Published online May 1, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. 1860-1861 (doi:10.1542/peds.2006-0474)
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Maternal Anxiety Impairs Lactation Initiation and Maintenance: In Reply

Cheryl A. Lovelady, PhD
Department of Nutrition

Kenneth J. Gruber, PhD
School of Human Environmental Sciences
University of North Carolina
Greensboro, NC 27402-6170

Paula M. Sisk, PhD
Department of Pediatrics

Robert G. Dillard, MD
Wake Forest University School of Medicine
Winston-Salem, NC 27157-1001

In Reply.—

We thank Zanardo et al for their interest in our study. There are several differences between our study and the study being conducted by them. Zanardo et al measured stress before discharge by using the State-Trait Anxiety Inventory1 in mothers of term infants. They reported that state anxiety levels of mothers were inversely correlated to the breastfeeding rate on the third and sixth postnatal months. No relationship was found between breastfeeding duration and maternal anxiety trait scores.

All participants in our study were mothers of very low birth weight infants and probably under more stress than mothers of term infants.2 Furthermore, we measured human milk volume received by the infants during hospitalization, not duration of breastfeeding. We did not find a correlation between state anxiety scores of mothers, regardless of their feeding plan before lactation counseling, and the amount of milk consumed by their infants. However, we did observe an inverse relationship between maternal anxiety trait and the amount of human milk that the infants received (r = –0.13; P = .01). The more anxious the mother reported herself normally to be, the lower the amount of human milk received by the infant. Despite the differences in these 2 studies, the conclusions are the same. Mothers under stress benefit from lactation counseling, and this counseling does not increase their anxiety.

REFERENCES

  1. Spielbergher C. Manual for the State-Trait Anxiety Inventory for Adults. Redwood City, CA: Mind Garden; 1983
  2. Sisk PM, Lovelady CA, Dillard RG, Gruber KJ. Lactation counseling for mothers of very low birth weight infants: effect on maternal anxiety and infant intake of human milk. Pediatrics. 2005;117(1) . Available at: www.pediatrics.org/cgi/content/full/117/1/e67
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics

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