Lactancia frustrada. Cuando la lactancia dura menos de lo deseado. Revisión sobre la experiencia materna de amamantar
Resumen Objetivo: A pesar del apoyo a la lactancia materna, muchas madres no logran amamantar como desean. Frecuentemente existen dificultades de lactancia, sentimientos de culpa, soledad y vergüenza y el cese de la lactancia se asocia en ocasiones con depresión. El objetivo es realizar una revisión sobre la relación entre la experiencia de lactancia y la salud mental materna y aportar recomendaciones a profesionales y familias. Material y métodos: Se realizó una revisión de la literatura publicada en PubMed (MEDLINE), Cochrane, APA PsycNet, PsycINFO, Enfispo y CINHAL con las palabras clave «maternal/motherhood», «experience breastfeeding», «guilt», «anxiety» y «depression». Resultados: La depresión o ansiedad materna se han relacionado con menores tasas de lactancia materna y la lactancia materna se ha identificado como factor protector contra la depresión. La falta de apoyo y la discordancia entre las expectativas y la experiencia real pueden asociarse a peor salud mental materna. Las intervenciones individualizadas e interdisciplinarias son más exitosas. Conclusiones: La asociación entre lactancia materna y depresión o ansiedad es inversa y bidireccional, y está influenciada por el apoyo social y las expectativas maternas. El puerperio es un periodo de especial vulnerabilidad, profesionales y familias deben ayudar a las madres evitando influir negativamente en su experiencia. Hacen falta más investigaciones sobre factores que condicionan la experiencia de lactancia y la eficacia de las intervenciones. La lactancia no es solo opción o responsabilidad de la madre, incumbe a toda la sociedad.
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2. Jackson L, De Pascalis L, Harrold J, Fallon V. Guilt, shame, and postpartum infant feeding outcomes: A systematic review. Matern Child Nutr. 2021;17(3):e13141.
3. Fernández IO, Ruiz-Berdún D, Requejo SV, Fernández IO, Ruiz-Berdún D, Requejo SV. La culpa de las madres. Promover la lactancia materna sin presionar a las mujeres. Dilemata. 2017;25:217-25.
4. Ayton JE, Tesch L, Hansen E. Women’s experiences of ceasing to breastfeed: Australian qualitative study. BMJ Open. 2019;9(5):e026234.
5. Wolf JB. Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign. J Health Polit Policy Law. 2007;32(4):595-636.
6. Gregory EF, Butz AM, Ghazarian SR, Gross SM, Johnson SB. Are unmet breastfeeding expectations associated with maternal depressive symptoms? Acad Pediatr. 2015;15(3):319-25.
7. Kristensen IH, Simonsen M, Trillingsgaard T, Pontoppidan M, Kronborg H. First-time mothers’ confidence mood and stress in the first months postpartum. A cohort study. Sex Reprod Healthc Off J Swed Assoc Midwives. 2018;17:43-9.
8. Nagata M, Nagai Y, Sobajima H, Ando T, Nishide Y, Honjo S. Maternity blues and attachment to children in mothers of full-term normal infants. Acta Psychiatr Scand. 2000;101(3):209-17.
9. Liu X, Wang S, Wang G. Prevalence and Risk Factors of Postpartum Depression in Women: A Systematic Review and Meta-analysis. J Clin Nurs. 2022;31(19-20):2665-77.
10. Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Womens Health Lond Engl. 2019;15:1745506519844044.
11. Madlala S, Kassier S. Antenatal and postpartum depression: effects on infant and young child health and feeding practices. South Afr J Clin Nutr. 2018;31(1):1-7.
12. Rahman A, Hafeez A, Bilal R, Sikander S, Malik A, Minhas F et al. The impact of perinatal depression on exclusive breastfeeding: a cohort study. Matern Child Nutr. 2016;12(3):452-62.
13. Tristão RM, Barbosa MP, Araújo T, Neiva ER, Costa KN, De Jesus JAL et al. Breastfeeding success and its relation to maternal pain, behaviour, mental health, and social support. J Reprod Infant Psychol. 2023;41(3):346-61.
14. Fallon V, Groves R, Halford JCG, Bennett KM, Harrold JA. Postpartum Anxiety and Infant-Feeding Outcomes. J Hum Lact Off J Int Lact Consult Assoc. 2016;32(4):740-58.
15. Fallon V, Bennett KM, Harrold JA. Prenatal Anxiety and Infant Feeding Outcomes: A Systematic Review. J Hum Lact Off J Int Lact Consult Assoc. 2016;32(1):53-66.
16. Hoff CE, Movva N, Rosen Vollmar AK, Pérez-Escamilla R. Impact of Maternal Anxiety on Breastfeeding Outcomes: A Systematic Review. Adv Nutr Bethesda Md. 1 de 2019;10(5):816-26.
17. Field T. Postnatal anxiety prevalence, predictors and effects on development: A narrative review. Infant Behav Dev.2018;51:24-32.
18. Oyetunji A, Chandra P. Postpartum stress and infant outcome: A review of current literature. Psychiatry Res. 2020;284:112769.
19. Jonas W, Mileva-Seitz V, Girard AW, Bisceglia R, Kennedy JL, Sokolowski M et al. Genetic variation in oxytocin rs2740210 and early adversity associated with postpartum depression and breastfeeding duration. Genes Brain Behav. 2013;12(7):681-94.
20. Nagel EM, Howland MA, Pando C, Stang J, Mason SM, Fields DA et al. Maternal Psychological Distress and Lactation and Breastfeeding Outcomes: a Narrative Review. Clin Ther. 2022;44(2):215-27.
21. Haas DM, Yang Z, Parker CB, Chung J, Parry S, Grobman WA et al. Factors associated with duration of breastfeeding in women giving birth for the first time. BMC Pregnancy Childbirth. 2022;22(1):722.
22. Keller N, Medved V, Armano G. The Influence of Maternal Personality and Risk Factors for Impaired Mother-Infant Bonding on Breastfeeding Duration. Breastfeed Med Off J Acad Breastfeed Med. 2016;11:532-7.
23. Brown A. Maternal trait personality and breastfeeding duration: the importance of confidence and social support. J Adv Nurs. 2014;70(3):587-98.
24. Eagen-Torkko M, Low LK, Zielinski R, Seng JS. Prevalence and Predictors of Breastfeeding After Childhood Abuse. J Obstet Gynecol Neonatal Nurs JOGNN. 2017;46(3):465-79.
25. Robbins CL, Zapata LB, D’Angelo D, Brewer LI, Pazol K. Pregnancy intention: Associations with maternal behaviors and experiences during and after pregnancy. J Womens Health. 2021;30(10):1440-7.
26. Yuen M, Hall OJ, Masters GA, Nephew BC, Carr C, Leung K et al. The Effects of Breastfeeding on Maternal Mental Health: A Systematic Review. J Womens Health 2002. 2022;31(6):787-807.
27. Gust K, Caccese C, Larosa A, Nguyen TV. Neuroendocrine Effects of Lactation and Hormone-Gene-Environment Interactions. Mol Neurobiol. abril de 2020;57(4):2074-84.
28. Kendall-Tackett K. The new paradigm for depression in new mothers: current findings on maternal depression, breastfeeding and resiliency across the lifespan. Breastfeed Rev Prof Publ Nurs Mothers Assoc Aust. 2015;23(1):7-10.
29. Yusuff ASM, Tang L, Binns CW, Lee AH. Breastfeeding and Postnatal Depression: A Prospective Cohort Study in Sabah, Malaysia. J Hum Lact Off J Int Lact Consult Assoc. 2016;32(2):277-81.
30. Cooklin AR, Amir LH, Nguyen CD, Buck ML, Cullinane M, Fisher JRW et al. Physical health, breastfeeding problems and maternal mood in the early postpartum: a prospective cohort study. Arch Womens Ment Health. 2018;21(3):365-74.
31. Whittingham K, Mitchell AE. Postnatal traumatic symptoms and shame: A cross-sectional study examining the role of birth, breastfeeding, psychological flexibility and self-compassion. J Context Behav Sci. 2023;28:248-55.
32. Mangrio E, Persson K, Bramhagen AC. Sociodemographic, physical, mental and social factors in the cessation of breastfeeding before 6 months: a systematic review. Scand J Caring Sci. 2018;32(2):451-65.
33. Beijers R, Riksen-Walraven JM, de Weerth C. Cortisol regulation in 12-month-old human infants: Associations with the infants’ early history of breastfeeding and co-sleeping. Stress Int J Biol Stress. 2013;16(3):267-77.
34. Pezley L, Cares K, Duffecy J, Koenig MD, Maki P, Odoms-Young A et al. Efficacy of behavioral interventions to improve maternal mental health and breastfeeding outcomes: a systematic review. Int Breastfeed J. 2022;17(1):67.
35. Spinelli MG, Endicott J, Goetz RR. Increased breastfeeding rates in black women after a treatment intervention. Breastfeed Med Off J Acad Breastfeed Med. 2013;8(6):479-84.
36. Mohd Shukri NH, Wells J, Eaton S, Mukhtar F, Petelin A, Jenko-Pražnikar Z et al. Randomized controlled trial investigating the effects of a breastfeeding relaxation intervention on maternal psychological state, breast milk outcomes, and infant behavior and growth. Am J Clin Nutr. 2019;110(1):121-30.
37. Shamsdanesh S, Nourizadeh R, Hakimi S, Ranjbar F, Mehrabi E. The effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy during COVID-19 pandemic: a ramdomized controlled trial. BMC Pregnancy Childbirth. 2023;23(1):26.
38. Ahmed AH, Roumani AM, Szucs K, Zhang L, King D. The Effect of Interactive Web-Based Monitoring on Breastfeeding Exclusivity, Intensity, and Duration in Healthy, Term Infants After Hospital Discharge. J Obstet Gynecol Neonatal Nurs JOGNN. 2016;45(2):143-54.
39. Zhao Y, Lin Q, Zhu X, Wang J. Randomized Clinical Trial of a Prenatal Breastfeeding and Mental Health Mixed Management Intervention. J Hum Lact Off J Int Lact Consult Assoc. 2021;37(4):761-74.
40. Wong MS, Chien WT. A Pilot Randomized Controlled Trial of an Online Educational Program for Primiparous Women to Improve Breastfeeding. J Hum Lact Off J Int Lact Consult Assoc. 2023;39(1):107-18.
41. Patnode CD, Henninger ML, Senger CA, Perdue LA, Whitlock EP. Primary Care Interventions to Support Breastfeeding: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2016;316(16):1694-705.
42. Gavine A, Shinwell SC, Buchanan P, Farre A, Wade A, Lynn F et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2022;10(10):CD001141.
43. McCarter D, Law AA, Cabullo H, Pinto K. Scoping Review of Postpartum Discharge Education Provided by Nurses. J Obstet Gynecol Neonatal Nurs JOGNN. 2022;51(4):377-87.
44. Zanardo V, Bertin M, Sansone L, Felice L. The adaptive psychological changes of elective induction of labor in breastfeeding women. Early Hum Dev. 2017;104:13-6.
45. Bradshaw L, Sawyer A, Armstrong-Buisseret L, Mitchell E, Ayers S, Duley L. Cord pilot trial, comparing alternative policies for timing of cord clamping before 32 weeks gestation: follow-up for women up to one year. BMC Pregnancy Childbirth. 2019;19(1):78.
46. Norholt H. Revisiting the roots of attachment: A review of the biological and psychological effects of maternal skin-to-skin contact and carrying of full-term infants. Infant Behav Dev. 2020;60:101441.
47. Da Silva Tanganhito D, Bick D, Chang YS. Breastfeeding experiences and perspectives among women with postnatal depression: A qualitative evidence synthesis. Women Birth J Aust Coll Midwives. 2020;33(3):231-9.
48. Leeming D, Marshall J, Hinsliff S. Self-conscious emotions and breastfeeding support: A focused synthesis of UK qualitative research. Matern Child Nutr. 2022;18(1):e13270.
49. Cortés-Rúa L, Díaz-Grávalos GJ. Interrupción temprana de la lactancia materna. Un estudio cualitativo. Enferm Clínica. 2019;29(4):207-15.
50. Constantinou G, Varela S, Buckby B. Reviewing the experiences of maternal guilt – the «Motherhood Myth» influence. Health Care Women Int. 2021;42(4-6):852-76.
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