Early Breastfeeding Experiences and Postpartum Depression

Watkins, Stephanie MSPH, MSPT; Meltzer-Brody, Samantha MD, MPH; Zolnoun, Denniz MD, MPH; Stuebe, Alison MD, MSc

doi: 10.1097/AOG.0b013e3182260a2d
Original Research

BACKGROUND: The first weeks after childbirth are a critical period for mother and newborn. Women may present with lactation failure and postpartum depression. It is unclear how a woman's early breastfeeding experiences relate to postpartum depression.

OBJECTIVE: We estimated the association between early breastfeeding experiences and postpartum depression at 2 months.

METHODS: We modeled this association with logistic regression in a secondary analysis of data from the Infant Feeding Practices Study II. We assessed postpartum depression status with the Edinburgh Postnatal Depression Scale.

RESULTS: In the neonatal period, 2,586 women reported ever breastfeeding, among whom 223 (8.6%) met criteria for major depression (Edinburgh Postnatal Depression Scale 13 or greater) at 2 months postpartum. Women who disliked breastfeeding in the first week were more likely to experience postpartum depression at 2 months (odds ratio [OR] 1.42, 95% confidence interval [CI] 1.04–1.93) adjusting for maternal age, parity, education, ethnicity, and postnatal WIC participation. Women with severe breastfeeding pain in the first day (adjusted OR 1.96, 95% CI 1.17–3.29), the first week (adjusted OR 2.13, 95% CI 0.74–6.15 compared with no pain), and the second week (adjusted OR 2.24, 95% CI 1.18–4.26 compared with no pain) were more likely to be depressed. Breastfeeding help appeared protective among women with moderate (adjusted OR 0.22, 95% CI 0.05–0.94) or severe (adjusted OR 0.17, 95% CI 0.04–0.75) pain with nursing.

CONCLUSION: Women with negative early breastfeeding experiences were more likely to have depressive symptoms at 2 months postpartum. Women with breastfeeding difficulties should be screened for depressive symptoms.

LEVEL OF EVIDENCE: II

Negative early breastfeeding experiences, including feelings about breastfeeding and pain with breastfeeding, are associated with postpartum depression at 2 months.

From Gillings School of Global Public Health and the Departments of Psychiatry and Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.

Corresponding author: Stephanie Watkins, MSPH, MSPT, UNC School of Global Public Health, Department of Epidemiology, 2101 McGavran-Greenberg Hall CB#7435, Chapel Hill, NC 27599-7435; e-mail: wat@email.unc.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 by The American College of Obstetricians and Gynecologists.