skip to main content

Father Support, Postpartum Depression, and Breastfeeding Weaning Time: A Structural Equational Model

*Imelda Iskandar orcid scopus  -  Sekolah Tinggi Ilmu Kesehatan Makassar, Indonesia
Azniah Syam orcid scopus publons  -  Sekolah Tinggi Ilmu Kesehatan Nani Hasanuddin, Indonesia
Open Access Copyright (c) 2024 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background:  Fathers are crucial to family well-being and beyond during pregnancy and childbirth. However, research on the long-term effects of father involvement during prenatal and its postpartum outcome, particularly in Indonesia, is limited.

Purpose: This study aimed to measure the direct and indirect effects of father support throughout pregnancy on postpartum depression and breastfeeding weaning time, by considering potential mediating pathways and controlling for relevant sociodemographic variables.

Methods: Prospective observational techniques were employed from January to July 2021, involving 648 consecutively selected mothers attending antenatal care in seven health clinics in Makassar. Data collection included sociodemographic factors, father support, and breastfeeding weaning time. Father support was assessed using the Father Support During Pregnancy questionnaire, administered three times at a 72-hour interval. Postpartum depression was measured using the Edinburgh Postnatal Depression Scale while breastfeeding weaning time was quantified in weeks. The analysis included Spearman's correlation and SEM using SPSS and SPSS Amos.

Result: The study identified negative correlations between maternal breastfeeding weaning time and postpartum depression (r=-0.183, p<0.01) and positive correlations with father support (r=0.148, p<0.01), parity (r=-0.269, p<0.01), and marital age (r=0.187, p<0.01). The standardized model showed a marginal rise in the overall influence of father support, parity, and marital age on breastfeeding weaning time (0.256, 0.016, and 0.123, respectively). Father support emerged as the primary contributor to postpartum depression, inversely impacting breastfeeding duration. Higher father support correlated with lower maternal depression scores and longer.

Conclusion: This study highlights the role of father support in reducing impact of postpartum depression on breastfeeding duration. Future research should incorporate objective measures of father support and comprehensive assessments of confounding variables. Intervention studies are needed to evaluate promoting father involvement in prenatal, delivery, and postpartum care. Nurses can contribute by participating in interdisciplinary research and advocating for comprehensive assessment approaches.
Fulltext View|Download
Keywords: Breastfeeding; father support; postpartum depression; weaning

Article Metrics:

  1. Asadi, M., Noroozi, M., & Alavi, M. (2020). Factors affecting women’s adjustment to postpartum changes: A narrative review. Iranian Journal of Nursing and Midwifery Research, 25(6), 463. https://doi.org/10.4103/ijnmr.IJNMR_54_20
  2. Ayton, J. E., Tesch, L., & Hansen, E. (2019). Women’s experiences of ceasing to breastfeed: Australian qualitative study. BMJ Open, 9(5), e026234. https://doi.org/10.1136/bmjopen-2018-026234
  3. Bascom, E. M., & Napolitano, M. A. (2016). Breastfeeding duration and primary reasons for breastfeeding cessation among women with postpartum depressive symptoms. Journal of Human Lactation, 32(2), 282–291. https://doi.org/10.1177/0890334415619908
  4. Battle, C. L., Londono Tobon, A., Howard, M., & Miller, I. W. (2021). Father’s perspectives on family relationships and mental health treatment participation in the context of maternal postpartum depression. Frontiers in Psychology, 12, 705655. https://doi.org/10.3389/fpsyg.2021.705655
  5. Borra, C., Iacovou, M., & Sevilla, A. (2015). New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions. Maternal and Child Health Journal, 19(4), 897–907. https://doi.org/10.1007/s10995-014-1591-z
  6. Boyce, W. T., Essex, M. J., Alkon, A., Goldsmith, H. H., Kraemer, H. C., & Kupfer, D. J. (2006). Early father involvement moderates biobehavioral susceptibility to mental health problems in middle childhood. Journal of the American Academy of Child & Adolescent Psychiatry, 45(12), 1510–1520. https://doi.org/10.1097/01.chi.0000237706.50884.8b
  7. Bujang, M. A. (2021). A step-by-step process on sample size determination for medical research. The Malaysian Journal of Medical Sciences, 28(2), 15–27. https://doi.org/10.21315/mjms2021.28.2.2
  8. Chauhan, A., & Potdar, J. (2022). Maternal mental health during pregnancy: A critical review. Cureus, 14(10), e30656. https://doi.org/10.7759/cureus.30656
  9. da Silva, C. F., Nunes, L. M., Schwartz, R., & Giugliani, E. R. J. (2016). Effect of a pro-breastfeeding intervention on the maintenance of breastfeeding for 2 years or more: Randomized clinical trial with adolescent mothers and grandmothers. BMC Pregnancy and Childbirth, 16, 97. https://doi.org/10.1186/s12884-016-0878-z
  10. deMontigny, F., Gervais, C., Larivière-Bastien, D., & St-Arneault, K. (2018). The role of fathers during breastfeeding. Midwifery, 58, 6–12. https://doi.org/10.1016/j.midw.2017.12.001
  11. Dennis, C., & Ross, L. (2005). Relationships among infant sleep patterns, maternal fatigue, and development of depressive symptomatology. Birth, 32(3), 187–193. https://doi.org/10.1111/j.0730-7659.2005.00368.x
  12. Dias, C. C., & Figueiredo, B. (2015). Breastfeeding and depression: A systematic review of the literature. Journal of Affective Disorders, 171, 142–154. https://doi.org/10.1016/j.jad.2014.09.022
  13. Duan, Z., Wang, Y., Jiang, P., Wilson, A., Guo, Y., Lv, Y., Yang, X., Yu, R., Wang, S., Wu, Z., Xia, M., Wang, G., Tao, Y., Xiaohong, L., Ma, L., Shen, H., Sun, J., Deng, W., Yang, Y., & Chen, R. (2020). Postpartum depression in mothers and fathers: A structural equation model. BMC Pregnancy and Childbirth, 20, 537. https://doi.org/10.1186/s12884-020-03228-9
  14. Figueiredo, B., & Conde, A. (2011). Anxiety and depression symptoms in women and men from early pregnancy to 3-months postpartum: Parity differences and effects. Journal of Affective Disorders, 132(1-2), 146-157. https://doi.org/10.1016/j.jad.2011.02.007
  15. Gebregzabiherher, Y., Haftu, A., Weldemariam, S., & Gebrehiwet, H. (2017). The prevalence and risk factors for low birth weight among term newborns in Adwa General Hospital, Northern Ethiopia. Obstetrics and Gynecology International, 2017, 2149156. https://doi.org/10.1155/2017/2149156
  16. Gianni, M. L., Bettinelli, M. E., Manfra, P., Sorrentino, G., Bezze, E., Plevani, L., Cavallaro, G., Raffaeli, G., Crippa, B. L., Colombo, L., Morniroli, D., Liotto, N., Roggero, P., Villamor, E., Marchisio, P., & Mosca, F. (2019). Breastfeeding difficulties and risk for early breastfeeding cessation. Nutrients, 11(10), 2266. https://doi.org/10.3390/nu11102266
  17. Greenhill, E., & Vollmer, R. L. (2019). Perceptions of a father’s role during a couple’s first pregnancy. Family and Consumer Sciences Research Journal, 48(1), 52–64. https://doi.org/10.1111/fcsr.12327
  18. Hansen, E., Tesch, L., & Ayton, J. (2018). ‘They’re born to get breastfed’- how fathers view breastfeeding: A mixed method study. BMC Pregnancy and Childbirth, 18(1), 238. https://doi.org/10.1186/s12884-018-1827-9
  19. Henry, J. B., Julion, W. A., Bounds, D. T., & Sumo, J. (2020). Fatherhood matters: An integrative review of fatherhood intervention research. The Journal of School Nursing, 36(1), 19–32. https://doi.org/10.1177/1059840519873380
  20. Houghtaling, B., Byker Shanks, C., Ahmed, S., & Rink, E. (2018). Grandmother and health care professional breastfeeding perspectives provide opportunities for health promotion in an American Indian community. Social Science & Medicine, 208, 80–88. https://doi.org/10.1016/j.socscimed.2018.05.017
  21. Karande, S., & Perkar, S. (2012). Do fathers′ attitudes support breastfeeding? A cross-sectional questionnaire-based study in Mumbai, India. Indian Journal of Medical Sciences, 66(1–2), 30–39. https://doi.org/10.4103/0019-5359.110861
  22. Lee, S., & Kelleher, S. L. (2016). Biological underpinnings of breastfeeding challenges: The role of genetics, diet, and environment on lactation physiology. American Journal of Physiology - Endocrinology and Metabolism, 311(2), E405–E422. https://doi.org/10.1152/ajpendo.00495.2015
  23. Lima, K. S. V., Carvalho, M. M. de B., Lima, T. M. C., Alencar, D. de C., De Sousa, A. R., & Pereira, Á. (2021). Father’s participation in prenatal care and childbirth: Contributions of nurses’ interventions. Investigación y Educación En Enfermería, 39(2), e13. https://doi.org/10.17533/udea.iee.v39n2e13
  24. Martínez-García, M., Paternina-Die, M., Desco, M., Vilarroya, O., & Carmona, S. (2021). Characterizing the brain structural adaptations across the motherhood transition. Frontiers in Global Women’s Health, 2, 742775. https://doi.org/10.3389/fgwh.2021.742775
  25. Meltzer-Brody, S., Boschloo, L., Jones, I., Sullivan, P. F., & Penninx, B. W. (2013). The EPDS-lifetime: Assessment of lifetime prevalence and risk factors for perinatal depression in a large cohort of depressed women. Archives of Women’s Mental Health, 16(6), 465–473. https://doi.org/10.1007/s00737-013-0372-9
  26. Mossman, M., Heaman, M., Dennis, C. L., & Morris, M. (2008). The influence of adolescent mothers’ breastfeeding confidence and attitudes on breastfeeding initiation and duration. Journal of Human Lactation, 24(3), 268–277. https://doi.org/10.1177/0890334408316075
  27. Nabulsi, M., Hamadeh, H., Tamim, H., Kabakian, T., Charafeddine, L., Yehya, N., Sinno, D., & Sidani, S. (2014). A complex breastfeeding promotion and support intervention in a developing country: Study protocol for a randomized clinical trial. BMC Public Health, 14, 36. https://doi.org/10.1186/1471-2458-14-36
  28. Napso, T., Yong, H. E. J., Lopez-Tello, J., & Sferruzzi-Perri, A. N. (2018). The role of placental hormones in mediating maternal adaptations to support pregnancy and lactation. Frontiers in Physiology, 9, 01091. https://doi.org/10.3389/fphys.2018.01091
  29. Negin, J., Coffman, J., Vizintin, P., & Raynes-Greenow, C. (2016). The influence of grandmothers on breastfeeding rates: A systematic review. BMC Pregnancy and Childbirth, 16, 91. https://doi.org/10.1186/s12884-016-0880-5
  30. Negron, R., Martin, A., Almog, M., Balbierz, A., & Howell, E. A. (2013). Social support during the postpartum period: Mothers’ views on needs, expectations, and mobilization of support. Maternal and Child Health Journal, 17(4), 616–623. https://doi.org/10.1007/s10995-012-1037-4
  31. Onyeze-Joe, C., & Godin, I. (2020). Experiences, views and needs of first-time fathers in pregnancy-related care: A qualitative study in south-East Nigeria. BMC Pregnancy and Childbirth, 20, 213. https://doi.org/10.1186/s12884-020-02889-w
  32. Perrella, S. L., Dix-Matthews, A., Williams, J., Rea, A., & Geddes, D. T. (2022). Breastfeeding and maternal perceptions of infant sleep, settle and cry patterns in the first 9 months. International Journal of Environmental Research and Public Health, 19(20), 13098. https://doi.org/10.3390/ijerph192013098
  33. Philpott, L. F., Savage, E., FitzGerald, S., & Leahy-Warren, P. (2019). Anxiety in fathers in the perinatal period: A systematic review. Midwifery, 76, 54–101. https://doi.org/10.1016/j.midw.2019.05.013
  34. Poh, H. L., Koh, S. S. L., & He, H.-G. (2014). An integrative review of fathers’ experiences during pregnancy and childbirth. International Nursing Review, 61(4), 543–554. https://doi.org/10.1111/inr.12137
  35. Qi, W., Liu, Y., Lv, H., Ge, J., Meng, Y., Zhao, N., Zhao, F., Guo, Q., & Hu, J. (2022). Effects of family relationship and social support on the mental health of Chinese postpartum women. BMC Pregnancy and Childbirth, 22(1), 65. https://doi.org/10.1186/s12884-022-04392-w
  36. Rempel, L. A., Rempel, J. K., & Moore, K. C. J. (2017). Relationships between types of father breastfeeding support and breastfeeding outcomes. Maternal & Child Nutrition, 13(3), e12337. https://doi.org/10.1111/mcn.12337
  37. Rivi, V., Petrilli, G., & Blom, J. M. C. (2020). Mind the mother when considering breastfeeding. Frontiers in Global Women’s Health, 1, 3. https://doi.org/10.3389/fgwh.2020.00003
  38. Scarborough, J., Norman, A., & Cooper, L. (2022). The bidirectional relationship between breastfeeding and mental health. British Journal of Midwifery, 30(10), 554–562. https://doi.org/10.12968/bjom.2022.30.10.554
  39. Seth, S., Lewis, A. J., & Galbally, M. (2016). Perinatal maternal depression and cortisol function in pregnancy and the postpartum period: A systematic literature review. BMC Pregnancy and Childbirth, 16, 124. https://doi.org/10.1186/s12884-016-0915-y
  40. Surkan, P. J., Dong, L., Ji, Y., Hong, X., Ji, H., Kimmel, M., Tang, W.-Y., & Wang, X. (2019). Paternal involvement and support and risk of preterm birth: Findings from the Boston birth cohort. Journal of Psychosomatic Obstetrics and Gynaecology, 40(1), 48–56. https://doi.org/10.1080/0167482X.2017.1398725
  41. Syam, A., Ashar, H. M., Abrar, E. A., & Syam, A. (2022). Marital age, cigarette exposure, physical activity, sleep duration, and prenatal depression. Disease Prevention and Public Health Journal, 16(2), 127–137. https://doi.org/10.12928/dpphj.v16i2.5374
  42. Syam, A., Iskandar, I., Hendrarti, W., & Salam, A. (2021). Prenatal depression and successful lactation. Medicina Clínica Práctica, 4, 100234. https://doi.org/10.1016/j.mcpsp.2021.100234
  43. Syam, A., & Musni, M. (2022). Constructing instrument of fathers’ support during pregnancy. Jurnal Kesehatan Masyarakat, 18(2), 289–295. https://doi.org/10.15294/kemas.v18i2.35764
  44. Syam, A., Qasim, M., Kadrianti, E., & Kadir, A. (2021). Factor structure of the Edinburgh postnatal depression scale Indonesian version. Medicina Clínica Práctica, 4, 100238. https://doi.org/10.1016/j.mcpsp.2021.100238
  45. Szpunar, M. J., & Parry, B. L. (2017). A systematic review of cortisol, thyroid-stimulating hormone, and prolactin in peripartum women with major depression. Archives of Women’s Mental Health, 21(2), 140–161. https://doi.org/10.1007/s00737-017-0787-9
  46. Vischer, L. C., Heun, X., Steetskamp, J., Hasenburg, A., & Skala, C. (2020). Birth experience from the perspective of the fathers. Archives of Gynecology and Obstetrics, 302(5), 1297–1303. https://doi.org/10.1007/s00404-020-05714-z
  47. Vismara, L., Rollè, L., Agostini, F., Sechi, C., Fenaroli, V., Molgora, S., Neri, E., Prino, L. E., Odorisio, F., Trovato, A., Polizzi, C., Brustia, P., Lucarelli, L., Monti, F., Saita, E., & Tambelli, R. (2016). Perinatal parenting stress, anxiety, and depression outcomes in first-time mothers and fathers: A 3-to 6-months postpartum follow-up study. Frontiers in Psychology, 7, 938. https://doi.org/10.3389/fpsyg.2016.00938
  48. Wilson, K. R., & Prior, M. R. (2011). Father involvement and child well-being. Journal of Paediatrics and Child Health, 47(7), 405–407. https://doi.org/10.1111/j.1440-1754.2010.01770.x
  49. Xue, W. L., Shorey, S., Wang, W., & He, H.-G. (2018). Fathers’ involvement during pregnancy and childbirth: An integrative literature review. Midwifery, 62, 135–145. https://doi.org/10.1016/j.midw.2018.04.013
  50. Ystrom, E. (2012). Breastfeeding cessation and symptoms of anxiety and depression: A longitudinal cohort study. BMC Pregnancy and Childbirth, 12(1), 36. https://doi.org/10.1186/1471-2393-12-36

Last update:

No citation recorded.

Last update: 2024-12-20 11:03:10

No citation recorded.