Impact of anxiety in the puerperium on breast-feeding outcomes: role of parity

J Pediatr Gastroenterol Nutr. 2009 Nov;49(5):631-4. doi: 10.1097/MPG.0b013e31819e6446.


Objective: : Studies in animals indicate that stress and anxiety can depress lactation, but there is much less information available concerning humans. We aimed to determine whether maternal anxiety in puerperium, potentially exacerbated by the primiparity inexperience, has a negative impact on breast-feeding outcomes.

Subjects and methods: : The state-trait anxiety inventory Y form (Spielberger, 1983) was administered to a total of 204 mothers, 101 primiparae, and 103 pluriparae on the third to fourth day postpartum.

Results: : We found that primiparae had state anxiety (T) scores significantly higher than pluriparae (44.57 +/- 5.85 vs 43.28 +/- 7.10, P = 0.03). Increased state anxiety levels impaired breast-feeding success. In addition, in the logistic regression analysis model used to assess factors predictive of breast-feeding longer than 3 months, maternal state anxiety was the most significant risk factor (odds ratio 0.99; 0.88-0.98, P < 0.01).

Conclusions: : In the puerperium, anxiety, potentially exacerbated by primiparae inexperience, is associated with impaired lactation. Alleviating maternal anxiety could be beneficial for stimulating breast-feeding in more vulnerable women.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anxiety / complications*
  • Anxiety / epidemiology
  • Breast Feeding / psychology*
  • Female
  • Humans
  • Lactation / physiology*
  • Lactation / psychology*
  • Logistic Models
  • Odds Ratio
  • Parity*
  • Postpartum Period
  • Pregnancy
  • Risk Factors