title: Breastfeeding Self-Efficacy, Mood, and Breastfeeding Outcomes among Primiparous Women.
abstract: BACKGROUND
  A link between postpartum mood and breastfeeding has been established in the literature, but little is known about the relationship of breastfeeding self-efficacy (BSE) to breastfeeding and mood outcomes, particularly in primiparous women.
  
  
  OBJECTIVE
  The purpose of this study was to prospectively evaluate the relationship among BSE, mood, and breastfeeding outcomes in primiparous women. A secondary purpose was to explore self-reported reasons for difficult emotional adjustment during the transition to motherhood.
  
  
  METHODS
  Primiparous women who initiated breastfeeding were surveyed at 2 days, 6 weeks, and 6 months postpartum. Breastfeeding self-efficacy, depressive symptoms, work status, breastfeeding difficulties, partner support, and use of lactation services were included in a hierarchical multiple regression analysis. Women who identified as emotionally distressed provided open-ended responses identifying the main cause of their stress.
  
  
  RESULTS
  High BSE at 2 days postpartum predicted positive emotional adjustment and fewer depressive symptoms at 6 weeks postpartum, as well as more exclusive breastfeeding at 6 months postpartum. Among distressed mothers, breastfeeding concerns were among the most commonly named reasons for stress, along with lack of sleep, lack of social support, and overwhelming learning demands involved with being a new parent.
  
  
  CONCLUSIONS
  Breastfeeding perceptions are associated with emotional health and breastfeeding outcomes. Bolstering women's early BSE may be an important goal for multiple dimensions of postpartum health.
authors.affiliation: Denison University, Granville, OH, USA henshawe@denison.edu.
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Henshaw
authors.affiliation: Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Fried
authors.affiliation: Denison University, Granville, OH, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Siskind
authors.affiliation: Riverside Methodist Hospital, Columbus, OH, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Newhouse
authors.affiliation: Riverside Methodist Hospital, Columbus, OH, USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Cooper
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D009035:Mothers / Q000523:psychology*; D010298:Parity; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011446:Prospective Studies; D020377:Self Efficacy; D013315:Stress, Psychological / Q000523:psychology
keywords: attitudes; breastfeeding; breastfeeding attitudes; breastfeeding barriers; breastfeeding duration; breastfeeding knowledge; breastfeeding rates; depression