Exclusive Breastfeeding at 6 Weeks Related to Pain Self-Management, Emotion and Self-Efficacy: A Secondary Analysis of a Pilot Randomized Control Trial

Abstract

AbstractIntroductionExclusive breastfeeding (EBF) outcomes can vary by concomitant emotions, ongoing pain, and breastfeeding self-efficacy. The purpose of this study is to examine the association of ongoing pain with breastfeeding, concomitant emotions and breastfeeding self-efficacy scores (BSES) with EBF outcomes at 6 weeks postpartum.DesignA secondary analysis of a randomized pilot trial of a home-based breastfeeding pain self-management (BSM) intervention for 56 mothers (26 BSM, 30 Control). The BSM intervention provided self-management strategies for breastfeeding and breastfeeding pain. Effect modification of EBF and associated symptoms of depression, anxiety, sleep, well-being pain severity scores, BSES, and group assignment was assessed using the likelihood ratio test.ResultsEBF at 6 weeks controlling for demographic covariates, the group, pain severity, anxiety and sleep were significant predictors. Mothers with every one point increase in their pain severity score and sleep score, had a decrease of 9% (OR = .91, 95%CI = [.79, .98]) and 25% (OR = .75, 95% CI = [.52, .95]) respectively and with a one point increase in the anxiety score, a 58% (OR = 1.58, 95% CI = [1.13, 2.72]) increase in the odds of EBF at week 6.ConclusionExaminations of EBF at 6 weeks should include evaluation of mothers’ ongoing pain and emotional distress, as mothers continue breastfeeding even at personal cost. Early identification and validation of breastfeeding challenges, ongoing pain, and emotional distress are needed to bolster mothers’ confidence in their breastfeeding skills, thus supporting their EBF goals.Quick pointsUnresolved pain during breastfeeding may affect breastfeeding self-efficacy, maternal self-efficacy and bondingThe effect of maternal emotion on breast and nipple pain and breastfeeding outcomes is not consistently evaluated during breastfeedingMothers who received breastfeeding pain self-management strategies reported higher breastfeeding self-efficacy scores and lower pain and anxiety scoresProviding breastfeeding pain self-management is a pathway to increase breastfeeding self-efficacy and exclusive breastfeedingEmpowering women with the skills needed to self-manage anxiety and pain by providing real-time support in the first weeks after birth support mother to reach their breastfeeding goals