Women who have breastfeeding difficulties in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared to 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.
"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. 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," said Stephanie Watkins, MSPH, MSPT, lead author of the study and a doctoral student in the UNC Gillings School of Global Public Health.
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, 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 said. "There was a tremendous clinical overlap."
In the study, Stuebe, Watkins and UNC co-authors Samantha Meltzer-Brody, MD, MPH and Denniz Zolnoun, MD, MPH, 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 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. But 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, can I come in and talk to you about it?' "
The study is scheduled for publication in the August 2011 print issue of the journal.
- Stephanie Watkins, Samantha Meltzer-Brody, Denniz Zolnoun, Alison Stuebe. Early Breastfeeding Experiences and Postpartum Depression. Obstetrics & Gynecology, 2011; DOI: 10.1097/AOG.0b013e3182260a2d
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