4.6 Article

Early Breastfeeding Experiences and Postpartum Depression

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OBSTETRICS AND GYNECOLOGY
卷 118, 期 2, 页码 214-221

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AOG.0b013e3182260a2d

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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. (Obstet Gynecol 2011;118:214-21) DOI: 10.1097/AOG.0b013e3182260a2d

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