Maternal Psychosocial Factors that Affect Breastfeeding Adaptation and Immune Substances in Human Milk

Eun Sook Kim; Mi Jo Jeong; Sue Kim; Hyun-A Shin; Hyang Kyu Lee; Kayoung Shin; Jee Hee Han

doi:10.4069/kjwhn.2014.20.1.14

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Kim, Jeong, Kim, Shin, Lee, Shin, and Han: Maternal Psychosocial Factors that Affect Breastfeeding Adaptation and Immune Substances in Human Milk

Original Article

Korean Journal of Women Health Nursing 2014; 20(1): 14-28.

Published online: 31 March 2014

DOI: https://doi.org/10.4069/kjwhn.2014.20.1.14

Maternal Psychosocial Factors that Affect Breastfeeding Adaptation and Immune Substances in Human Milk

Eun Sook Kim¹, Mi Jo Jeong¹, Sue Kim², Hyun-A Shin¹, Hyang Kyu Lee², Kayoung Shin¹, Jee Hee Han²

¹Graduate School, College of Nursing, Yonsei University, Seoul, Korea.

²College of Nursing · Nursing Policy Research Institute, Yonsei University, Seoul, Korea.

Corresponding author: Jeong, Mi Jo. Delivery Room, Hallym University Sacred Heart Hospital, 896 Pyeongchon-dong, Dongan-gu, Anyang 431-796, Korea. Tel: +82-31-380-3955, Fax: +82-31-380-4118, gungdeange@naver.com

Received 7 November 2013 Revised 20 December 2013 Accepted 7 March 2014

(open-access):

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.

Abstract

Purpose

This study was to identify relationships of maternal psychosocial factors including mother's mood state, childcare stress, social support and sleep satisfaction with breastfeeding adaptation and immune substances in breast milk, especially secretory immunoglobulin A (sIgA) and transforming growth factor-beta 2 (TGF-β2).

Methods

Data were collected from 84 mothers who delivered full-term infants by natural childbirth. Structured questionnaires and breast milk were collected at 2~4 days and 6 weeks postpartum. Data were analyzed using descriptive statistics, Pearson's correlation, multiple linear regression, and generalized estimating equation (GEE).

Results

Scores for the breastfeeding adaptation scale were significantly related with child care stress, mood state and social support. Mother's anger was positively correlated with the level of sIgA in colostrum (p<.01). Immune substances of breastmilk was significantly influenced by time for milk collection (p<.001) and the type of breastfeeding (sIgA, p<.001, TGF-β2, p=.003). Regression analysis showed that breastfeeding adaptation could be explained 59.1% by the type of breastfeeding, childcare stress, the Profile of Mood States, emotional support and sleep quality (F=16.67, p<.001).

Conclusion

The findings from this study provide important concepts of breastfeeding adaptation program and explanation of psychosocial factors by immune substances in breast milk. Future research, specially, bio-maker research on breast milk should focus on the ways to improve breastfeeding adaptation.

Keywords: Breastfeeding, Human milk, Adaptive behavior, Immunologic factors, Psychosocial factors

Figures and Tables

Figure 1

Data collection by measure time.

Table 1

Relationships among Study Variables

SCL=symptom of infection checklist.

^*p<.05, ^**p<.01.

Table 2

Related Factors to Breastfeeding Adaptation (N=66)

SCL=symptom of infection checklist.

^†Stepwise multiple regression was done; ^‡Dependent variable=breastfeeding adaptation excluding getting support; ^§10,000 won.

Table 3

Related Factors to Immune Substances of Breastmilk

SCL=symptom of infection checklist.

Table 4

General Characteristics of Dropouts and Subjects

Notes

This work was supported by the 2012 Faculty-Student Research Fund, College of Nursing, Yonsei University.

Summary Statement

▪ What is already known about this topic?

Breastfeeding adaptation of mothers was significantly related to child care stress and social support and immune substances of breastmilk was significantly influenced by time for measurement.

▪ What this paper adds?

The mother's psychosocial factors correlating with immune substances in breastmilk were anger, emotional support, practical support and sleep satisfaction, and breastfeeding adaptation was significantly related with immune substances in breast milk.

▪ Implications for practice, education and/or policy

Nursing interventions for breastfeeding should focuse on reducing stress and improving support and sleep quality, and sIgA of breastmilk can be utilized as a bio-marker in future studies of the emotion of postpartum women.

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