Psychosocial aspects of breastfeeding initiation in perinatal care

Lea Takács, Eliška Kodyšová, Kateřina Kejřová, Martina Bartošová


This study identifies major psychosocial determinants of perinatal care that can foster or inhibit successful breastfeeding initiation. Using statistical data analysis of a questionnaire survey with 199 primiparae and content analysis of semi-structured interviews with 18 primiparae and multiparae, it was found that the quality of breastfeeding is determined mainly by the postnatal ward atmosphere as perceived by the woman, the hospital staff attitude (ability to empathize, psychological support, and communication quality) and active offering of help by the staff. The breastfeeding support provided to women in perinatal healthcare should therefore focus both on compliance with the 10 steps for successful breastfeeding (on the basis of which the hospitals are certified as Baby Friendly Hospitals) as well as on meeting the psychological needs of women in the postnatal period.

(Fulltext in Czech)


perinatal psychology, healthcare communication, healthcare satisfaction, breastfeeding


Akman, İ., Kuscu, M. K., Yurdakul, Z., Özdemir, N., Solakoğlu, M., Orhon, L., Karabekiroğlu, A. & Özek, E. (2008). Breastfeeding duration and postpartum psychological adjustment: Role of maternal attachment styles. Journal of Paediatrics and Child Health, 44, 369–373.

Altemus, M., Deuster, P. A., Galliven, E., Carter, C. S. & Gold, P. W. (1995). Suppression of hypothalmic-pituitary-adrenal axis responses to stress in lactating women. Journal of Clinical Endocrinology & Metabolism, 80, 2954–2959.

Bailey, J., Clark, M. & Shepherd, R. (2008). Duration of breastfeeding in young women: psychological influences. British Journal of Midwifery, 16, 3, 172–178.

Blyth, R., Creedy, D. K., Dennis, C., Moyle, W., Pratt, J. & De Vries, S.M. (2002). Effect of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory. Birth, 29, 4, 278–284.

Dermer, A. (2001). A well-kept secret breastfeeding’s be­nefits to mothers. New Beginnings, 18, 4, 124–127.

Dewey, K. G. (2001). Maternal and fetal stress are associated with impaired lactogenesis. Journal of Nutrition, 131, 3012–3015.

Dewey, K. G., Nommsen-Rivers, L. A., Heinig, M. J., Cohen, R. J. & Vestermark, P. (2003). Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics, 112, 3, 607–19.

Donath, S. M. & Amir, L. H. (2003). Relationship between prenatal infant feeding intention and initiation and duration of breastfeeding: A cohort study. Acta Paediatrica, 92, 3, 352–356.

Earle, S. (2002). Factors affecting the initiation of breastfeeding: implications for breastfeeding promotion. Health Promotion International, 17, 3, 205–214.

Enkin, M., Keirse, M. J. N. C., Renfrew, M. & Nielson, J. (1998). Efektivní péče v perinatologii. Praha: Grada.

Ford, R. P., Taylor, B. J., Mitchell, E. A., Enright, S. A., Becroft, D. M., Scragg, R., Hassal, I. B., Barry, D. M. & Alen, E. M. (1993). Breastfeeding and the risk of sudden infant death syndrome. International Journal of Epidemiology, 22, 5, 885–90.

Forster, D. A. & McLachlan, H. (2007). Breastfeeding initiation and birth setting practices: A review of the literature. Journal of Midwifery and Women’s Health, 52, 3, 273–280.

Goldman, A. S. (1993). The immune system of human milk: antimicrobial, antiinflammatory and immunomodulating properties. Pediatric Infectious Disease Journal, 12, 8, 664–672.

Grajeda, R. & Perez-Escamilla, R. (2002). Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women. Journal of Nutrition, 132, 10, 3055–3060.

Howie, P. W., Forsyth, J. S., Ogston, S. A., Clark, A. & Florey, C. D. (1990). Protective effect of breast feeding against infection. British Medical Journal, 300, 6716, 11–16.

Chen, D. C., Nommsen-Rivers, L., Dewey, K. G., Lönnerdal, B. (1998). Stress during labor and delivery and early lactation performance. American Journal of Clinical Nutrition, 68, 335–344.

Chien, L. & Tai, C. (2007). Effect of delivery method and timing of breastfeeding initiation on breastfeeding outcomes in Taiwan. Birth, 34, 2, 123–130.

Klaus, M., Kennel, J. & Klaus, P. (2003). Mothering the mother. Reading: Addison Wesley Publishing.

Kroeger, M. (2004). Impact of birthing practices on breastfeeding: protecting the mother-baby continuum. Sudbury: Jones and Bartlett.

Kruse, L., Denk, C. E., Feldman-Winter, L. & Mojta Rotondo, F. (2005). Comparing sociodemographic and hospital influences on breastfeeding initiation. Birth, 32, 81–85.

Kuan, L. W., Britto, J. D., Schoettker, P. J., Atherton, H. D. & Kotagol, U. R. (1999). Health system factors contributing to breastfeeding success. Pediatrics, 104, 3, 28–35.

Kuzela, A., Stifter, C. & Worobey, J. (1990). Breastfeeding and mother-infant interactions. Journal of Reproductive and Infant Psychology, 8, 185–94. Labbok, M. (2001). Effects of breastfeeding on the mother. Pediatric Clinics of North America, 48, 1, 143–158.

Langer, A., Campero, L., Garcia, C. & Reynoso, S. (1998). Effects of psychosocial support during labour and childbirth on breastfeeding, medical interventions, and mothers’ wellbeing in a Mexican public hospital: a randomised clinical trial. BJOG: An International Journal of Obstetrics & Gynaecology, 105, 10, 1056–1063.

Lavelli, M. & Poli, M. (1998). Early mother-infant interaction during breast- and bottle-feeding. Infant Behavior and Development, 21, 4, 667–683.

Lederman, R., Lederman, E. & Work, B. (1978). The relationship of maternal anxiety, plasma catecholamines and plasma cortisol to progress in labor. American Journal of Obstetrics and Gynecology, 132, 5, 495–499.

Mårild, S., Hansson, S., Jodal, U., Odén, A. & Svedberget, K. (2004). Protective effect of breastfeeding against urinary tract infection. Acta Paediatrica Scandinavia, 93, 2, 164–168.

Morhason-Bello, I. O., Babatunde, O. A. & Oladosu, A. O. (2009). Social support during childbirth as a catalyst for early breastfeeding initiation for first-time Nigerian mothers. International Breastfeeding Journal, 4–16.

Mydlilová, A. Jen deset kroků. (Tisková zpráva ke Světovému a Českému týdnu kojení v září 2010) [online]. In Laktační liga, c2010 [cit. 2010–11–19]. Dostupné z www: <…a_zprava.doc>

Mydlilová, A., Šípek, A. & Wiesnerová, J. (2008). Vliv některých faktorů na počet kojených dětí při propuštění z porodnice v letech 2000 až 2004 v ČR. Česko-slovenská pediatrie, 63, 4, 182–191.

Patel, R., Liebling, R., Murphy, D. (2003). Effect of operative delivery in the second stage of labor on breastfeeding success. Birth, 30, 4, 255–260. Rey, J. (2003). Breastfeeding and cognitive development. Acta Pædiatrica, 92, 11–18.

Righard, L. R. (1990). Effect of delivery room routines on success of first breast-feed. The Lancet, 336, 8723, 1105–1107.

Rowe-Murray, H. J. & Fisher, J. R. (2002). Baby friendly hospital practices: cesarean section is a persistent barrier to early initiation of breastfeeding. Birth, 29, 2, 124–131.

Sadauskaitė-Kuehne, V., Ludvigsson, J., Padaiga, Ž., Jašinskienė, E. & Samuelsson, U. (2004). Longer breastfeeding is an independent protective factor against development of type 1 diabetes mellitus in childhood. Diabetes/Metabolism Research and Reviews, 20, 2, 150–157.

Šulová, L. (2005). Raný psychický vývoj dítěte. Praha: Karolinum.

Takács, L., Kodyšová, E., Kejřová, K. & Bartošová, M. (2011). Psychosociální klima porodnice a jeho vliv na emoční pohodu rodičky. Psychologie pro praxi, 3–4, v tisku.

Wells, K. J., Thompson, N. J. & Kloeblen-Tarver, A. S. (2006). Development and psychometric testing of the prenatal breastfeeding self-efficacy scale. American Journal of Health Behavior, 30, 2, 177–187.

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