The influence of postpartum PTSD on breastfeeding: A longitudinal population-based study

BackgroundIn most Western countries, breastfeeding rates are lower than what is recommended by the World Health Organization. Depression has been shown to influence breastfeeding outcomes; however, there is very little research on the role of postpartum posttraumatic stress disorder (PTSD). This study examined to what extent maternal postpartum PTSD predicted breastfeeding initiation, exclusive breastfeeding during the first 6months, and continuation up to 1 and 2years. MethodsThe study is part of the large, population-based Akershus Birth Cohort. Data from the hospital's birth record and questionnaire data from 8weeks and 2years postpartum were used (n=1480). All breastfeeding variables significantly correlated with postpartum PTSD were entered into stepwise logistic regression analyses. ResultsAlthough most mothers (97.1%) initiated breastfeeding, considerably fewer adhered to the World Health Organization's breastfeeding guidelines about exclusive breastfeeding during the first 6months (13.4%) or continued breastfeeding for 12 or 24months postpartum (37.7% and 4.2%, respectively). Even after adjustment for important confounding variables, maternal postpartum PTSD was significantly associated with not initiating breastfeeding (aOR 5.98 [95% CI 1.79-19.97]). Postpartum PTSD was also significantly related to not continuing breastfeeding up to 12months, although this association did not hold after adjusting for confounding variables. ConclusionIdentifying women at risk of not initiating breastfeeding is crucial to prevent a negative influence on infant development and the development of the mother-infant bond. Early screening and treatment of women at risk of developing postpartum PTSD might be a way forward.