Maternal satisfaction with breastfeeding in the first month postpartum and associated factors

Abstract

Background: Breastfeeding success has been measured based on its duration, disregarding satisfaction with the maternal experience. Studies to investigate maternal satisfaction with breastfeeding are rare, especially in Brazil, and little is known about their determinants. The aim of this study was to measure the level of satisfaction with breastfeeding in a group of women in the first month of their child's life, and to identify factors associated with higher maternal satisfaction. Methods: A cross-sectional study nested within a cohort was conducted with 287 women recruited at two (one public, one private) maternity services in the city of Porto Alegre, southern Brazil, from January to July 2016. Women residing in the municipality who had given birth to a healthy singleton born at term, were rooming in, and had initiated breastfeeding were randomly included. During the week after the child was 30 days old, women were interviewed at their homes to measure the level of maternal satisfaction with breastfeeding, using the Maternal Breastfeeding Evaluation Scale (MBFES), validated for use in the Brazilian population. Associations between maternal satisfaction and explanatory variables were estimated using multivariate Poisson regression with robust variance in a four-level hierarchical approach. Satisfaction level was categorized using as cutoff point the median score obtained with the MBFES. Women with scores equal to or above the median were considered to have higher levels of satisfaction, whereas those scoring below the median were considered to be less satisfied. Results: Maternal satisfaction with breastfeeding in the first month postpartum was high, with a median score of 124 on MBFES, close to the maximum score (145 points). The prevalence of more elevated levels of satisfaction with breastfeeding was higher among women with brown (pardo) and black skin color (prevalence ratio [PR] 1.33, 95%CI 1.05;1.69), those who lived with the partner (PR 1.75, 95%CI 1.05;2.94), who planned to breastfeed for 12 months or more (PR 1.48, 95%CI 1.02;2.17), and who did not report low milk supply (PR 1.47, 95%CI 1.03;2.10) or cracked nipples (PR 1.29, 95%CI 1.01;1.65). Conclusions: The factors associated with maternal satisfaction with breastfeeding in the first month postpartum include individual factors and maternal expectations, family constitution, as well as breastfeeding-related problems.

Family Socioecological Correlates of Lifestyle Patterns in Early Childhood: A Cross-Sectional Study from the EDEN Mother–Child Cohort

“…First, for a given lifestyle pattern and the sake of parsimony, we selected contextual factors associated with p < 0.20 from the univariable analyses [25]. Hierarchical linear regression analyses were then conducted to examine the associations between contextual factors (independent variables) and lifestyle patterns (outcome variables), within the conceptual framework defined above (Figure 1) [22].…”

“…Variables were added per block from the most distal to the most proximal. In the multivariable analyses, each variable of a given block was interpreted within the first model in which it was included (i.e., model 1 for Block 1 variables; model 2 for Block 2 variables; model 3 for Block 3 variables), regardless of its performance in the subsequent model(s) [22,25,26]. This hierarchical approach was intended to ensure that intermediate variables did not affect the association of the distal factors with the outcome (i.e., lifestyle pattern) under study.…”

Development of an instrument to measure mistreatment of women during childbirth through item response theory

“…All women living in Porto Alegre who gave birth to full-term newborns in the two participating maternity hospitals without unfavorable outcomes at delivery (death or admission to intensive care) and with no formal contraindication for breastfeeding were considered eligible. These eligibility criteria were defined in order to avoid biases in the measure of the main outcomes of interest (satisfaction with childbirth and breastfeeding prevalence) in the research that originated this study [ 18 , 22 ]. Women living in areas considered dangerous for home visits had to be excluded to preserve the safety of the research team.…”

Association between mistreatment of women during childbirth and symptoms suggestive of postpartum depression

“…All women living in Porto Alegre who gave birth to full-term newborns in the two participating maternity hospitals were eligible. Women or newborns with unfavorable outcomes at delivery (death or admission to intensive care) or who presented formal contraindication for breastfeeding were excluded from the study, to avoid biases in the measurement of women's perception of mistreatment during childbirth, postpartum depression, and other outcomes of interest in the research that originated this study, such as breastfeeding [29,30]. Women living in areas at risk for home visits were also excluded to preserve the safety of the research team.…”