Association of Parenting Stresses, Maternal Role Adjustment, and Types of Feeding during Hospital Stays at Birth to Breastfeeding Adaptation

Sukhee Ahn; Yunmi Kim

doi:10.4069/kjwhn.2015.21.4.262

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Ahn and Kim: Association of Parenting Stresses, Maternal Role Adjustment, and Types of Feeding during Hospital Stays at Birth to Breastfeeding Adaptation

Original Article

Korean Journal of Women Health Nursing 2015; 21(4): 262-271.

Published online: 25 December 2015

DOI: https://doi.org/10.4069/kjwhn.2015.21.4.262

Association of Parenting Stresses, Maternal Role Adjustment, and Types of Feeding during Hospital Stays at Birth to Breastfeeding Adaptation

Sukhee Ahn¹, Yunmi Kim²

¹College of Nursing, Chungnam National University, Daejeon, Korea.

²College 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

Received 19 August 2015 Revised 19 November 2015 Accepted 7 December 2015

(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 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.

Keywords: Maternal, Role, Parenting, Stress, Breastfeeding, Adaptation

Figures and Tables

Table 1

Differences in Breastfeeding Adaptation by Study Variables (N=183)

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
Employment	Unemployed	148 (80.9)	3.88±0.46	-1.10	.270
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
Subjective perception of mother's health status	Not good	12 (6.6)	3.52±0.55	4.23	.041
Previous breastfeeding experience for multipara (n=97)	Had	78 (42.6)	3.82±0.46	1.50	.137
Previous breastfeeding experience for multipara (n=97)	Did not have	19 (10.4)	3.63±0.63	1.50	.137
Gestational period (weeks)	<37	21 (11.5)	3.87±0.46	0.04	.952
Gestational period (weeks)	≥37	162 (88.5)	3.86±0.48	0.04	.952
Mother's perception of baby's heath status at birth	Good	174 (95.1)	3.88±0.47	6.99	.009
Mother's perception of baby's heath status at birth	Not good	9 (4.9)	3.46±0.47	6.99	.009
Type of delivery	Vaginal birth	127 (69.4)	3.88±0.46	0.34	.561
Type of delivery	Cesarean birth	56 (30.6)	3.83±0.51	0.34	.561

^†Mothers' mean age was 30.88±3.62.

Table 2

Differences in Maternal Role Adjustment, Parenting Stress, Breastfeeding Adaptation by Baby's Age, Type of Feeding, and Parity (N=183)

Variables	Categories	n	Parenting stress	F (p) post-hoc	Maternal role adjustment	F (p) post-hoc	Breastfeeding adaptation	F (p) post-hoc
Variables	Categories	n	M±SD	F (p) post-hoc	M±SD	F (p) post-hoc	M±SD	F (p) post-hoc
Baby's monthly age^†	1~3^a	24	2.43±0.73	3.99 (.009) a>b	3.02±0.37	1.58 (.195)	3.80±0.67	1.64 (.181)
	4~6^b	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)
Parity	Multipara	97	2.29±0.54	-3.60 (<.001)	3.06±0.33	1.79 (.074)	3.77±0.50	2.57 (.011)

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

Table 3

Relationships among Maternal Role Adjustment, Parenting Stress, Breastfeeding Adaptation, and Study Variables (N=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)

Table 4

Factors Influencing on Breastfeeding Adaptation (N=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

Notes

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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