title: Psychosocial predictors of primiparous breastfeeding initiation and duration.
abstract: BACKGROUND
  Many US women fall short of meeting the recommendations on breastfeeding. Whereas prenatal demographic factors have been well researched in relation to breastfeeding, psychosocial maternal characteristics are less understood but could be important predictors of breastfeeding initiation and duration.
  
  
  OBJECTIVE
  This study examined primiparous maternal psychosocial characteristics and temperamentally based negative infant affect as predictors of breastfeeding initiation and duration while accounting for depression and sociodemographic covariates.
  
  
  METHODS
  Prenatally, 237 primiparous women were administered the Adult Attachment Interview and completed a measure of beliefs related to infant crying. At 6 months postpartum, negative infant affect was assessed via mother report. Breastfeeding was assessed at 6 months and 1 year postpartum via mother report.
  
  
  RESULTS
  Results indicated that younger, low income, less educated, single, ethnic minority mothers and mothers with elevated depressive symptoms were less likely to initiate breastfeeding and breastfed for a shorter period than other women. Women who initiated breastfeeding tended to have higher adult attachment coherence scores (more secure attachment) than those who did not initiate breastfeeding (median score of 6.00 vs 4.00). An interaction was observed between negative infant affect and beliefs about crying related to spoiling, such that earlier cessation of breastfeeding was observed among mothers who reported high levels of negative infant affect and strongly endorsed the belief that responding to cries spoils infants (hazard ratio = 1.71, P < .01).
  
  
  CONCLUSIONS
  Although these psychosocial variables predicted relatively little variation in breastfeeding over and above covariates, the results suggest some novel approaches to promote breastfeeding.
authors.affiliation: The University of North Carolina at Greensboro, Greensboro, NC, USA.
authors.forename: Meagan E
authors.initials: ME
authors.lastname: Mathews
authors.affiliation: The University of North Carolina at Greensboro, Greensboro, NC, USA emleerke@uncg.edu.
authors.forename: Esther M
authors.initials: EM
authors.lastname: Leerkes
authors.affiliation: The University of North Carolina at Greensboro, Greensboro, NC, USA.
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Lovelady
authors.affiliation: The University of North Carolina at Greensboro, Greensboro, NC, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Labban
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D019052:Depression, Postpartum / Q000523:psychology; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D009657:North Carolina; D010298:Parity; D049590:Postpartum Period; D011247:Pregnancy; D011594:Psychometrics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: adult attachment; breastfeeding; breastfeeding duration; breastfeeding initiation; infant crying; prenatal factors; primiparous; temperament