Mothers with breastfeeding difficulties more likely to suffer postpartum depression

“We found that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months compared to women who liked breastfeeding,” Watkins said. “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 who did not experience pain with nursing.”

The idea for the study, published online ahead of print by the journal Obstetrics & Gynecology, grew from the clinical experience of senior author, Alison Stuebe, MD, assistant professor 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,” Stuebe said. “There was a tremendous clinical overlap.”

In the study, Stuebe, Watkins and UNC co-authors Samantha Meltzer-Brody, MD, MPH, associate professor of psychiatry, and Denniz Zolnoun, MD, MPH, associate professor of obstetrics and gynecology, set out to determine whether this anecdotal association could be supported by statistical analysis of relevant data. For this purpose, they used data collected as part of the Centers for Disease Control and Prevention’s 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 percent 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 health care providers, this study shows that mothers with breastfeeding difficulties should be screened for depression and referred to counseling when depression is confirmed. The study also provides a message for mothers, Stuebe said.

“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. Could I come in and talk to you about it?’ “

The study is scheduled for publication in the August 2011 print issue of the journal.

UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.