Maternal physical health and breastfeeding problems in Croatia: national online survey of new mothers

Abstract

Objective
To document maternal physical health and breastfeeding problems in the first six months after giving birth in Croatia during the pandemic.

Methods
We conducted a cross-sectional study using an online questionnaire between February and April 2022 among resident Croatian women who had enrolled in the RODA (‘Parents in Action’) online antenatal course. Women aged 18 + years, who had given birth in a Croatian maternity facility between February 2020 and December 2021 were eligible. The questionnaire contained 75 items, covering sociodemographic characteristics, hospital practices, community support, maternal mental and physical health.

Results
Postpartum health and breastfeeding items were completed by 1760 participants. Most women were primiparous (80 %, n = 1420) and 72 % birthed vaginally (n = 1274). Major physical health issues were fatigue (28 %; n = 487), back pain (14 %; n = 252), and haemorrhoids (10 %; n = 171). Urinary incontinence was a minor problem for 23 % (n = 397), somewhat of a problem for 8 % (n = 139) and a major problem for 4 % (n = 67).The most common breastfeeding problems were nipple pain/damage 50 % (n = 885), difficulty attaching 43 %, (n = 761), low milk supply 28 % (n = 490), mastitis 22 % (n = 391), engorgement 22 % (n = 393), breast refusal 22 % (n = 381), and too much milk 22 % (n = 380).

Conclusion
Consistent with reports of maternal postpartum health in other countries, women in Croatia experienced many physical health challenges in the six months after childbirth. Most women described problems with breastfeeding; the frequency of pain associated with breastfeeding is concerning. Healthcare systems need to provide effective assistance to enable new mothers to establish breastfeeding without nipple pain and damage even during times of emergency measures.