Poster #56 - Prenatal Depression and Breastfeeding Practices: A Role of Home Visitation Services Among Korean Women

• In Event: Poster Session 04

Abstract

It is not surprising that the rate of initiating breastfeeding is high but breastfeeding cessation during the first few weeks is remarkably high (Chalmers et al. 2009; Barnes et al. 2010). Depression, among then others, has long been considered a risk factor for breastfeeding. Existing literature showed that prenatal depression reduced the intention, initiation, and maintenance of breastfeeding during the postpartum period (Figueiredo et al., 2014). Thus, it is important to develop early intervention programs from pregnancy through postpartum to take care of maternal mental health and improve breastfeeding rates. Using a community survey of Korean women, this study sought to investigate 1) whether prenatal depression reduces the rate of exclusive breastfeeding in the postpartum period and 2) whether a sustained nurse home visitation service would help mitigate the negative influence of prenatal depression on breastfeeding practices.

A subsample of 26,824 women (Mage =32.98, SDage = 3.91) participating in the home visitation service in Seoul from 2013 to 2019 (Seoul Healthy First Step Project, SHFSP) was included in the analysis. The SHFSP provides two types of nurse home visitation services for child caring, feeding, development, and maternal mental health: Universal and sustained home visitation (Khang et al., 2022). The universal home visitation service consists of a one-time home visit within 6 weeks after birth, while the sustained home visitation program begins from pregnancy and offers 20-25 visits until children reach 24 months of age. During pregnancy, women provided information on their psychological and socioeconomic status (i.e., depression, stress, physical/psychological disability, single parent, drinking, smoking, ethnicity, family financial status) and delivery information, nipple condition, and breastfeeding type were reported during the first nurse home visit about 5–8 weeks postpartum period.

Results showed that 25% of participants exclusively breastfed their children. Employing logistic regression in SPSS, we found that higher scores on depression during pregnancy were associated with a reduction in the likelihood of exclusively breastfeeding during the postpartum period while controlling for other psychological, social, and medical conditions (b = -.010, SE = .004, OR = .990, p = .014, 95% CI[.982, .997]). Importantly, home vising service moderated the negative effects of prenatal depression on exclusive breastfeeding (b = .034, SE = .012, OR = 1.035, p = .005, 95% CI[1.011, 1.059]) (Table 1 and Figure 1). For those participating in sustained home visitation service, prenatal depression was associated with a significant increase in odds of exclusive breastfeeding (b = .021, SE = .011, OR = 1.021, p = .068, 95% CI[-.002, .043]) than those in universal home visitation (b = -.013, SE = .004, OR = .099, p = .001, 95% CI[-.021, -.005]).

This study confirmed the importance of managing psychological distress during pregnancy for successful breastfeeding practices and the preliminary effectiveness of sustained home visitation services. Discussion highlights the psychological and physiological mechanisms underlying the link between prenatal depression and breastfeeding practices and the need to develop effective intervention strategies targeting pregnant women and mothers with young children.

Authors

• Joo Hyun Kim, Seoul National University
  Presenting Author

• Young-Ho Khang, Seoul National University College of Medicine