Breastfeeding continuation is associated with trait mindfulness but not with trajectories of postpartum depressive symptoms

Lianne P Hulsbosch; Ivan Nyklíček; Myrthe Gbm Boekhorst; Eva S Potharst; Victor Jm Pop

doi:10.1016/j.midw.2023.103770

Breastfeeding continuation is associated with trait mindfulness but not with trajectories of postpartum depressive symptoms

Midwifery. 2023 Sep:124:103770. doi: 10.1016/j.midw.2023.103770. Epub 2023 Jun 30.

Authors

Lianne P Hulsbosch¹, Ivan Nyklíček², Myrthe Gbm Boekhorst², Eva S Potharst³, Victor Jm Pop²

Affiliations

¹ Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands. Electronic address: l.p.hulsbosch@tilburguniversity.edu.
² Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
³ UvA minds, academic outpatient (child and adolescent) treatment center of the University of Amsterdam, Amsterdam, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands.

PMID: 37419008
DOI: 10.1016/j.midw.2023.103770

Abstract

Objective: The WHO recommends breastfeeding for at least six months as breastfeeding has many benefits for both infant and mother. The association of breastfeeding continuation with trait mindfulness during pregnancy and trajectories of postpartum depressive symptoms has not been examined yet. The current study aimed to assess this association using cox regression analysis.

Design, setting and participants: The current research is part of a large longitudinal prospective cohort study following women from 12 weeks of pregnancy onwards in the South-East part of the Netherlands.

Measurements: A total of 698 participants filled out the Three Facet Mindfulness Questionnaire-Short Form (TFMQ-SF) at 22 weeks of pregnancy and completed both the Edinburgh Postnatal Depression Scale (EPDS) and questions on breastfeeding continuation one week, six weeks, four months, and eight months postpartum. Breastfeeding continuation was defined as exclusive breastfeeding or both breastfeeding and formula. The assessment eight months postpartum was used as a proxy for the WHO recommendation to continue breastfeeding for at least six months.

Findings: Two trajectories (classes) of EPDS scores were determined using growth mixture modeling: 1) low stable (N = 631, 90.4%), and 2) increasing (N = 67, 9.6%). Cox regression analysis showed that the trait mindfulness facet non-reacting was significantly and inversely associated with the risk of breastfeeding discontinuation (HR = 0.96, 95% CI [0.94, 0.99], p = .002), while no significant association was found for belonging to the increasing EPDS class versus belonging to the low stable class (p = .735), adjusted for confounders.

Key conclusions: This study is the first to show that higher trait mindfulness non-reacting scores, but not persistently low levels of postpartum depressive symptoms, increase the likelihood of breastfeeding continuation.

Implications for practice: Improving non-reacting in perinatal women by meditation practice as part of a mindfulness-based intervention may lead to better breastfeeding continuation outcomes. Several mindfulness-based programs may be suitable.

Keywords: Breastfeeding continuation; Mindfulness; Non-reacting; Postpartum depression; Trajectories.

MeSH terms

Breast Feeding
Depression
Depression, Postpartum* / diagnosis
Female
Humans
Infant
Mindfulness*
Postpartum Period
Pregnancy
Prospective Studies