title: Breastfeeding practices in mothers of high-respiratory-risk NICU infants: impact of depressive symptoms and smoking.
abstract: OBJECTIVE
  Mothers of infants in the neonatal intensive care unit (NICU) have very low breastfeeding rates and these high-respiratory-risk (HRR) NICU infants may benefit from breastfeeding through decreased risk for respiratory illnesses. This population's increased risk for maternal depression and high rates (22%) of maternal smoking may negatively affect breastfeeding.
  
  
  OBJECTIVE
  This exploratory study investigated associations of breastfeeding with depressive symptoms and maternal smoking in mothers of HRR NICU infants (i.e. presence of one household smoker and birth weight <1500 g or mechanical ventilation ≥12 h).
  
  
  METHODS
  Breastfeeding, depression and smoking data were collected from 104 mothers in the NICU following delivery.
  
  
  RESULTS
  Fifty-five (52.9%) mothers reported breastfeeding, 39 (37.5%) had a Center for Epidemiological Studies Depression Scale (CES-D) score (≥16) suggestive of depression, and 36 (34.6%) reported smoking. Mothers with CES-D scores ≥16 were less likely to breastfeed compared to those with scores <16 (38.5% versus 61.5%; p = 0.02). Breastfeeding and smoking were not significantly associated (p < 0.10). Mothers of HRR infants with significant depressive symptoms who smoke have significantly lower breastfeeding rates (21%) than mothers who are not depressed and do not smoke (65%).
  
  
  CONCLUSIONS
  Interventions to improve breastfeeding initiation and continuation that target depression and smoking are necessary.
authors.affiliation: Department of Family and Community Medicine .
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Northrup
authors.forename: Susan H
authors.initials: SH
authors.lastname: Wootton
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Evans
authors.forename: Angela L
authors.initials: AL
authors.lastname: Stotts
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D019052:Depression, Postpartum / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology; D007235:Infant, Premature, Diseases / Q000523:psychology; D019102:Infant, Very Low Birth Weight / Q000523:psychology; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000523:psychology; D012306:Risk; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult