Early breastfeeding difficulty is associated with postpartum depression

Women who have difficulty breastfeeding in the first 2 weeks after giving birth are about twice as likely to experience depression at 2 months postpartum, according to the findings of a study from the University of North Carolina at Chapel Hill.

Researchers there found that 2,586 women in their study reported ever breastfeeding. Among those, 223 had a score of 13 or greater on the Edinburgh Postnatal Depression Scale, indicating major depression.

Women who said that they disliked breastfeeding in the first week postpartum were 42% more likely to experience postpartum depression at 2 months (95% CI, 1.04-1.93, adjusting for maternal age, parity, education, ethnicity, and postnatal WIC Program participation) than those women who said they liked breastfeeding in the first week. Women who had severe pain upon breastfeeding in the first postpartum day, in the first postpartum week, or in the second postpartum week were 1.96 (95% CI, 1.17-3.29), 2.13 (95% CI, 0.74-6.15), and 2.24 times (95% CI, 1.18-4.26), respectively, as likely to experience postpartum depression by 2 months postpartum as women who reported no pain upon breastfeeding. Once depressed, the women were less likely to be able to continue breastfeeding at 2 months compared with women without depressive symptoms.

The researchers concluded that healthcare workers should screen women for depression who have difficulty soon after childbirth with breastfeeding; conversely, breastfeeding support should be offered to those new mothers who are displaying symptoms of depression.

Watkins S, Meltzer-Brody S, Zolnoun D, Stuebe A. Early breastfeeding experiences and postpartum depression. Obstet Gynecol. 2011;118(2 Pt 1):214-221.