Early Breastfeeding Experiences and Postpartum Depression

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

Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e3182260a2d
Original Research
Abstract

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

In Brief

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

Author Information

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.