A population-based study of exclusive breastfeeding in Icelandic women: is there a relationship with depressive symptoms and parenting stress?
Section snippets
Introduction and literature review
Exclusive breastfeeding (EBF) is defined as the feeding of breast milk only, and no other liquids or solids with the exception of drops or syrups consisting of vitamins, mineral supplements, or medicines (WHO/UNICEF, 1991). The World Health Organization has recently recommended EBF for of the first 6 months of life to obtain optimal health and well being of the infant and this policy has been adopted in Iceland (WHO, 2001; Icelandic Nutrition Council, 2003). In the Nordic countries, including
Aim and context of the study
The current study was a part of a larger national study on maternal distress and infant difficulties carried out between 1992 and 1996 in Iceland and parts of the study have been published elsewhere (Thome and Alder, 1999; Thome, 1996, Thome, 2000, Thome, 2003). The data have partly been reported in a study of depressive symptoms and their relationship with parenting stress and infant's difficulty in the population of Icelandic women and infants (Thome, 2000). The aim of this paper is to report
Sample and demographics
The final sample consisted of 734 women, which approximates a response rate of 70%. The age and residence distribution of the respondents did not differ from that of the general population of childbearing women in Iceland (Table 1).
Maternal education level was distributed as follows: EL 1 ( or 41.7%), EL 2 ( or 39.2%) and EL 3 ( or 19.1%). The range of education level varied significantly by residence as follows: EL 1 (lowest 34.1% in the capital city—highest 58.8% in villages),
Discussion
The 56% rate of EBF between the 2nd and 3rd postpartum month in the Icelandic population found in this study is 13% lower than reported previously in a multicentre study (Atladottir and Thorsdottir, 2000). The findings of varying rates of EBF between the two studies can be explained in two ways: First, there were large variations of EBF rates between electoral districts in this study and also differences in sample characteristics related to different presentation of the rural population in the
Conclusions and recommendations
It is concluded that the factors reducing the likelihood of EBF are low maternal education level, having twins, single motherhood and depressive symptoms. It is recommended that health professionals who are promoting EBF and shape breastfeeding policies should consider the adversely impacting factors in relation to the strength of maternal education level and offer help with management of depressive symptoms to distressed mothers. Mothers of twins should receive special attention. It is of
Acknowledgements
The study was supported by a grant from the University of Iceland Research Fund. The authors thank Bergthora Kristinsdottir, project manager, Faculty of Nursing, University of Iceland, for critically reading the draft.
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