeeding self-efficacy. There is a need for additional longitudinal research examining the body image and emotional intelligence perspective of breastfeeding self-efficacy.
Collapse
Affiliation(s)
- Hilal Bülbül
- Department of Pediatric Nursing, Institute of Health Sciences, Sakarya University, Sakarya, Türkiye; Gölcük Necati Çelik Public Hospital, Intensive Care Clinic, Kocaeli, Türkiye
| | - Dilek Menekşe
- Department of Pediatric Nursing, Faculty of Health Sciences, Sakarya University, Esentepe Campüs, Kemalpaşa Neighborhood, Üniversite Street, Sakarya 54187, Türkiye.
| |
Collapse
|
4
|
Değer MS, Sezerol MA, Altaş ZM. Breastfeeding Self-Efficacy, Personal Well-Being and Related Factors in Pregnant Women Living in a District of Istanbul. Nutrients 2023; 15:4541. [PMID: 37960194 PMCID: PMC10648377 DOI: 10.3390/nu15214541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
In this study, we examined breastfeeding self-efficacy levels, well-being and sociodemographic factors in pregnant women. The population of this descriptive study consisted of women with a pregnancy of 27 weeks or more in the Sultanbeyli district of Istanbul, Türkiye. A questionnaire was administered via telephone calls to pregnant women aged 18 years and older. The first part of the questionnaire included questions regarding breastfeeding history and sociodemographic information. The second part included the Prenatal Breastfeeding Self-Efficacy Scale, and the last part included the Personal Well-Being Scale. Higher scale scores indicate higher levels of self-efficacy and well-being. In total, 385 women participated in the study. The median age of the pregnant women was 28.0 years (18.0-43.0). The median gestational week was 33.0 (27.0-42.0). Among women who had received breastfeeding counseling, those with a higher level of knowledge about breastfeeding had higher breastfeeding self-efficacy (p < 0.05). Women with better economic status also had higher well-being scores (p < 0.05). There was a positive correlation between well-being and breastfeeding self-efficacy approaching the statistical significance level (p = 0.052). It is important to consider factors that may be associated with women's well-being and self-efficacy.
Collapse
Affiliation(s)
- Mehmet Sait Değer
- Department of Public Health, School of Medicine, Hitit University, Çorum 19040, Türkiye;
| | - Mehmet Akif Sezerol
- Epidemiology Program, Institute of Health Sciences, Istanbul Medipol University, Istanbul 34820, Türkiye;
- Department of Public Health, School of Medicine, Istanbul Medipol University, Istanbul 34820, Türkiye
- Sultanbeyli District Health Directorate, Istanbul 34935, Türkiye
| | | |
Collapse
|
5
|
Tarchi L, Merola GP, Selvi G, Caprara E, Pecoraro V, Cassioli E, Rossi E, Petraglia F, Ricca V, Castellini G. Pregorexia: a systematic review and meta-analysis on the constructs of body image dissatisfaction and eating disturbances by gestational age in the peripartum. Eat Weight Disord 2023; 28:64. [PMID: 37526698 PMCID: PMC10393903 DOI: 10.1007/s40519-023-01595-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE Pregorexia is a phenomenon posited to occur in the peripartum, characterized by an attempt to counter pregnancy's physiological changes in body shape through reduced calorie intake or increased physical activity. METHODS In this pre-registered systematic review and meta-analysis, body image dissatisfaction and eating psychopathology in the peripartum according to gestational age were formally assessed. PubMed was searched up to May 2023. Selection criteria were represented by studies on body image concerns or eating psychopathology in the peripartum (up to 1 year after delivery). The population needed to include women from the general population or among patients with a history of (or current) eating disorder. For the meta-analysis, 17 studies were included: 10 for body image dissatisfaction (2625 individuals overall), 7 for eating behaviors (2551 individuals overall). The interplay between body image and the following themes was examined in depth: the adoption of breastfeeding, peripartum depression, sociocultural influences on body image, sexual disturbances, experiencing or reporting an altered food intake. RESULTS Progressive dissatisfaction with body image during pregnancy by gestational age was observed, stably elevated for at least 12 months postpartum. Eating psychopathology was observed as elevated only at 12 months in the postpartum, but not during pregnancy. DISCUSSION The current work offers normative values of body image satisfaction and eating psychopathology in the peripartum by gestational age. The relevance of current results was discussed, in order to inform both current clinical practice and future public policies. LEVEL OF EVIDENCE Level I-Evidence obtained from: systematic reviews and meta-analyses.
Collapse
Affiliation(s)
- Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giuseppe Pierpaolo Merola
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giulia Selvi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Eleonora Caprara
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Vincenzo Pecoraro
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Felice Petraglia
- Obstetrics and Gynecology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Careggi, Viale Della Maternità, Padiglione 8B, 50121, Florence, FI, Italy.
| |
Collapse
|
6
|
Gyamfi A, Jefferson UT, O'Neill B, Lucas R, Spatz DL, Henderson WA. Disparities in 6 Month Exclusive Breastfeeding in Ghana, Africa: A Scoping Review. J Hum Lact 2023; 39:456-467. [PMID: 36305494 DOI: 10.1177/08903344221130988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Exclusive breastfeeding practice for 6 months is a critical global public health goal. In 2020, only 44% of infants globally, 31% in Central and West Africa, and 43% in Ghana, were exclusively breastfed for the first 6 months of life. RESEARCH AIM To critically evaluate disparities in exclusive breastfeeding practice for 6 months in Ghana. METHODS The scoping review was guided by Arksey and O'Malley's (2005) six-stage scoping review process. The online databases of American Psychological Association PsychInfo (APA PsychInfo), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Scopus were searched with keywords inclusive of Ghana, exclusive breastfeeding, breastfeeding, infant feeding, lactation, lactating, and exclusive. Eligibility criteria included full-text, peer-reviewed research articles written in the English language without limitation to specific years. Data were analyzed thematically. RESULTS Initially, 317 records were identified, and 15 full-text articles were eligible for the scoping review. Four main themes emerged as disparities in exclusive breastfeeding practice in Ghana. The themes were healthcare (prenatal clinic visits, delivery place, exclusive breastfeeding knowledge), personal (maternal age, Human Immunodeficiency Virus status, parity, type of delivery, breast problem), employment (unemployed, formal, or informal sector worker), and sociocultural (ethnicity/region, family support, religious beliefs, cultural practices). CONCLUSION Disparities in exclusive breastfeeding in Ghana warrant the collaborative efforts of stakeholders for successful mitigation. Future researchers should explore the role of religion and sociocultural practices to protect, promote, and support 6 months of exclusive breastfeeding in Ghana.
Collapse
Affiliation(s)
- Adwoa Gyamfi
- St Michael's Midwifery Training School, Ashanti Region, Ghana
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | | | - Barbara O'Neill
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Ruth Lucas
- School of Nursing, University of Connecticut, Storrs, CT, USA
- School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Diane Lynn Spatz
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Wendy A Henderson
- School of Nursing, University of Connecticut, Storrs, CT, USA
- School of Medicine, University of Connecticut, Farmington, CT, USA
| |
Collapse
|
7
|
Crawford KA, Gallagher LG, Baker ER, Karagas MR, Romano ME. Predictors of Breastfeeding Duration in the New Hampshire Birth Cohort Study. Matern Child Health J 2023; 27:1434-1443. [PMID: 37269393 DOI: 10.1007/s10995-023-03714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Breastfeeding has significant health benefits for infants and birthing persons, including reduced risk of chronic disease. The American Academy of Pediatrics recommends exclusively breastfeeding infants for 6 months and recently extended its recommendation for continuing to breastfeed with supplementation of solid foods from one to two years. Studies consistently identify lower breastfeeding rates among US infants, with regional and demographic variability. We examined breastfeeding in birthing person-infant pairs among healthy, term pregnancies enrolled in the New Hampshire Birth Cohort Study between 2010 and 2017 (n = 1176). METHODS Birthing persons 18-45 years old were enrolled during prenatal care visits at ~ 24-28 weeks gestation and have been followed since enrollment. Breastfeeding status was obtained from postpartum questionnaires. Birthing person and infant health and sociodemographic information was abstracted from medical records and prenatal and postpartum questionnaires. We evaluated the effects of birthing person age, education, relationship status, pre-pregnancy body mass index, gestational weight gain (GWG), smoking and parity, and infant sex, ponderal index, gestational age and delivery mode on breastfeeding initiation and duration using modified Poisson and multivariable linear regression. RESULTS Among healthy, term pregnancies, 96% of infants were breastfed at least once. Only 29% and 28% were exclusively breastfed at 6-months or received any breastmilk at 12-months, respectively. Higher birthing person age, education, and parity, being married, excessive GWG, and older gestational age at delivery were associated with better breastfeeding outcomes. Smoking, obesity, and cesarean delivery were negatively associated with breastfeeding outcomes. CONCLUSIONS Given the public health importance of breastfeeding for infants and birthing persons, interventions are needed to support birthing persons to extend their breastfeeding duration.
Collapse
Affiliation(s)
- Kathryn A Crawford
- Environmental Studies Program, Middlebury College, 276 Bicentennial Way, Middlebury, VT, 05753, USA.
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
| | - Lisa G Gallagher
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Emily R Baker
- Maternal Fetal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Megan E Romano
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| |
Collapse
|
8
|
Elbeltagi R, Al-Beltagi M, Saeed NK, Bediwy AS. Cardiometabolic effects of breastfeeding on infants of diabetic mothers. World J Diabetes 2023; 14:617-631. [PMID: 37273257 PMCID: PMC10236993 DOI: 10.4239/wjd.v14.i5.617] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/01/2023] [Accepted: 04/07/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Breast milk is the best and principal nutritional source for neonates and infants. It may protect infants against many metabolic diseases, predominantly obesity and type 2 diabetes. Diabetes mellitus (DM) is a chronic metabolic and microvascular disease that affects all the body systems and all ages from intrauterine life to late adulthood. Breastfeeding protects against infant mortality and diseases, such as necrotizing enterocolitis, diarrhoea, respiratory infections, viral and bacterial infection, eczema, allergic rhinitis, asthma, food allergies, malocclusion, dental caries, Crohn's disease, and ulcerative colitis. It also protects against obesity and insulin resistance and increases intelligence and mental development. Gestational diabetes has short and long-term impacts on infants of diabetic mothers (IDM). Breast milk composition changes in mothers with gestational diabetes. AIM To investigate the beneficial or detrimental effects of breastfeeding on the cardiometabolic health of IDM and their mothers. METHODS We performed a database search on different engines and a thorough literature review and included 121 research published in English between January 2000 and December 15, 2022, in this review. RESULTS Most of the literature agreed on the beneficial effects of breast milk for both the mother and the infant in the short and long terms. Breastfeeding protects mothers with gestational diabetes against obesity and type 2 DM. Despite some evidence of the protective effects of breastfeeding on IDM in the short and long term, the evidence is not strong enough due to the presence of many confounding factors and a lack of sufficient studies. CONCLUSION We need more comprehensive research to prove these effects. Despite many obstacles that may enface mothers with gestational diabetes to start and maintain breastfeeding, every effort should be made to encourage them to breastfeed.
Collapse
Affiliation(s)
- Reem Elbeltagi
- Department of Medicine, Irish Royal College of Surgeon, Busaiteen 15503, Bahrain
| | - Mohammed Al-Beltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Egypt
- Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Nermin Kamal Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Ministry of Health, Kingdom of Bahrain, Manama 12, Bahrain
- Department of Microbiology, Irish Royal College of Surgeon, Bahrain, Busaiteen 15503, Bahrain
| | - Adel Salah Bediwy
- Department of Chest Diseases, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| |
Collapse
|
9
|
Swami V, Todd J, Tylka TL. Measuring positive breast experience: Development and psychometric evaluation of the Breast Appreciation Scale (BrAS). Body Image 2022; 43:275-291. [PMID: 36206650 DOI: 10.1016/j.bodyim.2022.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/08/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022]
Abstract
Existing measures of women's breasted experiences have focused on negative experiences, which de-centres women's meaning-making and relationships with their breasts. To rectify this, we developed a novel measure of women's positive breasted experiences, the Breast Appreciation Scale (BrAS), and examined the psychometric properties of this novel measure across four studies. Study 1, with 307 United Kingdom women, led to the extraction of a 9-item, unidimensional model of BrAS scores that showed adequate composite reliability and 4-week test-retest reliability. Study 2, with 297 United Kingdom women, showed that the unidimensional model of BrAS scores had adequate fit and evidenced convergent, concurrent, discriminant, and incremental validity. Study 3, with 295 women from the United Kingdom, provided additional support for factorial validity and concurrent validity, and additionally provided evidence of known-groups validity insofar as mothers had greater breast appreciation than non-mothers. Study 4 showed that the BrAS was scalar invariant across women from Australia, the United Kingdom, and the United States (N = 573) and provided additional evidence of concurrent validity. Based on these results, we conclude that the BrAS is a psychometrically valid measure of women's positive breasted experiences that can be utilised in future research.
Collapse
Affiliation(s)
- Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia.
| | - Jennifer Todd
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
| | - Tracy L Tylka
- Department of Psychology, The Ohio State University, Columbus, OH, United States
| |
Collapse
|
10
|
Mantzorou M, Papandreou D, Vasios GK, Pavlidou E, Antasouras G, Psara E, Taha Z, Poulios E, Giaginis C. Exclusive Breastfeeding for at Least Four Months Is Associated with a Lower Prevalence of Overweight and Obesity in Mothers and Their Children after 2-5 Years from Delivery. Nutrients 2022; 14:nu14173599. [PMID: 36079855 PMCID: PMC9459704 DOI: 10.3390/nu14173599] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 12/16/2022] Open
Abstract
Introduction: Obesity is a current public health concern. Higher body weight is influenced by genetic and environmental parameters, and their interplay and is associated with a greater risk for several chronic diseases. Breastfeeding has been suggested as a preventive measure against obesity, which can further reduce long-term negative health outcomes for both women and children. Aim: The aim of the present study was to evaluate the role of breastfeeding on maternal and childhood overweight and obesity. Materials and Methods: This is a cross-sectional study conducted on 2515 healthy mothers and their children, aged 2−5 years, enrolled from nine different Greek rural and urban regions. Validated, standardized questionnaires were administrated that included anthropometric indices, socio-demographic characteristics of mothers and children, as well as breastfeeding practices. Results: Overall, 68% of participated women exclusively breastfed their children for at least 4 months. Mothers that exclusively breastfed showed a significantly lower prevalence of overweight and obesity after 2−5 years from delivery (p < 0.0001). Children that had exclusively been breastfed showed a significantly lower prevalence of overweight and obesity at the age of 2−5 years (p < 0.0001). Using multivariate regression analysis, exclusive breastfeeding for at least 4 months was associated with a two-fold lower risk for maternal and childhood overweight and obesity after 2−5 years from delivery, independent from maternal age, educational and economic status, and smoking habits (p < 0.0001). Conclusion: Exclusive breastfeeding for at least 4 months had a positive effect on childhood overweight and obesity, also contributing beneficially to post-natal maternal weight control. The beneficial effects of breastfeeding should be communicated to future and new mothers, while supportive actions for all mothers to initiate and continue breastfeeding their offspring should be implemented.
Collapse
Affiliation(s)
- Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Dimitrios Papandreou
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
- Correspondence:
| | - Georgios K. Vasios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Zainab Taha
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
| | - Efthymios Poulios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| |
Collapse
|
11
|
Yuen M, Hall OJ, Masters GA, Nephew BC, Carr C, Leung K, Griffen A, McIntyre L, Byatt N, Moore Simas TA. The Effects of Breastfeeding on Maternal Mental Health: A Systematic Review. J Womens Health (Larchmt) 2022; 31:787-807. [PMID: 35442804 DOI: 10.1089/jwh.2021.0504] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Breastfeeding has many positive effects on the health of infants and mothers, however, the effect of breastfeeding on maternal mental health is largely unknown. The goal of this systematic review was to (1) synthesize the existing literature on the effects of breastfeeding on maternal mental health, and (2) inform breastfeeding recommendations. Materials and Methods: A literature search was conducted in electronic databases using search terms related to breastfeeding (e.g., breastfeeding, infant feeding practices) and mental health conditions (e.g., mental illness, anxiety, depression), resulting in 1,110 records. After reviewing article titles and abstracts, 339 articles were advanced to full-text review. Fifty-five articles were included in the final analysis. Results: Thirty-six studies reported significant relationships between breastfeeding and maternal mental health outcomes, namely symptoms of postpartum depression and anxiety: 29 found that breastfeeding is associated with fewer mental health symptoms, one found it was associated with more, and six reported a mixed association between breastfeeding and mental health. Five studies found that breastfeeding challenges were associated with a higher risk of negative mental health symptoms. Conclusions: Overall, breastfeeding was associated with improved maternal mental health outcomes. However, with challenges or a discordance between breastfeeding expectations and actual experience, breastfeeding was associated with negative mental health outcomes. Breastfeeding recommendations should be individualized to take this into account. Further research, specifically examining the breastfeeding experiences of women who experienced mental health conditions, is warranted to help clinicians better personalize breastfeeding and mental health counseling.
Collapse
Affiliation(s)
- Megan Yuen
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Olivia J Hall
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Grace A Masters
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | - Catherine Carr
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine Leung
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Adrienne Griffen
- Maternal Mental Health Leadership Alliance, Arlington, Virginia, USA
| | | | - Nancy Byatt
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.,UMass Memorial Health, Worcester, Massachusetts, USA
| | - Tiffany A Moore Simas
- T.H. Chan School of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.,UMass Memorial Health, Worcester, Massachusetts, USA
| |
Collapse
|
12
|
Rodgers RF, Fischer LE, Zimmerman E. Partner influences, breastfeeding, and body image and eating concerns: An expanded biopsychosocial model. Appetite 2021; 169:105833. [PMID: 34863795 DOI: 10.1016/j.appet.2021.105833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent research among postpartum women has considered body image and eating attitudes as well as exclusive breastfeeding within common theoretical models. However, these efforts have so far neglected to include partner-related constructs, which constitutes an important gap. Thus, the aim of this study was to examine an integrated model of body image and eating concerns, and exclusive breastfeeding among mothers of infants six months and younger, that included partner appearance influences as well as general postpartum support. METHODS A sample of new mothers (N = 156), aged 20-47 years, mean = 32.7 (SD = 4.7) years, reported on postpartum partner support and appearance pressures, thin-ideal internalization and body dissatisfaction, symptoms of disordered eating, depression, breastfeeding self-efficacy and exclusive breastfeeding. Path analyses were conducted to test the hypothetical model. RESULTS Findings revealed that the final model was a good fit to these data. Postpartum partner support was associated with lower depression and higher breastfeeding self-efficacy, through which it was related to higher reports of exclusive breastfeeding and lower eating disorder symptoms. In addition, partner appearance pressures and thin-ideal internalization were associated with higher body dissatisfaction, and thin-ideal internalization was also related to lower breastfeeding self-efficacy. CONCLUSIONS Partner influences may be important to account for in models of body image and eating concerns among postpartum women, and exclusive breastfeeding, and further research on ways in which they can support mothers of young infants is warranted.
Collapse
Affiliation(s)
- Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, France.
| | - Laura E Fischer
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, USA
| | - Emily Zimmerman
- Speech & Neurodevelopment Lab, Department of Communication Sciences and Disorders, Northeastern University, Boston, USA
| |
Collapse
|
13
|
Acheampong AK, Abukari AS. Nurses' and midwives' perspectives on how the pursuit for the 'perfect' body image affects their own breastfeeding practices: a qualitative study in Ghana. Int Breastfeed J 2021; 16:74. [PMID: 34565392 PMCID: PMC8474936 DOI: 10.1186/s13006-021-00421-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022] Open
Abstract
Background Body image concerns have been widely documented in the literature as one reason why most women shorten the breastfeeding duration of their infants. Negative body image concerns among breastfeeding mothers may lead to depressive symptoms. There is a paucity of literature on how body image affects the breastfeeding practices of nurses and midwives. Therefore, this study explored the perspectives of breastfeeding nurses and midwives on how their body image affected their breastfeeding practices. Methods A qualitative design was used in this study. Five focus group discussions were conducted with each group having five members. The study was conducted in the Greater Accra Region of Ghana between November and December of 2020. Participants were recruited into the study using a purposive sampling method. Focus group sessions were audiotaped and transcribed verbatim. Data were analyzed using a content analysis. Results Three main themes emerged from the data analysis: body image concerns and breastfeeding, sociocultural pressures and breastfeeding and coping strategies. Participants had concerns regarding weight gain due to the need to eat adequately while breastfeeding. Body image concerns included increase in abdominal size, sagging breasts and generalized weight gain. These concerns and pressures negatively affected the breastfeeding practices of participants. Body image concerns reflected sociocultural pressures such as negative comments from loved ones and in the social media. The coping strategies adopted by the mothers were self-motivation and the love they had for their children. Conclusions The perspectives of breastfeeding nurses and midwives on the ways their body image affected their breastfeeding practices identified the need for support in order to successfully breastfeed.
Collapse
|
14
|
Gyamfi A, O'Neill B, Henderson WA, Lucas R. Black/African American Breastfeeding Experience: Cultural, Sociological, and Health Dimensions Through an Equity Lens. Breastfeed Med 2021; 16:103-111. [PMID: 33591226 PMCID: PMC7891224 DOI: 10.1089/bfm.2020.0312] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Disparities in breastfeeding (BF) continue to be a public health challenge, as currently only 42% of infants in the world and 25.6% of infants in the United States are exclusively breastfed for the first 6 months of life. In 2019, the infants least likely to be exclusively breastfed at 6 months are African Americans (AA) (17.2%). Materials and Methods: A scoping review of the literature was undertaken by using Arksey and O'Malley's six-stage framework to determine key themes of AA women's experience BF through an equity lens. Electronic databases of CINAHL and PubMed were searched for peer-reviewed, full-text articles written in the English language within the past 5 years by using the terms BF, AA, Black, sociological, cultural, equity, health, attitude, exposure, initiation, continuation, barriers, and facilitators. Results: Initially, 497 articles were identified, and 26 peer-reviewed articles met the eligibility criteria. Through an equity lens, three main themes emerged, which summarized AA women's BF experience: cultural (family, peers and community support; misconceptions; personal factors), sociological (prejudices, racism, home environment; financial status; sexuality issues; BF role models; employment policies), and health dimensions (family involvement; timely and honest information from staff; baby-friendly hospital initiatives; postnatal follow-up; special supplemental nutrition program for women, infants, and children). Conclusion: For AA women, exclusively BF is beset with diverse cultural, health, and sociological challenges. Multifaceted approaches are needed for successful resolution of BF challenges to bridge the racial gap in BF in the United States. Future studies may explore interventions targeted to modifiable barriers to improve BF outcomes.
Collapse
Affiliation(s)
- Adwoa Gyamfi
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
| | - Barbara O'Neill
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
| | - Wendy A Henderson
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
| | - Ruth Lucas
- School of Nursing, University of Connecticut, Storrs, Connecticut, USA
| |
Collapse
|
15
|
|
16
|
Amugsi DA, Dimbuene ZT, Kyobutungi C. Correlates of the double burden of malnutrition among women: an analysis of cross sectional survey data from sub-Saharan Africa. BMJ Open 2019; 9:e029545. [PMID: 31272983 PMCID: PMC6615784 DOI: 10.1136/bmjopen-2019-029545] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries. DESIGN Secondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50-24.99 kg/m2), overweight (25.0-29.9 kg/m2) and obesity (≥30.0 kg/m2). SETTINGS Ghana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC). SUBJECTS Women aged 15-49 years (n=64698). RESULTS Compared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight. CONCLUSIONS Our analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.
Collapse
Affiliation(s)
- Dickson Abanimi Amugsi
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Zacharie Tsala Dimbuene
- Population Sciences and Development, University of Kinshasa, Kinshasa, The Democratic Republic of the Congo
- Social Analysis and Modeling Division, Statistics Canada, Ottawa, Canada
| | - Catherine Kyobutungi
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| |
Collapse
|
17
|
Predictors of Exclusive Breastfeeding Among Health Care Workers in Urban Kano, Nigeria. J Obstet Gynecol Neonatal Nurs 2019; 48:433-444. [DOI: 10.1016/j.jogn.2019.04.285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2019] [Indexed: 11/19/2022] Open
|
18
|
Rodgers RF, O'Flynn JL, Bourdeau A, Zimmerman E. A biopsychosocial model of body image, disordered eating, and breastfeeding among postpartum women. Appetite 2018; 126:163-168. [DOI: 10.1016/j.appet.2018.04.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/02/2018] [Accepted: 04/08/2018] [Indexed: 12/20/2022]
|