Maternal positive emotions during infant feeding and breastfeeding outcomes
Creators: name: Stuebe, Alison
name: Meltzer-Brody, Samantha
name: Zvara, Bharathi
name: Tucker, Christine
name: Wouk, Kathryn
name: Pence, Brian
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2018

description: Background: Major medical organizations in the U.S. recommend exclusive breastfeeding for six months, with continued breastfeeding through the first year “or longer as mutually desired by the woman and her infant.” Few studies have explored the role of maternal emotions in breastfeeding outcomes. Dr. Barbara Fredrickson’s broaden-and-build theory of positive emotions suggests that experiences of positive emotions lead to adaptive benefits by broadening one’s thought-action repertoire, allowing the accrual of personal and social resources to improve health and well-being.Aims/Purpose: To estimate the association between maternal positive emotions during infant feeding at two months and time to any and exclusive breast milk feeding cessation and overall maternal evaluation of breastfeeding at 12 months.Narrative: 185 women from a longitudinal cohort of mother-infant dyads were followed from the third trimester through 12 months postpartum. All women intended to breastfeed at least two months. We measured positive emotions during infant feeding at 2 months using the mean subscale score of the modified Differential Emotions Scale (mDES). The mDES asks the “greatest amount” 10 positive and 10 negative emotions were experienced during infant feeding over the past week using a 5-point Likert scale. We used Cox proportional hazards regression to estimate hazard ratios for time to any and exclusive breast milk feeding cessation associated with a one-unit increase in positive emotions. We also estimated the association between positive emotions and the maternal evaluation of breastfeeding at 12 months using the Maternal Breastfeeding Evaluation Scale (MBFES), which asks about agreement or disagreement with 30 statements about breastfeeding and/or expressing milk as an overall experience using a 5-point Likert scale. A one-unit increase in positive emotions at 2 months was associated with a 26% lower hazard of stopping any breast milk feeding and 42% reduced hazard of ceasing exclusive breast milk feeding (see Table 1). The association with breast milk feeding cessation was stronger where women had met their prenatal breastfeeding intention at 2 months and among Non-Hispanic White women, while the association with exclusive breast milk feeding cessation was stronger among women of color. Positive emotions at 2 months were also associated with a better maternal report of the overall breastfeeding experience at 12 months, with a stronger association among women who were breast milk feeding at 2 months. Positive emotions at 2 months were more strongly associated with the maternal enjoyment and role attainment subscale of the MBFES.Conclusions: Positive emotions during feeding at 2 months were associated with a longer time to cessation of any and exclusive breast milk feeding. More research is needed to understand trajectories of maternal emotions during infant feeding and maternal and infant outcomes associated with positive emotions.