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The Importance of Personal and Familial Factors on Breastfeeding Intention and Practices, and Postpartum Distress during the Pandemic: A Longitudinal Observational Study

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Abstract

Background

The COVID-19 pandemic has significantly impacted pregnant and breastfeeding women. Both low- and high-risk groups adopted preventive approaches such as mask-wearing and handwashing to slow down and prevent viral transmission during critical periods that may affect mother-child interactions.

Methods

A longitudinal observational study was conducted with primiparous women recruited using convenience sampling from the postpartum care ward of Afzalipour Teaching Hospital in Kerman from August 1, 2020 to March 30, 2021. The research questionnaires included demographic information, preventive behaviors, breastfeeding intention and practices, postpartum distress, and Edinburgh Postpartum Depression Scale. All the questionnaires were self-reported online in three stages: before discharge from the postpartum ward, the first month after delivery, and the third month after delivery.

Results

A Total of 160 primiparous women were included. The results showed significant changes in preventive behaviors and postpartum distress levels during the study. Breastfeeding intention and practices were negatively affected by postpartum distress (P = 0.034), unwanted pregnancies (P = 0.009), and cesarean delivery (P < 0.001). Postpartum distress was directly affected by the presence of depression (P < 0.001). Preventive behaviors at discharge were significantly associated with postpartum distress three months after delivery (P = 0.013). The study also found an association between women’s and partner’s education, unwanted pregnancy, and cesarean delivery that determined postpartum distress.

Conclusions

Pandemic restrictions did not affect breastfeeding intentions or practices, possibly due to sufficient social and family support during the pandemic. However, robust guidelines are required to increase enable women’s access to specializede care to cope with future pandemics, particularly during the first few weeks after childbirth.

Significance

• Sufficient social and family support can overcome such concerns to promote breastfeeding.

• Maternal support services are vital during the current and future pandemic periods to promote breastfeeding.

• Pandemics like COVID-19 will become more common in the future. The outcome of this study provides a useful perspective for the future.

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Acknowledgements

We would like to thank all participants for their valuable time participating in the Study. We also wish to thank all the research staff for their significant contribution to the study preparation and implementation.

Funding

This study was funded by the Student Research Committee, the Kerman University of Medical Sciences.

Author information

Authors and Affiliations

  1. Department of Reproductive Health and Midwifery, Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran

    Farzaneh Ashrafinia

  2. Foetal Programming, School of Life Sciences, University of Technology Sydney, Sydney, Australia

    Hui Chen

  3. Midwifery, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

    Omolbanin Heydari

  4. Obstetrics and Gynecology, Infertility, Jiroft University of Medical Sciences, Jiroft, Iran

    Maryam Mirzaei

  5. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Fatemeh Abdi

Authors
  1. Farzaneh Ashrafinia
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  2. Hui Chen
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  4. Maryam Mirzaei
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  5. Fatemeh Abdi
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Contributions

Conceptualization, Methodology, Writing – original draft, Writing – review & editing: Farzaneh Ashrafinia and Hui Chen., Investigation, Writing – review & editing: Fatemeh Abdi and Maryam Mirzaei., Data collection: Omolbanin Heydari and Farzaneh Ashrafinia., Data analysis: Farzaneh Ashrafinia and Maryam Mirzaei.

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Correspondence to Farzaneh Ashrafinia.

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The authors declare that they have no conflict of interest.

Study Registration

This study was approved by Kerman University of Medical Sciences (#IR.KMU.REC.1399.202). Written informed consent was obtained from all study participants.

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Ashrafinia, F., Chen, H., Heydari, O. et al. The Importance of Personal and Familial Factors on Breastfeeding Intention and Practices, and Postpartum Distress during the Pandemic: A Longitudinal Observational Study. Matern Child Health J 28, 513–523 (2024). https://doi.org/10.1007/s10995-023-03813-2

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