Effect of Maternal Effortful Control on Breastfeeding Continuation

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Breastfeeding has health benefits for mother and child, allowing a mother to protect her newborn from numerous infections while promoting healthy nutrition and growth. Breastfed babies have decreased risk of later negative health problems including respiratory infection, asthma, obesity, and Type II diabetes. The minimum acceptable time a mother should breastfeed is six weeks, but major healthcare organizations, such as the American Academy of Pediatrics, recommend exclusive breastfeeding for the first six months of life. Nationally, 43.1% of babies were exclusively breastfed the first six weeks in 2009, and rates in rural Appalachia are known to be significantly lower than national averages. Researchers have found factors such as age, socioeconomic, marital, and smoking statuses to be predictive of breastfeeding continuation, but maternal innate characteristics have not been explored extensively. To clarify why a mother chooses to breastfeed or not, it is important to additionally look at intrinsic characteristics such as temperament. Temperament is an individual’s biologically based ability to think, behave, and react. Effortful control, a specific component of temperament, is the voluntary regulation of emotions and behaviors. The current study examined the impact of effortful control on participants’ likelihood of breastfeeding at six weeks postpartum. Informationwas collected from pregnant women recruited from Northeast Tennessee as part of the Tennessee Intervention for Pregnant Smokers Program. As part of the larger study, women completed detailed research interviews multiple times during pregnancy, and at six weeks post-partum. The responses of interest came from 230 women who had complete demographic questionnaire, Adult Temperament Questionnaire (ATQ), delivery and birth chart information, and six-week interview breastfeeding status. Logistic regression was used to assess the impact of maternal effortful control (subscale of the ATQ) on the mother’s decision to exclusively breastfeed the child up to six weeks postpartum. The model contained five variables that were significantly correlated with the breastfeeding continuation: maternal age, birth weight (normal/low), prematurity (yes/no), delivery type (vaginal/C-section), and maternal effortful control scores. The full model containing all predictors was statistically significant, X2 (5, N=230) =24.610, p < .001. Effortful control had an Exp(B) of .420, CI (.264, .668) p<.001. Those women who are still breastfeeding at six weeks have significantly higher self-reported effortful control than those who are not still breastfeeding at six weeks, controlling for several other known correlates of breastfeeding continuation. Effortful control was found to predict decreased breastfeeding at six weeks. Because effortful control is an aspect of temperament, and is therefore relatively fixed, its measurement may be useful for identifying women who are less likely to breastfeed so they can be targeted by health educators and clinicians for more intensive intervention. Any increase in breastfeeding holds the potential for positive health outcomes for both mother and child.


Johnson City, TN

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