Exploring the association between loneliness and breastfeeding duration in Chinese primiparas

Reaching the recommendations for exclusive breastfeeding (EBF) during the first 6 months postpartum remains a worldwide challenge. Meanwhile, Chinese primiparas suffered from the loneliness associated with the traditional practice of zuoyuezi and the isolation during the COVID-19 pandemic. As far as we know, little is known about whether there is the association between loneliness in Chinese primiparas and breastfeeding duration.

This study aimed to explore whether loneliness in Chinese primiparas was associated with reduced breastfeeding duration, and further to explore the endocrine mechanisms.

The Chinese primiparas were assessed for loneliness using the Los Angeles Loneliness Scale (R-UCLA) within 7-14 days postpartum. According to the scores of R-UCLA, the subjects were divided into three groups: no loneliness group (n=162), a low loneliness group (n=65) and a high loneliness group (n=40). The Postpartum Breastfeeding Questionnaire was filled out to record breastfeeding duration. The expression levels of the serum lactation hormone(prolactin)and the stress hormone (cortisol) were measured.

The time and rate of breastfeeding initiation within 3 days postpartum, as well as the frequencies of exclusive breastfeeding at 15 and 30 days postpartum, were significantly lower in Chinese primiparas with high loneliness; specifically, High loneliness was associated with lower exclusive breastfeeding rates by 25.2% (P<0.01) within 24 hours postpartum, 19.9% (P < 0.01) at 24 to 48 hours postpartum, 22.5% (P < 0.01) at 48 to 72 hours postpartum, 39.8% (P < 0.01) at 90 days postpartum, respectively. The probability of cumulative 90- and 180-day exclusive breastfeeding was the lowest in Chinese primiparas with high loneliness. The probability of cumulative 90- and 180-day exclusive breastfeeding rates decreased as the scores on the Loneliness Scale increased. Compared with primiparas in the no-loneliness and low-loneliness groups, those in the high-loneliness group exhibited the highest expression levels of the stress hormone (serum cortisol) and the lowest expression levels of the lactation hormone (serum prolactin) at 3, 15, and 45 days postpartum, respectively.

Loneliness in Chinese primiparas during lactation was associated with lower exclusive breastfeeding rates and duration.