title: Is maternal anxiety a barrier to exclusive breastfeeding?
abstract: OBJECTIVE
  To assess the association of maternal anxiety with nonadherence to exclusive breastfeeding.
  
  
  METHODS
  This questionnaire-based study was conducted at a tertiary care teaching hospital in South India mothers with infants less than 6 months of age and not exclusively breastfeeding were interviewed and their demographic and clinical details were noted. The Iowa Infant Feeding Attitude Scale (IIFAS) and Hospital Anxiety and Depression Scale (HADS) were administered to these mothers.
  
  
  RESULTS
  A total of 85 mother-infant dyads were included. The mean age of the mothers was 26 years and 57% were from urban areas. Among the additional feeds given, cow's milk was the commonest (57.6%), followed by gripe water (28.2%) and formula feeds (16.5%). The mean HADS anxiety subscale score was 12.2 (±5.3) and HADS depression subscale score was 9.5 (±3.8). The mean score on IIFAS was 58.4 (±3.6) suggesting a relatively favorable attitude toward breastfeeding. On linear regression analysis, higher HADS depression score, lower birth weight and lower per capita income were independent predictors of poorer attitudes toward breastfeeding.
  
  
  CONCLUSIONS
  Maternal anxiety may be an independent risk factor for nonadherence to exclusive breastfeeding for the initial six months.
authors.affiliation: a Department of Pediatrics and.
authors.forename: Javath Hussain
authors.initials: JH
authors.lastname: Arifunhera
authors.affiliation: a Department of Pediatrics and.
authors.forename: Rangan
authors.initials: R
authors.lastname: Srinivasaraghavan
authors.affiliation: b Department of Psychiatry , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry , India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: b Department of Psychiatry , Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) , Pondicherry , India.
authors.forename: Shivanand
authors.initials: S
authors.lastname: Kattimani
authors.affiliation: a Department of Pediatrics and.
authors.forename: Bethou
authors.initials: B
authors.lastname: Adhisivam
authors.affiliation: a Department of Pediatrics and.
authors.forename: B
authors.initials: B
authors.lastname: Vishnu Bhat
mesh_terms: D000328:Adult; D001007:Anxiety; D001942:Breast Feeding / Q000523:psychology*; D005260:Female; D006801:Humans; D055815:Young Adult
keywords: Anxiety; depression; exclusive breastfeeding; maternal behavior