Stress and feeding choices: How do socio-demographic factors shape formula use among Polish mothers?

Background: Breastfeeding is widely recognized as the gold standard in infant nutrition, yet many women discontinue exclusive breastfeeding earlier than recommended. Maternal stress has been identified as a potential factor contributing to breastfeeding difficulties; however, its interaction with socio-demographic variables remains insufficiently explored. In Poland, where breastfeeding initiation rates are high but exclusive breastfeeding drops to only 4% by six months postpartum, understanding these interactions is essential to improve breastfeeding outcomes. Objective: In this study, it was examined whether maternal stress moderates the relationship between socio-demographic factors and the introduction of formula supplementation among Polish mothers. Methods: An observational, cross-sectional study was conducted among 1,092 mothers of infants ≤6 months. Data were collected via an anonymous online questionnaire assessing socio-demographic characteristics, feeding practices and maternal stress using the Perceived Stress Scale (PSS-10). Logistic regression models were applied separately for low/moderate and high stress groups. Results: Socio-demographic influences on formula supplementation were moderated by maternal stress level. In high-stress mothers, older age (AOR ≈ 1.81, Conclusion: Maternal stress plays a moderating role in the relationship between socio-demographic variables and infant feeding practices. These findings provide novel evidence that psychological and environmental factors jointly shape feeding decisions. Integrating stress assessment and psychosocial support into postnatal and breastfeeding care may strengthen public health interventions aimed at sustaining exclusive breastfeeding in Poland.