Guilt, shame, and postpartum infant feeding outcomes: A systematic review

Jackson, Leanne, De Pascalis, Leonardo ORCID: 0000-0002-9150-3468, Harrold, Jo ORCID: 0000-0002-0899-4586 and Fallon, Victoria ORCID: 0000-0002-7350-2568 (2021) Guilt, shame, and postpartum infant feeding outcomes: A systematic review. MATERNAL AND CHILD NUTRITION, 17 (3). e13141-.

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Official URL: http://dx.doi.org/10.1111/mcn.13141

Abstract

Negative maternal affect (e.g., depression and anxiety) has been associated with shorter breastfeeding duration and poorer breastfeeding intention, initiation, and exclusivity. Other affective states, including guilt and shame, have been linked with formula feeding practice, though existing literature has yet to be synthesised. A narrative synthesis of quantitative data and a framework synthesis of qualitative and quantitative data were conducted to explore guilt and/or shame in relation to infant feeding outcomes. Searches were conducted on the DISCOVER database between December 2017 and March 2018. The search strategy was rerun in February 2020, together yielding 467 studies. The study selection process identified 20 articles, published between 1997 and 2017. Quantitative results demonstrated formula feeders experienced guilt more commonly than breastfeeding mothers. Formula feeders experienced external guilt most commonly associated with healthcare professionals, whereas breastfeeding mothers experienced guilt most commonly associated with peers and family. No quantitative literature examined shame in relation to infant feeding outcomes, warranting future research. The framework synthesis generated four distinct themes which explored guilt and/or shame in relation to infant feeding outcomes: 'underprepared and ineffectively supported', 'morality and perceived judgement' (breastfeeding), 'frustration with infant feeding care' and 'failures, fears and forbidden practice' (formula feeding). Both guilt and shame were associated with self-perception as a bad mother and poorer maternal mental health. Guilt and shame experiences were qualitatively different in terms of sources and outcomes, dependent on infant feeding method. Suggestions for tailored care to minimise guilt and shame, while supporting breastfeeding, are provided.

Item Type:	Article
Uncontrolled Keywords:	breastfeeding, infant feeding, infant formula, maternal mental health, postpartum, systematic review
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	22 Mar 2021 11:03
Last Modified:	18 Jan 2023 22:55
DOI:	10.1111/mcn.13141
Open Access URL:	https://doi.org/10.1111/mcn.13141
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3117982