***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This prospect i ve study examined the relation of neonatal sucking to later feeding , postnatal growth , maternal postpartum depression , and feeding practice s.  Healthy infants of at least 37 weeks gestational age were recruited . At 1 week of age , a strain-gage device was attached to the infant 's cheeks during sucking to identify sucking efficiency . Two-hundred and two infants ( 100 males , 102 females ; mean age 39.6 weeks , SD 1.1 weeks ) with efficient sucking and 207 ( 101 males , 106 females ; mean gestational age 39.4 weeks , SD 1.2 weeks ) with inefficient sucking were identified .  Growth was measured at 2 , 6 , 10 , and 14 months . Mothers completed a  feeding question naire  and the  Edinburgh Postnatal Depression Scale  at the same testing points . While 18 infants ( 5 % ) showed a downward shift in growth , their clinical picture did not present as non-organic failure to thrive ( NFTT ) . Inefficient neonatal sucking did not predict postnatal growth , later feeding difficulties , nor maternal feeding practice s , but concurrent inefficient feeding did . Maternal  depression did not affect feeding practice s , infant feeding abilities , nor growth , suggesting that the importance of maternal postpartum depression in association with feeding may be less than previously assumed . The term NFTT , therefore , merits reexamination and a more focused definition BACKGROUND Although much research has focused on identifying factors that influence breastfeeding initiation and duration , many high-risk factors are nonmodifiable demographic variables . Predisposing factors for low breastfeeding duration rates that are amenable to supportive interventions should be identified . The purpose of this study was to assess the effect of maternal confidence ( breastfeeding self-efficacy ) on breastfeeding duration . METHOD A prospect i ve survey was conducted with 300 women in the last trimester of pregnancy recruited from the antenatal clinic of a large metropolitan hospital in Brisbane , Australia .  Telephone interviews were conducted at 1 week and 4 months postpartum to assess infant feeding methods and breastfeeding confidence using the Breastfeeding Self-Efficacy Scale . RESULTS Although 92 percent of participants initiated breastfeeding , by 4 months postpartum almost 40 percent discontinued and only 28.6 percent were breastfeeding exclusively ; the most common reason for discontinuation was insufficient milk supply . Antenatal and 1-week Breastfeeding Self-Efficacy Scale scores were significantly related to breastfeeding outcomes at 1 week and 4 months . Mothers with high breastfeeding self-efficacy were significantly more likely to be breastfeeding , and doing so exclusively , at 1 week and 4 months postpartum than mothers with low breastfeeding self-efficacy . CONCLUSIONS Maternal breastfeeding self-efficacy is a significant predictor of breastfeeding duration and level . Integrating self-efficacy enhancing strategies may improve the quality of healthcare that healthcare professionals deliver and may increase a new mother 's confidence in her ability to breastfeed , and to persevere if she does encounter difficulties One method used to determine utilization rates of cervical screening is  women 's self-report . Few studies have assessed the accuracy of this measure -- none has been conducted in Australia -- although there are a number of reasons for suspecting its validity . This study examined and quantified the accuracy of self-report of Pap smear use  among a r and omly selected sample of women from an Australian community .  Accuracy of Pap smear utilization self-report within a three-year period was assessed by comparison with pathology records . Results indicated that almost half of the women who have not had Pap smears within three years will be missed by a self-report measure of utilization . Some implication s for the measurement and use of self-report data are discussed One hundred and forty-two women at six weeks postpartum were asked to complete Cox 's  Edinburgh Postnatal Depression Scale .  Thirty-eight scored positively for depression and 28 of these were followed up by a psychiatrist .  Twenty-eight controls were r and omly selected from those who scored negatively . Numerous variables were considered , including the type of labour , whether the mother was breastfeeding or not , and the presence or absence of a psychiatric history . In addition the depressed group completed the Eysenck Personality Inventory . A past psychiatric history was found to be a very significant risk factor and there is a definite association between postnatal depression and delivery by forceps , vacuum or caesarian section . Maternal age and breastfeeding were not found to be of aetiological significance BACKGROUND  Postnatal depression is a major public health problem . The aim of this study is to vali date the use of the  Edinburgh Postnatal Depression Scale ( EPDS )  in the early postpartum , and to identify the markers for risk of postnatal depression . METHODS 815 women filled out an EPDS and general information question naire between the third and the fifth day postpartum . The women with an EPDS score of > 8 and a r and omized control group from those with scores of < 8 were contacted 8 weeks postpartum . 363 women therefore had a structured diagnostic interview by telephone at 8 weeks postpartum ( MINI-DSM-IV ) , without knowledge of their EPDS scores  , to screen for a major or minor depressive episode . RESULTS The sensitivity of EPDS  was measured as 0.82 [ 0.78 - 0.86 ] , with a positivity threshold of 9.5/30 . For an estimated prevalence for all depressive episodes of 16.1 % , the positive predictive value of EPDS was measured as 42.8 % [ 39.1 - 46.5 % ] . Multivariate risk analysis using logistical regression identified the following as risk markers for postnatal depression : previous history of depression ( postnatal or other ) , unemployment , premature delivery or stopping breast-feeding in the first month for non-medical reasons . CONCLUSION The use of EPDS between the third and fifth day postpartum is valid . An  EPDS score of > 10 should be completed by a clinical assessment and suitable management . The risk markers identified here are clinical indices that can be used for first-line early screening by non-psychiatric health workers OBJECTIVE Breastfeeding rates fall short of goals set in Healthy People 2010 and other national recommendations . The current , national breastfeeding continuation rate of 29 % at 6 months lags behind the Healthy People 2010 goal of 50 % . The objective of this study was to evaluate associations between breastfeeding discontinuation at 2 and 12 weeks postpartum and clinician support , maternal physical and mental health status , workplace issues , and other factors amenable to intervention . METHODS A prospect i ve cohort study was conducted of low-risk mothers and infants who were in a health maintenance organization and enrolled in a r and omized , controlled trial of home visits . Mothers were interviewed in person at 1 to 2 days postpartum and by telephone at 2 and 12 weeks . Logistic regression modeling was performed to assess the independent effects of the predictors of interest , adjusting for sociodemographic and other confounding variables . RESULTS Of the 1163 mother-newborn pairs in the cohort , 1007 ( 87 % ) initiated breastfeeding , 872 ( 75 % ) were breastfeeding at the 2-week interview , and 646 ( 55 % ) were breastfeeding at the 12-week interview . In the final multivariate models , breastfeeding discontinuation at 2 weeks was associated with lack of confidence in ability to breastfeed at the 1- to 2-day interview ( odds ratio [ OR ] : 2.8 ; 95 % confidence interval [ CI ] : 1.02 - 7.6 ) , early breastfeeding problems ( OR : 1.5 ; 95 % CI : 1.1 - 1.97 ) , Asian race/ethnicity ( OR : 2.6 ; 95 % CI : 1.1 - 5.7 ) , and lower maternal education ( OR : 1.5 ; 95 % CI : 1.2 - 1.9 ) . Mothers were much less likely to discontinue breastfeeding at 12 weeks postpartum if they reported ( during the 12-week interview ) having received encouragement from their clinician to breastfeed ( OR : 0.6 ; 95 % CI : 0.4 - 0.8 ) . Breastfeeding discontinuation at 12 weeks was also associated with demographic factors and maternal depressive symptoms ( OR : 1.18 ; 95 % CI : 1.01 - 1.37 ) and returning to work or school by 12 weeks postpartum ( OR : 2.4 ; 95 % CI : 1.8 - 3.3 ) . CONCLUSIONS Our results indicate that support from clinicians and maternal depressive symptoms are associated with breastfeeding duration . Attention to these issues may help to promote breastfeeding continuation among mothers who initiate . Policies to enhance scheduling flexibility and privacy for breastfeeding mothers at work or school may also be important , given the elevated risk of discontinuation associated with return to work or school STUDY OBJECTIVE --Retrospective infant feeding data are important to the study of child and adult health patterns . The accuracy of maternal recall of past infant feeding events was examined and specifically the infant 's age when breast feeding was stopped and formula feeding and solid foods were introduced . DESIGN AND SETTING --The sample consisted of Bedouin Arab women ( n = 318 ) living in the Negev in Israel who were a part of a larger cohort participating in a prospect i ve study of infant health and who were delivered of their infants between July 1 and December 15 , 1981 . Data from interviews conducted 12 and 18 months postpartum were compared to the st and ard data collected six months postpartum . MAIN RESULTS --As length of recall increased there was a small increase in the mean difference , and its st and ard deviation , between the st and ard and recalled age when breast feeding was stopped and formula feeding and solid foods were started . Recall on formula feeding was less accurate than recall on solid foods and breast feeding . In particular , among those 61 % reporting formula use at the six month interview , 51 % did not recall introducing formula when interviewed at 18 months . The odds ratio ( 95 % CI ) of stunting versus normal length for age for formula fed versus breast fed infants based on recall data ( OR = 2.07 ; 95 % CI 0.82 - 5.22 ) differed only slightly from those based on the st and ard data ( OR = 2.21 ; 95 % CI 0.77 - 6.37 ) . The accuracy of a mother 's recall varied with her child 's nutritional status at the time of the interview , but not with other sociodemographic , infant , or interviewer characteristics . CONCLUSIONS --Retrospective infant feeding data based on maternal recall of events up to 18 months in the past can be used with confidence in epidemiological studies . However , data on formula feeding may not be as accurate as data on breast feeding and solid food feeding , and accuracy may decrease as length of recall increases Despite well-documented health benefits of breastfeeding for mothers and babies , most women discontinue breastfeeding before the recommended 12 months to 2 years . The purpose of this study was to assess the effect of modifiable antenatal variables on breastfeeding outcomes . A prospect i ve , longitudinal study was conducted with 300 pregnant , Australian women . Question naires containing variables of interest were administered to women during their last trimester ; infant feeding method was assessed at 1 week and 4 months postpartum . Intended breastfeeding duration and breastfeeding self-efficacy were identified as the most significant modifiable variables predictive of breastfeeding outcomes . Mothers who intended to breastfeed for < 6 months were 2.4 times as likely to have discontinued breastfeeding at 4 months compared to those who intended to breastfeed for > 12 months ( 35.7 % vs 87.5 % ) . Similarly , mothers with high breastfeeding self-efficacy were more likely to be breastfeeding compared to mothers with low self-efficacy ( 79.3 % vs 50.0 % ) . J Hum Lact . 20(1):30 - 38 Hormonal factors have been suggested as a cause of post-natal depression , but suckling frequency which is the major influence on hormone levels post-partum has not been considered in previous studies . Eighty-nine women who had taken part in a prospect i ve study of post-natal depression were asked about their feeding patterns 18 months after childbirth . Half the mothers who were breast feeding introduced solids or artificial milk feeds before 12 weeks and were likely to have lowered prolactin levels and increased ovarian follicular activity . Mothers who totally breastfed their babies for at least 12 weeks or who were on the pill , had a higher incidence of post-natal depression than those who were not on the pill or who partially breastfed . Among the 62 women who attempted breast feeding those most likely to have normal levels of endogenous hormones were those least likely to have depressive symptoms Purpose To examine patterns of exclusive breastfeeding , combination feeding , and exclusive bottle-feeding among a sample of women identified at 2–4 weeks postpartum with positive PPD symptoms . Study Design and Methods The sample included 122 women who were part of a larger study testing an intervention for promoting maternal-infant interaction among women with elevated PPD symptoms . Data were collected during three postpartum home visits . Demographic and feeding pattern data were described . Variables related to and predictors of feeding pattern were analyzed . The sample was compared to a r and om sample of postpartum women in New Engl and .  Results Severity of depression was not significantly related to breastfeeding . Older maternal age , living with a partner , and higher income were positively related to breastfeeding . Comp 
    Output:
    
The results from this review suggest that women with depressive symptomatology in the early postpartum period may be at increased risk for negative infant-feeding outcomes including decreased breastfeeding duration , increased breastfeeding difficulties , and decreased levels of breastfeeding self-efficacy .
There is also beginning evidence to suggest that depressed women may be less likely to initiate breastfeeding and do so exclusively .
Depressive symptomatology in the postpartum period negatively influences infant-feeding outcomes .