Tools
The participants were asked to self-complete a standardized questionnaire during their routine outpatient clinic visits. The standardized questionnaire consisted of sociodemographic features including age, number of siblings, primary and other caregivers of the child, sociodemographic features of the mother, history of any allergic, psychiatric or physical disease in the mother/family, any medications used for psychiatric disease, detailed dietary history including number and categories of foods eliminated from the mother’s diet, source of information for dietary recommendations, (physician/written sources/internet/social environment/friends/relatives). Any weight loss in the mother, change in volume, consistency or cessation of breast milk, any changes in feeding frequency of infant and validated tools assessing the psychosocial functioning of the mother were also collected.
The validated tools were the following:
1. Symptom Checklist 90 (SCL-90R): SCL-90R is a self-administered psychiatric symptom checklist consisting of 90 items on a likert scale ranged from 0-to-9. SCL-90R was developed by Derogatis et al (8). and validated in Turkish by Dag et al (9).
2. Beck Depression Inventory (BDI): BDI which evaluated the risk and severity of depression in adults with a cut-off point of 17 points was developed in 1961 by Beck et al. (10) and validated in Turkish by Hisli et al. in 1989 (11).
3. Beck Anxiety Inventory (BAI): BAI assesses the frequency of anxiety symptoms composed of 21 items on a likert scale ranged from 0-to-3. BAI developed in 1998 by Beck et al (12) and validated in Turkish by Ulusoy et al in 1998 (13).
4. Brockington Postpartum Bonding Questionnaire (Bonding):Bonding was developed to evaluate the problems of mother-to-infant relationship on a 6-item likert scale described as “every day”, “very often”, “often”, “sometimes”, “rare”, “never” pointed 0-5. The questionnaire composed of 25-item, 17 of which were inversely associated and validated (14-15). The scale consists of four subscales such as the General factor (12 items), Rejection and Pathological Anger (7 items), Infant-focused Anxiety (4 items) and Incipient Abuse (2 items). The cut-off scores are General factor ≥ 12, Rejection and Pathological Anger ≥ 17, Infant-focused Anxiety ≥ 10 and Incipient Abuse ≥ 3, respectively.