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- Cato, Karin, 1977-, et al.
(författare)
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Antenatal depressive symptoms and early initiation of breastfeeding in association with exclusive breastfeeding six weeks postpartum : a longitudinal population-based study
- 2019
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDepressive symptoms negatively impact on breastfeeding duration, whereas early breastfeeding initiation after birth enhances the chances for a longer breastfeeding period. Our aim was to investigate the interplay between depressive symptoms during pregnancy and late initiation of the first breastfeeding session and their effect on exclusive breastfeeding at six weeks postpartum.MethodsIn a longitudinal study design, web-questionnaires including demographic data, breastfeeding information and the Edinburgh Postnatal Depression Scale (EPDS) were completed by 1217 women at pregnancy weeks 17–20, 32 and/or at six weeks postpartum. A multivariable logistic regression model was fitted to estimate the effect of depressive symptoms during pregnancy and the timing of the first breastfeeding session on exclusive breastfeeding at six weeks postpartum.ResultsExclusive breastfeeding at six weeks postpartum was reported by 77% of the women. Depressive symptoms during pregnancy (EPDS> 13); (OR:1.93 [1.28–2.91]) and not accomplishing the first breastfeeding session within two hours after birth (OR: 2.61 [1.80–3.78]), were both associated with not exclusively breastfeeding at six weeks postpartum after adjusting for identified confounders. Τhe combined exposure to depressive symptoms in pregnancy and late breastfeeding initiation was associated with an almost 4-fold increased odds of not exclusive breastfeeding at six weeks postpartum.ConclusionsWomen reporting depressive symptoms during pregnancy seem to be more vulnerable to the consequences of a postponed first breastfeeding session on exclusive breastfeeding duration. Consequently, women experiencing depressive symptoms may benefit from targeted breastfeeding support during the first hours after birth.
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| 2. |
- Cato, Karin, 1977-, et al.
(författare)
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Risk factors for exclusive breastfeeding lasting less than two months-Identifying women in need of targeted breastfeeding support
- 2017
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 12:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breastfeeding rates in Sweden are declining, and it is important to identify women at risk for early cessation of exclusive breastfeeding.Objective: The aim of this study was to investigate factors associated with exclusive breastfeeding lasting less than two months postpartum.Methods: A population-based longitudinal study was conducted at Uppsala University Hospital, Sweden. Six hundred and seventy-nine women were included in this sub-study. Questionnaires were sent at five days, six weeks and six months postpartum, including questions on breastfeeding initiation and duration as well as several other background variables. The main outcome measure was exclusive breastfeeding lasting less than two months postpartum. Multivariable logistic regression analysis was used in order to calculate adjusted Odds Ratios (AOR) and 95% Confidence Intervals (95% CI).Results: Seventy-seven percent of the women reported exclusive breastfeeding at two months postpartum. The following variables in the multivariate regression analysis were independently associated with exclusive breastfeeding lasting less than two months postpartum: being a first time mother (AOR 2.15, 95% CI 1.32 +/- 3.49), reporting emotional distress during pregnancy (AOR 2.21, 95% CI 1.35 +/- 3.62) and giving birth by cesarean section (AOR 2.63, 95% CI 1.34 +/- 5.17).Conclusions: Factors associated with shorter exclusive breastfeeding duration were determined. Identification of women experiencing emotional distress during pregnancy, as well as scrutiny of caregiving routines on cesarean section need to be addressed, in order to give individual targeted breastfeeding support and promote longer breastfeeding duration.
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| 3. |
- Cato, Karin, 1977-, et al.
(författare)
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Breastfeeding as a balancing act - Pregnant Swedish women's voices on breastfeeding
- 2020
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Ingår i: International Breastfeeding Journal. - : Springer Science and Business Media LLC. - 1746-4358. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breastfeeding provides health benefits to both women and children. The rationale behind an individual woman's decision to breastfeed or not can depend on several factors, either independently or in combination. The aim of the current study was to explore attitudes towards breastfeeding among pregnant women in Sweden who intend to breastfeed. Methods: Eleven mothers-to-be, one of whom had previous breastfeeding experience, participated in the study. The women were interviewed either by telephone or face-to-face during late pregnancy, with the aim of exploring their attitudes towards breastfeeding. A semi-structured interview-guide was used, and the transcripts of the interviews were analyzed using thematic analysis. The social ecological model of health is the theory-based framework underpinning this study. The model provides a comprehensive approach to understanding the factors that influence breastfeeding intention. Results: When interviewed during pregnancy, women described breastfeeding as a balancing act between societal norms and personal desires. The women perceived a societal pressure to breastfeed, however it was accompanied by boundaries and mixed messages. This perceived pressure was balanced by their own knowledge of breastfeeding, in particular their knowledge of other women's experience of breastfeeding. When envisioning their future breastfeeding, the women made uncertain and preliminary plans, and negotiated the benefits and drawbacks of breastfeeding. There was a wish for individual breastfeeding support and information. Conclusions: Pregnant Swedish women perceive their future breastfeeding as a balancing act between societal norms and personal desires. These findings suggest that while discussing breastfeeding during pregnancy, it could be of interest to collect information from pregnant women on their knowledge of breastfeeding and from where they have gained this knowledge, since stories from family and friends may make them question their own capacity to breastfeed. A thorough review of the woman's experiences and attitudes of breastfeeding is important in order to offer the best evidence-based breastfeeding support.
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| 4. |
- Cato, Karin, 1977-
(författare)
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Breastfeeding – Initiation, duration, attitudes and experiences
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to increase knowledge about factors that influence breastfeeding initiation and duration, as well as about women’s attitudes towards breastfeeding during pregnancy.The first two studies were a part of the UPPSAT project, a population-based cohort study conducted in Uppsala, Sweden. The women answered questionnaires five days, six weeks and six months postpartum, including questions on breastfeeding initiation and duration. Eight hundred and seventy-nine women and 679 women were included in the first study (Paper I) and second study (Paper II), respectively. The third study (Paper III) was part of the BASIC study, a large cohort following women from pregnancy and up to one year postpartum. In BASIC, the women completed web-questionnaires, and 1217 women participated during mid-pregnancy and postpartum. The fourth study (Paper IV) was part of a qualitative project, “Narratives of breastfeeding”, and included 11 women, interviewed individually in late pregnancy.The prevalence of the hands-on approach was 38%. Women who received the hands-on approach were more likely to report a negative experience of the first breastfeeding session (Paper I). Seventy-seven percent of the women reported exclusive breastfeeding up to, at least, two months postpartum. Being a first-time mother, reporting emotional distress during pregnancy, and giving birth by cesarean section were factors independently associated with exclusive breastfeeding lasting less than two months postpartum (Paper II). Women with depressive symptoms during pregnancy who breastfed for the first time later than two hours postpartum had the highest odds of not breastfeeding exclusively at six weeks postpartum (Paper III). When pregnant women thought about their future breastfeeding, they were balancing between social norms and personal desires (Paper IV).These results can help to develop clinical practice to improve women’s experience of the first breastfeeding session. Additionally, the results may facilitate identifying women in need for targeted support, in order to promote longer exclusive breastfeeding duration. By acknowledging pregnant women’s thoughts and attitudes about breastfeeding, breastfeeding information and support, health care professionals can meet the needs and desires of women.
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| 5. |
- Cato, Karin, et al.
(författare)
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Experience of the First Breastfeeding Session in Association with the Use of the Hands-On Approach by Healthcare Professionals : A Population-Based Swedish Study
- 2014
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Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert Inc. - 1556-8253 .- 1556-8342. ; 9:6, s. 294-300
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to investigate the prevalence of healthcare professionals' use of the hands-on approach during the first breastfeeding session postpartum and its possible association with the mothers' experience of their first breastfeeding session. Materials and Methods: This was a population-based longitudinal study conducted at Uppsala University Hospital, Uppsala, Sweden, of all women giving birth at the hospital from May 2006 to June 2007. Six months postpartum, a questionnaire including questions regarding breastfeeding support, caregiving routines, depressive symptoms, and the woman's experience of the first breastfeeding session was sent to the mothers. The main outcome measures were use of the hands-on approach during the first breastfeeding session and the mother's experience of the breastfeeding session. Results: In total, 879 women participated in the study. Thirty-eight percent of the women received the hands-on approach during the first breastfeeding session. High body mass index, primiparity, and having the first breastfeeding session postponed were all independently associated with the hands-on approach. Women who received the hands-on approach were more likely to report a negative experience of the first breastfeeding session (odds ratio = 4.48; 95% confidence interval, 2.57-7.82), even after adjustment for possible confounders (odds ratio = 2.37; 95% confidence interval, 1.02-5.50). Conclusions: This study indicates that the hands-on approach is commonly used during the first breastfeeding session and is associated with a more negative experience of the first breastfeeding session. Consequently, caregivers need to question the use of this method, and further research about breastfeeding support is required.
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| 6. |
- Cato, Karin, 1977-, et al.
(författare)
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Instrument development and an intervention to increase parents' self-efficacy regarding their infant's sleep
- 2024
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveMany Swedish parents experience that their infant has sleeping problems. Parents’ self-efficacy regarding their infants’ sleep may play an important role in how they perceive these problems. This pilot study aimed to develop an instrument measuring parents’ self-efficacy regarding their infant’s sleep and to examine if parents’ self-efficacy was affected by an intervention focusing on parental education.MethodMothers and fathers, at a maternity unit in Sweden, were drawn into either an intervention (n = 46) or a control (n = 42) group. The intervention group received a home visit from a nurse who provided information about infant sleep; the importance of attachment; and advice regarding sleep, breastfeeding and bed sharing, including guidelines for safe bed sharing. Three months later, the participants answered questions on background data, breastfeeding, sleep and self-efficacy.ResultsThe 11-item two-factor Uppsala Parental Self-Efficacy about Infant Sleep Instrument (UPPSEISI) was constructed to measure parents’ perceived self-efficacy. In adjusted analyses, being in the intervention group was associated with a higher self-efficacy (P = 0.035), as were being a mother (P = 0.003) and being satisfied with one’s own sleep (P = 0.007), while parents’ own sleeping problems were associated with a lower self-efficacy (P = 0.015).ConclusionImportantly, parental education may increase parents’ self-efficacy regarding their infant’s sleep.
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| 7. |
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| 8. |
- Cato, Karin, 1977-
(författare)
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The first breastfeeding session: studies on caregivers' support and breastfeeding duration
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- AbstractCato, K. 2015 The first breastfeeding session: studies on caregivers’ support and breastfeeding duration. 33pp. Uppsala. ISBN 978-91-506-2494-6 It is well-known that the first breastfeeding session can be essential for breastfeeding duration. The hands-on approach given by health care professionals, where health care professionals touch the woman’s breast and the baby in order to stimulate latch on and breastfeeding, has been described as awkward and disturbing. The aim of this thesis was to increase knowledge on the first breastfeeding session postpartum, as to frequency and experience of the hands-on approach, and possible correlates of shorter breastfeeding duration. Questionnaires were sent five days, six weeks and six months postpartum, including questions regarding breastfeeding initiation and duration. Eight hundred and fifty-four women and 679 women were included in Study I and Study II, respectively. The prevalence of the hands-on approach was 38%. Women who received the hands-on approach were more likely to report a negative experience of the first breastfeeding session (Study I). Seventy-seven percent of the women reported exclusive breastfeeding at two months postpartum. Being a first time mother, reporting emotional distress during pregnancy and giving birth by cesarean section were factors independently associated with exclusive breastfeeding less than two months postpartum (Study II). These results can help to develop clinical practice, in order to improve women’s experience of the first breastfeeding session and identifying women in need of targeted, individualized support, to be able to promote longer exclusive breastfeeding duration.
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