Improvement of the breastfeeding self-efficacy and postpartum mental health after lactation consultations - Observational study.

OBJECTIVE: Maternal self-efficacy in breastfeeding may be undermined by common mental health difficulties in the postpartum, leading to an early breastfeeding cessation. The relationship may also be the opposite: problems with effective breastfeeding and breastfeeding cessation may increase the postpartum mental health difficulties. The purpose of this study was the assessment of the effectiveness of lactation consultations in strengthening the breastfeeding self-efficacy and maternal postpartum mental health. DESIGN AND PARTICIPANTS: 160 Polish women (90 consultation participants and 70 controls) completed a structured interview, the General Health Questionnaire, and the Breastfeeding Self-Efficacy Scale twice: before lactation consultation and one month later. SETTING: Research was conducted in the city of Gdansk, Poland. FINDINGS: Study revealed that women seeking lactation support exhibited greater mental health difficulties while their breastfeeding self-efficacy was similar to the control group. Initial breastfeeding self-efficacy was negatively correlated with the severity of the postpartum mental health problems. One month after lactation consultations, a significant increase in the breastfeeding self-efficacy and significantly reduced symptoms of mental health difficulties (somatic symptoms, functional disorders, and anxiety and insomnia) were observed among mothers. KEY CONCLUSIONS: Women willing to benefit from the lactation consultations may exhibit symptoms of mental health difficulties that may be associated with difficulties in breastfeeding. Strengthening the breastfeeding confidence during lactation consultations, may reflect in the improvement of the woman's mental health. IMPLICATIONS FOR PRACTICE: Midwives and lactation consultants can make a difference in the mental health promotion by offering breastfeeding interventions which address the emotional needs of a mother.

The program of psychological and breastfeeding support "Maternity step by step": an example of effective solution for the prevention, diagnostics and treatment of prenatal and postpartum depression. / Program opieki psychologiczno-laktacyjnej "Macierzynstwo krok po kroku" jako przyklad profilaktyki, diagnostyki i leczenia depresji w okresie okoloporodowym.

OBJECTIVES: Postpartum depression affects about 13-20% of women. Depression during pregnancy is observed in 19% of pregnant women. In Poland we lack asupport system for this group of patients. This article presents the elements of the pilot program of psychological interventions and breastfeeding support "Motherhood: step by step", financed by the municipality of Gdansk. The aim of the program was to provide inhabitants of Gdansk with professional breastfeeding support and psychological help during pregnancy and in the first year of infant's life. METHODS: The study involved three groups of women: 36 mothers participating in psychological consultations and short-term therapy, 123 women from breastfeeding support group and 104 women in the control group. The evaluation was based on questionnaires prepared by the researchers, the General Health Questionnaire-28 and the Parenting Stress Index -3rd version. RESULTS: The evaluation showed a significant decrease in symptoms of mental disorders in both groups of treated women: women from psychological intervention and breastfeeding intervention group. In women from psychological intervention group a significant decrease in parental stress was observed. CONCLUSIONS: Conducted analyses showed that the implemented program is characterized by high effectiveness and may be recommended for the continuation in the subsequent years. It may be considered as asolution for changes in the new standards for perinatal care in Poland.