Korean J Women Health Nurs KJWHN Korean Journal of Women Health Nursing 2287-1640 2093-7695 Korean Society of Women Health Nursing 10.4069/kjwhn.2015.21.4.262 Original Article Association of Parenting Stresses, Maternal Role Adjustment, and Types of Feeding during Hospital Stays at Birth to Breastfeeding Adaptation Ahn Sukhee 1 Kim Yunmi 2 College of Nursing, Chungnam National University, Daejeon, Korea. College of Nursing, Gachon University, Incheon, Korea. Corresponding author: Kim, Yunmi. College of Nursing, Gachon University, 191 Hambakmoero, Yeunsoo-gu, Incheon 21936, Korea. Tel: +82-32-820-4203, Fax: +82-32-820-4201, ymkim@gachon.ac.kr 12 2015 25 12 2015 21 4 262 271 19 08 2015 19 11 2015 07 12 2015 © 2015 Korean Society of Women Health Nursing 2015 This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose

This study was to explore association of maternal role adjustments, parenting stresses, and demographic factors to breastfeeding adaptation.

 Methods

A correlational survey design was used to recruit 183 mothers who breastfeed or breastfed their babies. Participants' visited outpatient departments and were admitted to pediatric ward at 2 hospitals in metropolitan city of Korea. Inclusion criteria for subjects were mothers whose babies were from 1 month to 24 months old. Data were collected using a self-report questionnaire for mothers' and babies' demographic variables, maternal role adjustments, parenting stresses, and maternal breastfeeding adaptations.

 Results

Higher levels of maternal adaptations and low levels of parenting stresses were associated with greater maternal breastfeeding adaptations. Types of feeding during hospital stays and baby's health status at birth were also associated with maternal breastfeeding adaptation.

 Conclusion

Results showed that a higher level of mothers' adjustment to breastfeeding; indicated lesser parenting stresses with higher levels of maternal adaptation. Nursing interventions for breastfeeding should be applied for appropriate breastfeeding adaptation during mothers' hospital stay. As baby's poor health status at birth medical team should provide a proper breastfeeding education.

 Maternal Role Parenting Stress Breastfeeding Adaptation Chungnam National University http://dx.doi.org/10.13039/501100002462

This study was supported by research fund of Chungnam National University in 2015.

 Summary Statement

▪ What is already known about this topic?

Mothers with lower marital satisfaction, problems with breastfeeding, and higher parenting stresses was associated with low breastfeeding adaptations.

▪ What this paper adds?

High maternal role adjustments and low parenting stresses were associated with maternal breastfeeding adaptations. Type of feeding during hospital stays and baby's health status at birth were also associated with maternal breastfeeding adaptation.

▪ Implications for practice, education and/or policy

Nursing interventions for breastfeeding should be applied towards appropriate breastfeeding adaptations during mothers' hospital stays. As baby's poor health status at birth medical team should provide a proper breastfeeding education.

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Variables Categories n (%) M±SD t or F p (post-hoc)
Age (year)† <30 66 (36.1) 3.89±0.47 0.97 .381
30~35 100 (54.6) 3.83±0.48
≥36 17 (9.3) 3.98±0.40
Education High school 82 (44.8) 3.85±0.50 0.05 .954
College 93 (50.8) 3.87±0.46
Graduate school 8 (4.4) 3.88±0.48
Subjective perception of family income Insufficient 69 (37.7) 3.82±0.51 1.39 .252
Adequate 91 (49.7) 3.86±0.45
Sufficient 23 (12.6) 4.01±0.48
Employment Employed 35 (19.1) 3.78±0.52 -1.10 .270
Unemployed 148 (80.9) 3.88±0.46
Satisfaction with marriage Unsatisfied 9 (4.9) 3.89±0.70 1.49 .228
Moderate 53 (29.0) 3.77±0.49
Satisfied 121 (66.1) 3.90±0.45
Subjective perception of mother's health status Good 171 (93.4) 3.88±0.47 4.23 .041
Not good 12 (6.6) 3.52±0.55
Previous breastfeeding experience for multipara (n=97) Had 78 (42.6) 3.82±0.46 1.50 .137
Did not have 19 (10.4) 3.63±0.63
Gestational period (weeks) <37 21 (11.5) 3.87±0.46 0.04 .952
≥37 162 (88.5) 3.86±0.48
Mother's perception of baby's heath status at birth Good 174 (95.1) 3.88±0.47 6.99 .009
Not good 9 (4.9) 3.46±0.47
Type of delivery Vaginal birth 127 (69.4) 3.88±0.46 0.34 .561
Cesarean birth 56 (30.6) 3.83±0.51

†Mothers' mean age was 30.88±3.62.

 Differences in Maternal Role Adjustment, Parenting Stress, Breastfeeding Adaptation by Baby's Age, Type of Feeding, and Parity (<italic>N</italic>=183)
Variables Categories n Parenting stress F (p) post-hoc Maternal role adjustment F (p) post-hoc Breastfeeding adaptation F (p) post-hoc
M±SD M±SD M±SD
Baby's monthly age† 1~3a 24 2.43±0.73 3.99(.009)a>b 3.02±0.37 1.58(.195) 3.80±0.67 1.64(.181)
4~6b 46 2.01±0.46 3.13±0.30 3.94±0.40
7~12 88 2.14±0.30 3.14±0.31 3.88±0.46
13~24 25 2.28±0.39 3.02±0.30 3.70±0.42
Total‡ 2.17±0.53 3.11±0.32 3.86±0.48
Type of feeding during hospital stay Breastmilk 104 2.11±0.52 1.79(.170) 3.15±0.32 2.62(.075) 3.96±0.43 7.81(.001)a>c
Mixed feeding 63 2.22±0.52 3.05±0.30 3.80±0.46
Formula milk 16 2.33±0.53 3.02±0.34 3.50±0.63
Parity Primipara 86 2.02±0.48 -3.60(<.001) 3.15±0.30 1.79(.074) 3.96±0.43 2.57(.011)
Multipara 97 2.29±0.54 3.06±0.33 3.77±0.50

†It indicated M±SD of Parenting Stress, Maternal Role Adjustment, and Breastfeeding Adaptation; ‡Babies' monthly mean age was 8.38±4.65.

 Relationships among Maternal Role Adjustment, Parenting Stress, Breastfeeding Adaptation, and Study Variables (<italic>N</italic>=183)
Variables X1 X2 X3 X4 X5 X6 X7
X1. Subjective perception of mother's health status (1=good) 1.00
X2. Previous breastfeeding experience (1=had experience) .06(.425) 1.00
X3. Parity (1=multipara) .08(.274) .81(<.001) 1.00
X4. Mother's perception of baby's heath status at birth (1=good) .10(.161) .01(.910) .08(.274) 1.00
X5. Type of feeding during hospital stay (1=breastfeeding) .01(.908) .10(.162) .01(.936) .17(.024) 1.00
X6. Maternal Role Adjustment .43(<.001) .12(.100) -.13(.074) .09(.243) .17(.023) 1.00
X7. Parenting stress .32(<.001) .16(.027) .26(<.001) .03(.652) -.13(.080) -.69(<.001) 1.00
X8. Breastfeeding adaptation .33(<.001) -.08(.257) -.19(.011) .19(.009) .24(<.001) .57(<.001) -.58(<.001)
Factors Influencing on Breastfeeding Adaptation (<italic>N</italic>=183)
Variables B SE β t p
Parenting stress -0.32 0.07 -.36 -4.54 <.001
Maternal role adjustment 0.43 0.12 .29 3.62 <.001
Type of feeding during hospital stay (=breastfeeding) 0.29 0.10 .30 2.87 .005
Baby's heath status at birth (1=good) 0.26 0.13 .12 2.06 .041
Adj. R2=.42, F=27.58, p<.001