Effect of acceptance and commitment therapy on mental health and breastfeeding self-efficacy in mothers with preterm infant: a randomized controlled trial

Preterm infants’ mothers experience higher level of anxiety and depression, and are more prone to postpartum depression compared to the mothers of term infants. This anxiety at the beginning of and during the breastfeeding process causes serious disorders. Given the fact that psychological interventions can reduce individuals’ problems, the present study aimed to investigate the effect of acceptance and commitment therapy on mental health and breastfeeding self-efficacy of the preterm infants’ mothers.

In this randomized controlled trial, 90 mothers of preterm infants admitted to the neonatal ward and neonatal intensive care unit (NICU) of two university-affiliated hospitals in Tabriz in 2021 were examined. Participants were assigned to the intervention and control groups adopting stratified block randomization method. The intervention group received group counseling on ACT in eight 60-minute sessions, and the control group received routine care. The Depression Anxiety Stress Scale-21 (DASS-21) and the Breastfeeding Self-Efficacy Scale (BSES) were completed by the participants before and immediately after the intervention. ANCOVA test with adjustment of confounding variables was used to compare two groups regarding the outcomes.

The total mean score of BSE in the intervention group was significantly higher than that in the control group (Mean difference (MD): 5.7; 95% CI: 4.6 to 6.8, P<0.001). Furthermore, the mean score of all subscales of mental health, including anxiety, stress, and depression in the intervention group was significantly lower than that in the control group (P<0.001).

The mental health and BSE of preterm infants’ mothers may have been improved using ACT. It was recommended that counselling sessions (e.g., ACT) should be offered for preterm infants’ mothers during postpartum period.

Preterm birth was a stressful event for parents and may have aroused negative emotions in mothers. Our study results showed that counseling based on acceptance and commitment therapy may have improved the mental health and breastfeeding self-efficacy of mothers with preterm infants