BMC Pregnancy Childbirth. 2025 Oct 17;25(1):1112. doi: 10.1186/s12884-025-08186-8.
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.
PMID:41107789 | DOI:10.1186/s12884-025-08186-8
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