Kathryn Gwinn Wouk’s PhD thesis analyzed data in the Mood, Mother and Infant Cohort

Katie Wouk and Alison Stuebe celebrate her successful dissertation defense.

Katie Wouk completed her undergraduate work at University of Virginia, where she majored in Spanish and Foreign Relations. She spent two years in the Peace Corps, and then went on to complete a Master’s Degree in Nutrition and Science Policy at Tufts University. From 2011-2013, she worked as a clinical nutritionist in the Bronx, and she enrolled in the doctoral program at UNC in 2013. During her time at UNC, she participated in the Mary Rose Tully Training Initiative and become an International Board Certified Lactation Consultant. She has contributed to multiple posters, presentation and publications, and completed her doctoral dissertation, The role of positive emotions during infant feeding in maternal mental health and breastfeeding. In this work, she lifts up the importance of the mother’s lived experience of nurturing her child as an essential component of perinatal health.

The Role of Positive Emotions in Perinatal Mental Health and Breastfeeding

Abstract: Major medical organizations in the U.S. recommend exclusive breastfeeding for six months, with continued breastfeeding through the first year or longer as desired by the woman and her infant. Public health programs have primarily aimed to increase breastfeeding duration and exclusivity without addressing the emotional experience of breastfeeding. Barbara Fredrickson’s broaden-and-build theory of positive emotions suggests that experiences of positive emotions lead to adaptive benefits by broadening thoughts and actions, facilitating the accrual of resources to improve health and well-being. In the context of the postpartum, this theory suggests that positive emotions experienced during infant feeding may broaden the scope of a mother’s thoughts and actions, allowing her to build resources to cope with challenges.

We used longitudinal data from the Mood, Mother and Infant cohort of women followed from the third trimester across the first year postpartum to test the extent to which positive emotions during infant feeding were associated with postpartum depression and anxiety and breastfeeding outcomes. We used generalized linear mixed effects models and time-to-event analyses to explore these associations, exploring modification by women’s baseline psychopathology.

Among women without a diagnosis of prenatal depression, positive emotions during feeding were inversely associated with postpartum depression symptoms. On the other hand, among women with a diagnosis of prenatal anxiety, positive emotions were associated with significantly lower postpartum anxiety symptoms. We speculate that women with prenatal anxiety who neverthess enjoy the experience of infant feeding may benefit from anxiolytic effects of oxytocin during breastfeeding and mother-infant interaction.

Positive emotions were not significantly associated with time to any breast milk feeding cessation; however, positive emotions were significantly associated with a longer time to exclusive breast milk feeding cessation and with a better overall maternal breastfeeding experience, especially with dimensions of maternal enjoyment, role attainment, and lifestyle compatibility. Positive feelings about breastfeeding in the first week were similarly associated with breastfeeding outcomes, suggesting the importance of the early maternal experience of breastfeeding on long-term outcomes.

Mother-centered programs and policies that support the experiential aspects of infant feeding may improve postpartum mental health, breastfeeding rates, and maternal satisfaction with breastfeeding.