Severe maternal morbidity and breastfeeding outcomes in the early post‐natal period: a prospective cohort study from one English maternity unit

Abstract

Previous research has identified potential issues of establishing and maintaining breastfeeding among women who experience severe maternal morbidity associated with pregnancy and birth, but evidence in the UK maternity population was scarce. We explored the association between severe maternal morbidity and breastfeeding outcomes (uptake and prevalence of partial and exclusive breastfeeding) at 6 to 8 weeks post-partum in a UK sample. Data on breastfeeding outcomes were obtained from a large cohort study of women who gave birth in one maternity unit in England to assess the impact of women's experiences of severe maternal morbidity (defined as major obstetric haemorrhage, severe hypertensive disorder or high dependency unit/intensive care unit admission) on their post-natal health and other important outcomes including infant feeding. Results indicated that among women who responded (n = 1824, response rate = 53%), there were no statistically significant differences in breastfeeding outcomes between women who did or did not experience severe morbidity, except for women with severe hypertensive disorder who were less likely to breastfeed either partially or exclusively at 6 to 8 weeks post-partum. Rather, breastfeeding outcomes were related to multi-dimensional factors including sociodemographic (age, ethnicity, living arrangement), other pregnancy outcomes (neonatal intensive care unit admission, mode of birth, women's perceived control during birth) and post-natal psychological factors (depressive symptoms). Women who experience severe maternal morbidity can be reassured that establishing successful breastfeeding can be achieved. More studies are required to understand what support is best for women who have complex health/social needs to establish breastfeeding.

Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners

“…Consequently, the duration of time that mother's breastfed exclusively in this study was significantly lower than the recommendation of 6 months by WHO. The reasons for this might be multifactorial [10,11,27,33]. Certain changes in Sweden in recent decades may have affected mothers who want to breastfeed and contributed to less incidences of breastfeeding.…”

Factors affecting exclusive breastfeeding in the first month of life among Amazonian children

“…In this study, the percentage of studied children exclusively breastfed at 30 days of age (36.7%) was far from compliant with the WHO recommendation of EBF in the first six months of life [13]. In addition, this number is much lower than what was previously reported from prospective studies conducted in high-income countries including England (52.1%) [35], Spain (76.2%) [36], Italy (61.2%) [37] and Greece (43.5%) [38]. Such differences might be explained by the fact that wealthier mothers generally have higher educational level.…”

The needs of women who have experienced “maternal near miss“: A systematic review of literature

“…[39] An example is mothers who have social needs to establish breastfeeding. [40] There is critical need to provide support to survivors to enable them cope with social, physical, psychological, and economic consequences. [41] The implementation of integrated care which involves psychological, spiritual, physical, and social supports of women's health may help diminish the burden that maternal morbidity impose on women around the world.…”

“…[49] There should be a transparent pathway for access to counselling services for near-miss mothers. [12] These counseling services should be provided for successful breastfeeding,[40] sexual problems, and marital problems. [50] Investigation of long-term repercussions of MNM on women's sexual life aspects has been scarcely performed, indicating that worse consequences for those experiencing morbidity are beyond depressive symptoms and postpone sexual activity.…”