Association between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in Thailand

Abstract Background Maternal beliefs towards COVID-19 vaccine safety may be associated with infant feeding practice and postpartum depression (PPD). Since there is a paucity of studies, this study aims to identify associations of COVID-19-related cognitive factors (e.g., COVID-19-vaccination-related...

Full description

Saved in:
Bibliographic Details
Main Authors: Wichukorn Suriyawongpaisal, Punpawee Kittikul, Eun Young Lee, Li-Yin Chien, Yan-Shing Chang, Kelly Pereira Coca, Doungjai Buntup, Seo Ah Hong
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-025-22672-w
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850202632256225280
author Wichukorn Suriyawongpaisal
Punpawee Kittikul
Eun Young Lee
Li-Yin Chien
Yan-Shing Chang
Kelly Pereira Coca
Doungjai Buntup
Seo Ah Hong
author_facet Wichukorn Suriyawongpaisal
Punpawee Kittikul
Eun Young Lee
Li-Yin Chien
Yan-Shing Chang
Kelly Pereira Coca
Doungjai Buntup
Seo Ah Hong
author_sort Wichukorn Suriyawongpaisal
collection DOAJ
description Abstract Background Maternal beliefs towards COVID-19 vaccine safety may be associated with infant feeding practice and postpartum depression (PPD). Since there is a paucity of studies, this study aims to identify associations of COVID-19-related cognitive factors (e.g., COVID-19-vaccination-related belief and COVID-19-related knowledge and attitude) with infant feeding practices and their associations with PPD during the COVID-19 pandemic in Thai postpartum mothers. Methods A cross-sectional online survey was conducted among 840 postpartum mothers whose infants were less than or equal to 6 months old. Mothers with a score ≥ 13 using the Edinburgh Postnatal Depression Scale (EPDS) were considered to have PPD. Student t-tests were used to measure the association between infant feeding practices and COVID-19-related cognitive factors, and Chi-square tests were used to assess their associations with PPD. Significant variables (p < 0.05) from the chi-square test were included in the logistic regression analysis. Multivariable logistic regression analyses were performed to identify factors associated with PPD. The associations were reported in adjusted odds ratio at 95% confidence interval. Results This study showed one-third of the participants (32.4%) were at risk of having PPD. Mothers who fed expressed breastmilk had positive beliefs towards COVID-19 vaccination and higher scores on COVID-19 knowledge and attitude, while mothers who fed infant formula or solid, semi-solid, or soft food had negative beliefs towards the vaccination compared to their counterparts. Multivariable logistic regression showed women who fed their infant with solid, semi-solid, and soft foods (AOR = 3.28; 95% CI = 1.35–10.92) had significantly higher odds of PPD. Among COVID-19-related cognitive factors, negative or moderate COVID-19-related attitudes were associated with higher odds of PPD (1.91; 1.19–3.07 and 1.85; 1.20–2.86, respectively). Socio-demographic factors associated with PPD included living in urban areas, residing outside the Southern region, having food insecurity during the pandemic, having unintended pregnancy, and having health problems during the perinatal period. Conclusions The association of COVID-19-related cognitive factors and feeding practices with PPD may suggest that proper education on prevention, control, and vaccination of emerging infectious diseases such as COVID-19, as well as support for appropriate infant feeding practices, should be provided to postpartum mothers, which ultimately contributes to improving their mental health.
format Article
id doaj-art-86e667ac3bf04df796f03396c4885457
institution OA Journals
issn 1471-2458
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj-art-86e667ac3bf04df796f03396c48854572025-08-20T02:11:42ZengBMCBMC Public Health1471-24582025-04-0125111110.1186/s12889-025-22672-wAssociation between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in ThailandWichukorn Suriyawongpaisal0Punpawee Kittikul1Eun Young Lee2Li-Yin Chien3Yan-Shing Chang4Kelly Pereira Coca5Doungjai Buntup6Seo Ah Hong7ASEAN Institute for Health Development, Mahidol UniversityBreastfeeding Clinic Nakhon Pathom HospitalDepartment of Nursing, Catholic Kkottongnae UniversityInstitute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung UniversityFlorence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College LondonEscola Paulista de Enfermagem, Universidade Federal de São PauloDepartment of Community Health, Faculty of Public Health, Mahidol UniversityDepartment of Public Health Administration, Faculty of Public Health, Mahidol UniversityAbstract Background Maternal beliefs towards COVID-19 vaccine safety may be associated with infant feeding practice and postpartum depression (PPD). Since there is a paucity of studies, this study aims to identify associations of COVID-19-related cognitive factors (e.g., COVID-19-vaccination-related belief and COVID-19-related knowledge and attitude) with infant feeding practices and their associations with PPD during the COVID-19 pandemic in Thai postpartum mothers. Methods A cross-sectional online survey was conducted among 840 postpartum mothers whose infants were less than or equal to 6 months old. Mothers with a score ≥ 13 using the Edinburgh Postnatal Depression Scale (EPDS) were considered to have PPD. Student t-tests were used to measure the association between infant feeding practices and COVID-19-related cognitive factors, and Chi-square tests were used to assess their associations with PPD. Significant variables (p < 0.05) from the chi-square test were included in the logistic regression analysis. Multivariable logistic regression analyses were performed to identify factors associated with PPD. The associations were reported in adjusted odds ratio at 95% confidence interval. Results This study showed one-third of the participants (32.4%) were at risk of having PPD. Mothers who fed expressed breastmilk had positive beliefs towards COVID-19 vaccination and higher scores on COVID-19 knowledge and attitude, while mothers who fed infant formula or solid, semi-solid, or soft food had negative beliefs towards the vaccination compared to their counterparts. Multivariable logistic regression showed women who fed their infant with solid, semi-solid, and soft foods (AOR = 3.28; 95% CI = 1.35–10.92) had significantly higher odds of PPD. Among COVID-19-related cognitive factors, negative or moderate COVID-19-related attitudes were associated with higher odds of PPD (1.91; 1.19–3.07 and 1.85; 1.20–2.86, respectively). Socio-demographic factors associated with PPD included living in urban areas, residing outside the Southern region, having food insecurity during the pandemic, having unintended pregnancy, and having health problems during the perinatal period. Conclusions The association of COVID-19-related cognitive factors and feeding practices with PPD may suggest that proper education on prevention, control, and vaccination of emerging infectious diseases such as COVID-19, as well as support for appropriate infant feeding practices, should be provided to postpartum mothers, which ultimately contributes to improving their mental health.https://doi.org/10.1186/s12889-025-22672-wPostpartum depressionCOVID-19 knowledge and attitudeCOVID-19 vaccinationInfant feeding practicesPostpartum mothers
spellingShingle Wichukorn Suriyawongpaisal
Punpawee Kittikul
Eun Young Lee
Li-Yin Chien
Yan-Shing Chang
Kelly Pereira Coca
Doungjai Buntup
Seo Ah Hong
Association between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in Thailand
BMC Public Health
Postpartum depression
COVID-19 knowledge and attitude
COVID-19 vaccination
Infant feeding practices
Postpartum mothers
title Association between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in Thailand
title_full Association between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in Thailand
title_fullStr Association between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in Thailand
title_full_unstemmed Association between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in Thailand
title_short Association between infant feeding practices, COVID-19 related cognitive factors, and postpartum depression during the COVID-19 pandemic: a cross-sectional online study in Thailand
title_sort association between infant feeding practices covid 19 related cognitive factors and postpartum depression during the covid 19 pandemic a cross sectional online study in thailand
topic Postpartum depression
COVID-19 knowledge and attitude
COVID-19 vaccination
Infant feeding practices
Postpartum mothers
url https://doi.org/10.1186/s12889-025-22672-w
work_keys_str_mv AT wichukornsuriyawongpaisal associationbetweeninfantfeedingpracticescovid19relatedcognitivefactorsandpostpartumdepressionduringthecovid19pandemicacrosssectionalonlinestudyinthailand
AT punpaweekittikul associationbetweeninfantfeedingpracticescovid19relatedcognitivefactorsandpostpartumdepressionduringthecovid19pandemicacrosssectionalonlinestudyinthailand
AT eunyounglee associationbetweeninfantfeedingpracticescovid19relatedcognitivefactorsandpostpartumdepressionduringthecovid19pandemicacrosssectionalonlinestudyinthailand
AT liyinchien associationbetweeninfantfeedingpracticescovid19relatedcognitivefactorsandpostpartumdepressionduringthecovid19pandemicacrosssectionalonlinestudyinthailand
AT yanshingchang associationbetweeninfantfeedingpracticescovid19relatedcognitivefactorsandpostpartumdepressionduringthecovid19pandemicacrosssectionalonlinestudyinthailand
AT kellypereiracoca associationbetweeninfantfeedingpracticescovid19relatedcognitivefactorsandpostpartumdepressionduringthecovid19pandemicacrosssectionalonlinestudyinthailand
AT doungjaibuntup associationbetweeninfantfeedingpracticescovid19relatedcognitivefactorsandpostpartumdepressionduringthecovid19pandemicacrosssectionalonlinestudyinthailand
AT seoahhong associationbetweeninfantfeedingpracticescovid19relatedcognitivefactorsandpostpartumdepressionduringthecovid19pandemicacrosssectionalonlinestudyinthailand