***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: AIM The aim of this prospect i ve study was to examine the relationship between success of exclusive breastfeeding and postpartum depressive symptomatology . Our hypothesis was that mothers with depressive symptoms initially fail exclusive breastfeeding . SUBJECTS AND METHODS One hundred ninety-seven mothers were enrolled in the study . The participants were interviewed twice . The first visit was within the first 48 hours after birth . The Edinburgh Postnatal Depression Scale ( EPDS ) was completed by the participants . The second interview was performed at 6 weeks . Participants answered questions regarding methods of breastfeeding for 6 weeks , any method ological problems , and nipple pain . The EPDS was again completed by the participants at 6 weeks . All newborns were term infants . RESULTS All the participants were divided into two groups : exclusive breastfeeding and mixed-feeding ( partial breastfeeding and /or bottle feeding ) . Both groups were compared in terms of features , such as mode of delivery , parity , prevalence of depressive symptomatology ( at 48 hours and 6 weeks ) , and delayed onset of lactation within the first 48 hours . Statistical significance was found for only three variables : delayed onset of lactation within the first 48 hours , gestational age , and the problems related to breastfeeding methods . CONCLUSIONS Clinicians should pay special attention to any lactation difficulty during the first week postpartum . Early lactation difficulties are associated with greater risk of early termination of breastfeeding and lower breastfeeding success OBJECTIVE : To examine the associations of duration of exclusive breastfeeding with infections in the upper respiratory ( URTI ) , lower respiratory ( LRTI ) , and gastrointestinal tracts ( GI ) in infancy . METHODS : This study was embedded in the Generation R Study , a population -based prospect i ve cohort study from fetal life onward in the Netherl and s. Rates of breastfeeding during the first 6 months ( never ; partial for < 4 months , not thereafter ; partial for 4–6 months ; exclusive for 4 months , not thereafter ; exclusive for 4 months , partial thereafter ; and exclusive for 6 months ) and doctor-attended infections in the URTI , LRTI , and GI until the age of 12 months were assessed by question naires and available for 4164 subjects . RESULTS : Compared with never-breastfed infants , those who were breastfed exclusively until the age of 4 months and partially thereafter had lower risks of infections in the URTI , LRTI , and GI until the age of 6 months ( adjusted odds ratio [ aOR ] : 0.65 [ 95 % confidence interval ( CI ) : 0.51–0.83 ] ; aOR : 0.50 [ CI : 0.32–0.79 ] ; and aOR : 0.41 [ CI : 0.26–0.64 ] , respectively ) and of LRTI infections between the ages of 7 and 12 months ( aOR : 0.46 [ CI : 0.31–0.69 ] ) . Similar tendencies were observed for infants who were exclusively breastfed for 6 months or longer . Partial breastfeeding , even for 6 months , did not result in significantly lower risks of these infections . CONCLUSIONS : Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants . Our findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months , but preferably 6 months , in industrialized countries It is well known that women are often depressed after child-birth , but only those ill enough to be admitted to hospital have received much study . A r and om sample of 305 maternity hospital patients was given a question naire design ed to measure anxiety and depression associated with childbirth in the seventh month of pregnancy and again 6 - 8 weeks after delivery . Potential depressives , whose scores had increased , and potential controls , free from depression , with unchanged or diminished scores , were thus obtained , and the diagnosis was confirmed or excluded by clinical interview . Depressives were followed up by question naire one year later . Thirty-three ( 10 - 8 per cent . ) subjects developed puerperal depression . In only one of these was the illness classical ; in the rest it was atypical . Twelve depressives ( 3.9 per cent . of the total population studied ) had not improved after one year . There were also 19 subjects ( 6.2 per cent . ) with new or exacerbated psychological symptoms who were classified as doubtfully depressed . Depressives differed most from controls in their M.P.I. scores . Their neuroticism scores were highly significantly greater , and their extraversion scores significantly less . It is unsure whether these scores represented their previous personalities , or simply the fact that they were depressed . At probably significant levels , more depressives had a history of recent dysmenorrohea , more had been married for less than three years , fewer had obstetric complications in pregnancy , and more suffered " Maternity Blues " in the early puerperium . There were no significant differences in respect of previous psychiatric , physical or obstetric disorder , age , endocrine abnormality , complicated labour or obvious psychological or social factors . Atypical depression is , therefore , a common and important complication of the puerperium , about which more needs to be known OBJECTIVE : Postpartum anxiety screening does not typically occur , despite changes in life roles and responsibility after childbirth . We sought to determine the prevalence of postpartum anxiety during the maternity hospitalization and its associations with maternal and child outcomes . We further aim ed to compare correlates of anxiety with correlates of depression . METHODS : For a r and omized controlled trial of mothers with “ well ” newborns ≥34 weeks ’ gestation comparing 2 post – hospital discharge care models , mothers completed baseline in-person interviews during the postpartum stay and telephone surveys at 2 weeks , 2 months , and 6 months to assess health care use , breastfeeding duration , anxiety , and depression . All participants intended to breastfeed  . State anxiety scores ≥40 on the State Trait Anxiety Inventory ( STAI ) and depression scores ≥12 on the Edinburgh Postnatal Depression Survey ( EPDS ) were considered positive . RESULTS : A total of 192 ( 17 % ) of 1123 participating mothers had a positive baseline STAI ; 62 ( 6 % ) had a positive EPDS . Primiparity was associated with a positive STAI ( 20 % vs 15 % , P = .02 ) , but not a positive EPDS ( 4 % vs 7 % , P = .05 ) . Positive STAI scores were associated with cesarean delivery ( 22 % vs 15 % , P = .001 ) , reduced duration of breastfeeding ( P = .003 ) , and increased maternal , but not infant total unplanned health care utilization within 2 weeks of delivery ( P = .001 ) . Positive STAI scores occurred more frequently than positive EPDS scores at each assessment through 6 months postpartum . CONCLUSIONS : Postpartum state anxiety is a common , acute phenomenon during the maternity hospitalization that is associated with increased maternal health care utilization after discharge and reduced breastfeeding duration . State anxiety screening during the postpartum stay could improve these outcomes BACKGROUND The Baby-Friendly Hospital Initiative was launched by the World Health Organization and UNICEF in 1989 to promote , protect , and support breastfeeding worldwide . The objective of this study was to report breastfeeding rates and adherence to the Baby Friendly Hospital Initiative of the World Health Organization and UNICEF in Canada , as reported by participants in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System . METHODS Eligible women ( n = 8,244 ) were identified from a r and omly selected sample of infants born 3 months before the May 2006 Canadian Census , and stratified by province or territory . Birth mothers living with their infants at the time of interview were invited to participate in a computer-assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada . Interviews took approximately 45 minutes and were completed when infants were between 5 and 10 months old ( between 9 and 14 months in the territories ) . Completed responses were obtained from 6,421 women ( 78 % response rate ) . Nineteen of 309 questions concerned early mother-infant contact and breastfeeding practice s. RESULTS Breastfeeding intention ( 90.0 % ) and initiation ( 90.3 % ) rates were high , although exclusive breastfeeding rates at 6 months after birth ( 14.4 % ) were lower than desirable . The findings suggested a low adherence to several best practice s advocated by the Baby-Friendly Hospital Initiative . CONCLUSION Although breastfeeding initiation rates were relatively high in Canada , exclusive breastfeeding duration fell short of globally recommended st and ards BACKGROUND Studies on the relationship between prenatal psychosocial risk factors and breastfeeding are sparse , particularly in Hispanic women . METHODS We evaluated this association among 424 participants in Proyecto Buena Salud , an ongoing prospect i ve cohort of pregnant Hispanic women in Western Massachusetts .  The Perceived Stress Scale ( PSS ) , the State-Trait Anxiety Inventory ( STAI ) , and the Edinburgh Postnatal Depression Scale ( EPDS )  were administered by bilingual interviewers in early pregnancy ( mean 13.6 weeks gestation ) and midpregnancy ( mean 25.7 weeks gestation ) . Information on sociodemographic , behavioral , and acculturation factors was also collected . Breastfeeding intention was abstract ed from medical records . Poisson regression was used to calculate prevalence risk ratios ( PRR ) and 95 % confidence intervals ( CI ) . RESULTS A total of 274 ( 64.6 % ) women reported a positive intention to breastfeed . In multivariate analyses , women in the highest quartile of perceived stress ( PRR 0.76 , 95 % CI 0.62 - 0.94 ) in early pregnancy and highest quartile of anxiety in early pregnancy ( PRR 0.66 , 95 % CI 0.54 - 0.81 ) and midpregnancy ( PRR 0.80 , 95 % CI 0.64 - 1.00 ) were less likely to intend to breastfeed compared to women in the lowest quartile . Women who had at least probable minor depression ( EPDS score ≥13 ) ( PRR 0.79 , 95 % CI 0.65 - 0.95 ) or probable major depression ( EPDS score ≥15 ) ( PRR 0.77 , 95 % CI 0.62 - 0.96 ) during midpregnancy were less likely to intend to breastfeed compared to women without depressive symptoms . Similarly , women with persistent depressive symptoms over pregnancy were 24%-33 % less likely to intend to breastfeed compared to women without depressive symptoms . CONCLUSIONS Psychosocial risk factors during pregnancy are important predictors of breastfeeding intention among Hispanic women OBJECTIVES To determine the relationships between maternal depressive symptoms  and the use of infant health services , parenting practice s , and injury-prevention measures . METHODS A prospect i ve , community-based survey of women attending Philadelphia public health centers between February 2000 and November 2001 was conducted . Women were surveyed at 3 time points before and after parturition . Depressive symptoms were determined with the Center for Epidemiologic Studies Depression Scale at each time point . We studied 6 outcomes , clustered into 3 categories : 1 ) infant health service use ( adequate well-child care and ever being hospitalized ) ; 2 ) parenting practice s ( breastfeeding for > or = 1 month and use of corporal punishment ) ; and 3 ) injury-prevention measures ( having a smoke alarm and using the back sleep position ) . RESULTS The sample consisted of 774 largely single ( 74 % ) , uninsured ( 63 % ) , African American ( 65 % ) women , with a mean age of 24 + /- 6 years and a mean annual income of 8063 dollars . Forty-eight percent of women had depressive symptoms at 1 or 2 time points ( ever symptoms ) and 12 % had depressive symptoms at all points ( persistent symptoms ) . Compared with women who never had depressive symptoms ( without symptoms ) , women with persistent symptoms were nearly 3 times as likely to have their child ever hospitalized ( adjusted odds ratio : 2.89 ; 95 % confidence interval : 1.61 - 5.07 ) and twice as likely to use corporal punishment ( adjusted odds ratio : 1.90 ; 95 % confidence interval : 1.08 - 3.34 ) . Mothers with persistent depressive symptoms were nearly three-quarters less likely to have smoke alarms in their homes ( adjusted odds ratio : 0.28 ; 95 % confidence interval : 0.11 - 0.70 ) and one-half as likely to use the back sleep position ( adjusted odds ratio : 0.56 ; 95 % confidence interval : 0.35 - 0.91 ) , compared with women without symptoms . There was no association between maternal depressive symptoms and infant receipt of well-child care or the likelihood of breastfeeding for > or = 1 month . CONCLUSIONS Maternal depressive symptoms persisting from the prepartum to postpartum periods were associated with increased risks of infant hospitalization and use of corporal punishment and with lower likelihood of having a smoke alarm and using the back sleep position . Additional efforts are needed to identify and evaluate mothers with depressive symptoms to improve the health and safety of young infants AIM Depressive and anxiety symptoms are common in new mothers . The aim of this study is to explore the link between postpartum psychological adjustment and feeding preferences of 
    Output:
    
RESULTS Pregnancy depression predicts a shorter breastfeeding duration , but not breastfeeding intention or initiation .
Breastfeeding duration is associated with postpartum depression in almost all studies .
Pregnancy and postpartum depression are associated with shorter breastfeeding duration .
Breastfeeding may mediate the association between pregnancy and postpartum depression .
Pregnancy depression predicts shorter breastfeeding duration and that may increase depressive symptoms during postpartum .