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Mothers With Breastfeeding Difficulties More Likely to Suffer Postpartum Depression

Women who have breastfeeding difficulties in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared with women without such difficulties.

For that reason, women with breastfeeding difficulties should be screened for depressive symptoms, according to a new study by researchers at the University of North Carolina at Chapel Hill (UNC).

“We found that women who said they disliked breastfeeding were 42% more likely to experience postpartum depression at two months compared to women who liked breastfeeding. We also found that women with severe breast pain at day one and also at two weeks postpartum were twice as likely to be depressed compared to women that did not experience pain with nursing,” says Stephanie Watkins, MSPH, MSPT, lead study author and a doctoral student in the UNC Gillings School of Global Public Health.

The idea for the study, published online in Obstetrics & Gynecology, grew from the clinical experience of senior author, Alison Stuebe, MD, an assistant professor in the Department of Obstetrics and Gynecology in the UNC School of Medicine.

“We found that very commonly the same moms who were struggling with breastfeeding were also depressed,” she says. “There was a tremendous clinical overlap.”

In the study, researchers set out to determine if this anecdotal association would be backed up by statistical analysis of relevant data. For this purpose, they used data collected as part of the Infant Feeding and Practices Study II, and assessed the postpartum depression status of the 2,586 women in that study with the Edinburgh Postnatal Depression Scale.

Of those women, 8.6% met the criteria for major depression two months after giving birth. Women who reported disliking breastfeeding during the first week were 1.42 times as likely to be depressed at two months. Women who reported severe breastfeeding pain on their first day were 1.96 times as likely to be depressed at two months.

For healthcare providers, this study shows that mothers with breastfeeding difficulties should be screened for depression and referred to counseling when depression is confirmed. But the study also provides a message for mothers, Stuebe says.

“If they’re struggling with breastfeeding, they should seek help and tell their provider. If they don’t have joy in their life, if they wake up in the morning and think, ‘I just can’t do this another day’—that’s a medical emergency. They shouldn’t just say, ‘I’m going to power through this and snap out of it.’ They should call their provider and say, ‘I just don’t feel right, I’m wondering if I could be depressed, can I come in and talk to you about it?’”

— Source: University of North Carolina at Chapel Hill School of Medicine