260069 Relationship between the maternal Stress to Resiliency Ratio (SRR) during pregnancy and breastfeeding initiation: Findings from the 2007 Los Angeles Mommy and Baby (LAMB) study

Wednesday, October 31, 2012 : 9:15 AM - 9:25 AM

Fathima Wakeel, PhD, MPH , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Lauren E. Wisk, BS , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Rebekah Gee, MD, MPH, MSHPR , School of Public Health, Louisiana State University, New Orleans, LA
Shin Margaret Chao, PhD, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Whitney P. Witt, PhD, MPH , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
OBJECTIVE: To examine the association between the maternal Stress to Resiliency Ratio (SRR) and breastfeeding initiation.

METHODS: We used data from the Los Angeles Mommy and Baby (LAMB) study, a mailed survey based on a multistage clustered design with telephone follow-up for non-respondents. Analyses were based on the responses of 3,148 women who had a live birth in LA County in 2007. The maternal resiliency index comprised personal resources (self-esteem and mastery) and social resources (partner, social network, and neighborhood support) that women drew upon during pregnancy. The stress index consisted of severe life events and perceived stress during pregnancy. The stress index was divided by the resiliency index to create the raw SRR, which was then transformed into a natural log SRR (range -1.5 to 1.5). An SRR>0 signified greater stress relative to resiliency. Logistic regression analyses were used to assess the association between the SRR and breastfeeding initiation.

RESULTS: Among respondents, the mean SRR was -0.033, and 21.9% did not initiate breastfeeding after delivery. The maternal SRR was significantly associated with not initiating breastfeeding (AOR=1.5, 95% CI=1.2, 2.1), even after controlling for sociodemographic factors, parity, prenatal depression, pregnancy complications, having a low birthweight or preterm baby, and poor health of the mother or infant after delivery.

CONCLUSIONS: Experiencing greater stress than resiliency during pregnancy is significantly associated with lack of breastfeeding initiation. Interventions to increase maternal resiliency among high-stress women are warranted in order to improve breastfeeding initiation rates and consequently, long-term child health outcomes.

Learning Areas:
Administer health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
1) Explain the components of the maternal stress to resiliency ratio; 2) Describe the relationship between the maternal stress to resiliency ratio and breastfeeding initiation; 3) Discuss programmatic and policy implications of our findings.

Keywords: Breastfeeding, Stress

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been extensively working with the LAMB study since 2006, and I have presented various findings using the LAMB study data since October 2008. I am also the first author on work regarding the development the maternal stress-to-resiliency ratio (SRR) and its relationships with a number of prenatal, obstetric, and postpartum outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.