title: Initiation and exclusivity of breastfeeding: association with mothers' and fathers' prenatal and postnatal depression and marital distress.
abstract: BACKGROUND
  This study explored the effects of mothers' and fathers' prenatal and postnatal depressive symptoms and marital distress on breastfeeding initiation and exclusive breastfeeding (EBF) duration.
  
  
  METHODS
  This was a prospective follow-up of a cohort sample of 873 families participating to an intensive follow-up cohort of longitudinal Steps to the Healthy Development and Well-being of Children study (The STEPS study) in Southwestern Finland. The depressive symptoms were evaluated by The Edinburgh Postpartum Depression Scale and marital distress by the Revised Dyadic Adjustment Scale at 20th gestational week and at 4 months postpartum. EBF was self-reported real-time and defined as an infant receiving no food or drink other than mother's breast milk since birth, except occasionally water.
  
  
  RESULTS
  Neither parents' prenatal depressive symptoms predicted breastfeeding initiation or EBF duration. The mothers' prenatal depressive symptoms, in turn, predicted their postnatal depressive symptoms, which were associated with shorter duration of EBF. The EBF duration was shortest amongst the mothers who had depressive symptoms both pre- and postnatally compared to mothers who had depressive symptoms only in either time point alone (M = 1.54, 2.06 and 2.04 months, respectively). Higher prenatal maternal marital distress was associated with longer EBF duration.
  
  
  CONCLUSIONS
  The findings suggest that the continuity of maternal depressive symptoms throughout the perinatal period has adverse effect on EBF duration. Identification and treatment of mothers' depressive symptoms already during the prenatal period may improve breastfeeding practices. The finding of mothers' marital distress having positive impact on breastfeeding practices requires further investigation.
authors.affiliation: Turku Institute for Child and Youth Research, University of Turku, Turku, Finland.|Department of Psychology, University of Turku, Turku, Finland.
authors.forename: Sari
authors.initials: S
authors.lastname: Ahlqvist-Björkroth
authors.affiliation: Turku Institute for Child and Youth Research, University of Turku, Turku, Finland.
authors.forename: Jenni
authors.initials: J
authors.lastname: Vaarno
authors.affiliation: Turku Institute for Advanced Studies & Centre for Learning Research, University of Turku, Turku, Finland.
authors.forename: Niina
authors.initials: N
authors.lastname: Junttila
authors.affiliation: Department of Child Psychiatry, University of Turku, & Academy of Finland, Turku, Finland.
authors.forename: Marjaterttu
authors.initials: M
authors.lastname: Pajulo
authors.affiliation: Department of Psychology, University of Turku, Turku, Finland.
authors.forename: Hannele
authors.initials: H
authors.lastname: Räihä
authors.affiliation: Turku Institute for Child and Youth Research, University of Turku, Turku, Finland.|Department of Pediatrics and Physiology, University of Turku, Turku, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Niinikoski
authors.affiliation: Turku Institute for Child and Youth Research, University of Turku, Turku, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Lagström
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D019052:Depression, Postpartum / Q000523:psychology; D005220:Fathers / Q000523:psychology*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
keywords: Depression; breastfeeding initiation; exclusive breastfeeding; marital satisfaction; pregnancy