Maternal extraversion, emotional stability and conscientiousness are associated with initiation and continuation of breastfeeding
- Correspondence to: Professor Debra Bick, King's College London, Florence Nightingale School of Nursing and Midwifery, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK;
Implications for practice and research
Understanding maternal trait personality could inform targeted interventions for women identified as requiring additional breastfeeding support and help to facilitate discussion of barriers to breastfeeding.
Further research is needed to explore the impact of maternal personality on effectiveness of interventions designed to increase coping strategies and influence of social networks among women who wish to start and continue to breastfeed.
It is well established that influences on breastfeeding initiation and duration are multifactorial. These include sociodemographic factors, environmental context, maternal confidence and self-efficacy, social and emotional support, personality and beliefs about benefits of breastfeeding.1–3 Although some empirical studies have suggested that personality is associated with infant-feeding decisions, these have tended to be small-scale, undertaken in non-UK populations and limited to breastfeeding intent.2 ,3 This exploratory study conducted in the UK by Brown examined associations between maternal personality and attitudes, breastfeeding initiation and duration, and experiences of breastfeeding.
A cross-sectional survey approach was used. A self-selected sample of 602 women with infants aged 6–12 months completed self-report inventories on personality and attitudes towards breastfeeding. Women were recruited from local mother and baby groups, or via adverts placed on online parenting forums in the UK. Participants were asked to self-report duration of breastfeeding, with those who breastfed for less than 6 months asked to indicate reasons for stopping from a series of questions examining why. Participants’ demographic information including age, education, marital status, occupation and parity (eg, primiparity) was also collected. An exploratory factor analysis was used to identify key themes. Further analyses were used to determine which variables should be retained for entry into a multiple analysis of variance. Data were transformed to enable parametric rather than non-parametric tests to be run, although some aspects of the data indicated that without transformation they did not meet accepted criteria for parametric tests.
Maternal personality trait was associated with breastfeeding initiation and duration. Women who were introverted or had high levels of trait anxiety were less likely to initiate and continue breastfeeding. Maternal introversion and anxiety may affect women's ability to breastfeed successfully. These personality traits were associated with social and psychological variables known to predict low breastfeeding duration. For example, women self-reported to have high levels of introversion were more likely to stop breastfeeding because of feeling embarrassed, or feeling pressured by others to stop breastfeeding.
This was an exploratory cross-sectional study and caution should be applied to findings. Nevertheless, some important issues were raised with respect to the potential influence of maternal personality traits on infant feeding decisions.
The study included a reasonably large sample of women, although participants were self-selected and did not appear to be representative of a cross-section of UK women. The personality inventory also required self-report. These aspects may limit the reliability of information provided, as women who breastfed or experienced breastfeeding difficulties may have been more likely to participate in the study. Moreover, the author did not include measures of other factors which could have acted as confounders on outcomes over time, such as maternal mental and physical health and perceived level of social support—factors which may be associated with higher levels of anxiety.
The statistical analyses seemed thorough, although the number of corrections for skew and the need for some data to be transformed may limit the reliability of findings. While future research should consider including these measures, it would also seem important to include trained researchers’ observations to determine women's personality traits. The translation and implementation of findings into practice would have to be considered, as would potential for such an intervention to influence other aspects of maternal health behaviour, including smoking and diet, as well as potential to generate further introversion and anxiety if women feel under pressure to breastfeed.
Overall this was an interesting study in a complex health area, but more work is needed to find out how reliable personality measurements are, and whether current study findings could be replicated in a larger, more representative sample of women. It is also important to consider how women who were more anxious and introverted could be effectively helped to develop positive attitudes towards breastfeeding, taking experiences and social environment into consideration.