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Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants

Journal of Perinatology volume 27, pages 399–408 (2007)Cite this article

Abstract

Objective:

(1) To compare maternal characteristics and psychological stress profile among African-American, Caucasian and Hispanic mothers who delivered very low birthweight infants. (2) To investigate associations between psychosocial factors, frequency of milk expression, skin-to-skin holding (STS), and lactation performance, defined as maternal drive to express milk and milk volume.

Study Design:

Self-reported psychological questionnaires were given every 2 weeks after delivery over 10 weeks. Milk expression frequency, STS, and socioeconomic variables were collected.

Result:

Infant birthweight, education, and milk expression frequency differed between groups. Trait anxiety, depression and parental stress in a neonatal intensive care unit (PSS:NICU) were similar. African-American and Caucasian mothers reported the lowest scores in state anxiety and social desirability, respectively. Maternal drive to express milk, measured by maintenance of milk expression, correlated negatively with parental role alteration (subset of PSS:NICU) and positively with infant birthweight and STS. Milk volume correlated negatively with depression and positively with milk expression frequency and STS.

Conclusion:

Differences between groups were observed for certain psychosocial factors. The response bias to self-reported questionnaires between groups may not provide an accurate profile of maternal psychosocial profile. With different factors correlating with maintenance of milk expression and milk volume, lactation performance can be best enhanced with a multi-faceted intervention program, incorporating parental involvement in infant care, close awareness and management of maternal mental health, and encouragement for frequent milk expression and STS.

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Acknowledgements

We thank P Burns, RN C Bryant, RN, P Gordon, RN, and A Thomas for their assistance in the collection of the data, Ken Fraley for statistical assistance and all the mothers who participated in this project. This work was supported by grants from the National Institutes of Child Health and Human Development (R01-HD28140 and R01-HD44469), the General Clinical Research Center, Baylor College of Medicine/Texas Children's Hospital Clinical Research Center (M01-RR-00188), National Institute of Health. Partial funding also was provided from the USDA/ARS, Children's Nutrition Research Center and the Department of Pediatrics, Baylor College of Medicine Texas Children's Hospital, Houston, TX. The contents of this publication do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products or organizations imply endorsement by the US government.

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Authors and Affiliations

  1. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    C Lau, N M Hurst & E O Smith

  2. Division of Neonatal-Perinatal Medicine, North Shore University Hospital, Manhasset, NY, USA

    R J Schanler

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  1. C Lau
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Correspondence to C Lau.

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Lau, C., Hurst, N., Smith, E. et al. Ethnic/racial diversity, maternal stress, lactation and very low birthweight infants. J Perinatol 27, 399–408 (2007). https://doi.org/10.1038/sj.jp.7211770

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