Fionnuala McAuliffe, MD, highlights importance of timely breastfeeding discussions with patients

A 10-year prospective cohort study published in BMJ Open found that women who breastfed were less likely to report depression or anxiety in later reproductive years, adding to growing evidence that breastfeeding may confer long-term mental health benefits for mothers.

The study analyzed 168 parous women from the ROLO Longitudinal Cohort in Ireland who had lifetime breastfeeding data and repeated assessments of health history, including depression, anxiety, and medication use. Mean (SD) age at follow-up was 42.4 (3.8) years. Overall, 72.6% of participants reported ever breastfeeding, and 37.5% breastfed for at least 12 months over their lifetime.

At the 10-year follow-up, 13.1% of women reported depression or anxiety, while 20.8% reported these conditions at any point over the study period. Ever breastfeeding was associated with lower odds of depression or anxiety at 10 years (OR 0.34; 95% CI, 0.12–0.94; P = .04). Across the full study period, ever breastfeeding (OR 0.40; P = .03), longer duration of exclusive breastfeeding (OR 0.98 per week; P = .03), and lifetime breastfeeding of 12 months or more (OR 0.38; P = .04) were all associated with lower odds of depression and anxiety.

“We were interested to see that there was an association between the length of time—or, first of all, between those that breastfed and those that didn’t,” said Fionnuala McAuliffe, MD, FRCOG, FRCPI, FSEM, FACOG, FICOG, chair and full academic professor of Obstetrics & Gynaecology at University College Dublin. “Those that breastfed had lower rates of anxiety and depression, and then we were very excited to see a dose–response effect. So the longer she breastfed for, the stronger the relationship was.”

McAuliffe noted that many women who experience pregnancy complications or are concerned about postnatal mood disorders may feel overwhelmed and view formula feeding as the easier option. “They might be delivered preterm because they had blood pressure problems, they had gestational diabetes, they had other complications… so you can understand that there’s a lot going on,” she said.

However, she emphasized that women are often surprised to learn about maternal health benefits of breastfeeding.

“When I enumerate the benefits to them personally in terms of reduction in cardiovascular disease and diabetes… I think they’re quite surprised to hear that, and that is another motivator for them,” McAuliffe said.

She stressed the importance of discussing breastfeeding early in pregnancy. “We do know that women, their intention to breastfeed is a very strong predictor of them successfully breastfeeding,” McAuliffe said. “Those conversations in pregnancy are very important, and patients will listen to their healthcare providers.”

According to McAuliffe, understanding potential long-term mental health benefits may help women persist through challenges and enlist family support. “Knowing those extra benefits to them personally… will help them continue to breastfeed if they overcome challenges,” she said. “Introducing the topic in early pregnancy is really key.”

Reference:

McNestry C, O’Reilly SL, Twomey PJ, et al. Breastfeeding and later depression and anxiety in mothers in Ireland: a 10-year prospective observational study. BMJ Open. 2026;16:e097323. doi:10.1136/bmjopen-2024-097323