Breastfeeding difficulties and maternal mental health: role of social support in rural northwestern China
Bibliographic record
Abstract
BACKGROUND: Globally, escalating mental health issues among postpartum women underscore their significant impact on individuals, children, and society. This study investigates the associations between breastfeeding difficulties and maternal mental health in rural areas of northwestern China. Additionally, we examine how mothers' perceived family support and home visits by community health workers (CHWs) are associated with variations in maternal mental health outcomes. METHODS: Data for this study were collected in March and December 2021. Descriptive statistics and multivariate linear regression analyses were conducted to examine the prevalence of maternal mental health problems and the association between breastfeeding difficulties and maternal mental health. Maternal mental health was assessed using Depression, Anxiety, and Stress Scale (DASS-21), while breastfeeding difficulties were measured based on mothers' self-reported experiences with common breastfeeding challenges. Perceived family support for breastfeeding and a community-based home visit intervention were analyzed to explore differences in associations across subgroups. RESULTS: Greater overall breastfeeding difficulty was significantly associated with higher maternal stress (β = 2.391, P = 0.001), and showed marginally positive associations with depression (β = 1.186, P = 0.102) and anxiety (β = 0.953, P = 0.082). Among specific categories, feeding process difficulties were significantly associated with increased anxiety (β = 1.173, P = 0.031) and stress (β = 2.031, P = 0.008). Among mothers with lower practical support, breastfeeding difficulties were significantly associated with higher depression (β = 1.782, P = 0.009), anxiety (β = 1.577, P = 0.002), and stress (β = 2.722, P < 0.001), whereas associations in the higher support group were not significant. For emotional support, a stronger association with stress was observed in the lower support group (β = 2.748, P = 0.008) but not in the higher support group. Stratification by community health worker home visits showed minimal subgroup differences. CONCLUSIONS: In essence, this study underscores the impact of breastfeeding challenges on maternal mental health and highlights family support's pivotal role, calling for targeted intervention to support rural mothers. TRIAL REGISTRATION: The study was approved by the Medical Ethics Committee of Shaanxi Normal University and Xi'an Jiaotong University of China (No: 2020 - 1240) on 08/03/2019. Meantime, the study obtained the registration numbers ISRCTN98898991 from the ISRCTN registry, which is recognized by WHO and ICMJE, on 26/03/2019.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".