title: Breastfeeding duration and postpartum psychological adjustment: role of maternal attachment styles.
abstract: OBJECTIVE
  Depressive and anxiety symptoms are common in new mothers. The aim of this study is to explore the link between postpartum psychological adjustment and feeding preferences of the mothers.
  
  
  METHODS
  Sixty mothers and newborns were enrolled in this prospective, longitudinal study. Maternal depressive symptoms were screened by the Edinburgh Postpartum Depression Scale (EPDS), and maternal anxiety level was assessed by the State-Trait Anxiety Inventory at 1 month postpartum. The Multidimensional Scale of Perceived Social Support was used for the assessment of maternal social support. The Adult Attachment Scale was used to determine the attachment style of the mother. Infants were examined and evaluated at 1 and 4 months of life.
  
  
  RESULTS
  All mothers started breastfeeding their infants postpartum; 91% and 68.1% continued exclusive breastfeeding at 1 and 4 months, respectively. The first-month median EPDS score of mothers who breastfeed at the fourth month was statistically significantly lower than those who were not breastfeeding (6 and 12, respectively) (P = 0001). The first-month median EPDS score of mothers with secure attachment was lower than the median score of mothers with insecure attachment (5 and 9, respectively) (P < 0001). Exclusive breastfeeding rate was not statistically different among mothers with secure and insecure attachment styles. The median state and trait anxiety scores and social support scores of mothers were not different between groups according to breastfeeding status.
  
  
  CONCLUSIONS
  This study has shown an association between higher EPDS scores and breastfeeding cessation by 4 months after delivery.
authors.affiliation: Division of Neonatology, Department of Paediatrics, Marmara University Medical School, Istanbul, Turkey. ipekakman@yahoo.com
authors.forename: Ipek
authors.initials: I
authors.lastname: Akman
authors.forename: M Kemal
authors.initials: MK
authors.lastname: Kuscu
authors.forename: Ziya
authors.initials: Z
authors.lastname: Yurdakul
authors.forename: Nihal
authors.initials: N
authors.lastname: Ozdemir
authors.forename: Mine
authors.initials: M
authors.lastname: Solakoğlu
authors.forename: Lale
authors.initials: L
authors.lastname: Orhon
authors.forename: Aytül
authors.initials: A
authors.lastname: Karabekiroğlu
authors.forename: Eren
authors.initials: E
authors.lastname: Ozek
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000209:etiology; D001942:Breast Feeding / Q000523:psychology*; D019052:Depression, Postpartum / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008423:Maternal Age; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D009769:Object Attachment; D010298:Parity; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011446:Prospective Studies; D012944:Social Support; D013997:Time Factors