Breastfeeding Duration and Primary Reasons for Breastfeeding Cessation among Women with Postpartum Depressive Symptoms

Abstract

Background: Although postpartum depression is associated with lower breastfeeding initiation rates and shorter breastfeeding duration, the potential mechanisms through which this relationship functions are not well understood.

Objective: This study examined the breastfeeding behaviors of women with postpartum depressive symptoms (PDS) to identify potential motivations for early breastfeeding cessation.

Methods: An analysis of quantitative data from the Infant Feeding Practices Study II examined the relationship between PDS and breastfeeding behaviors, including breastfeeding duration and primary reasons for early breastfeeding cessation.

Results: Of the women in the sample, 30.9% met criteria for mild PDS. Women with PDS had shorter overall (18.4 vs 21.8 weeks, P = .001) and exclusive breastfeeding duration (3.6 vs 4.7 weeks, P = .012) than women without PDS. A larger proportion of women with PDS stopped breastfeeding before 6 months (68.7% vs 57.2%, P < .001). After controlling for socioeconomic status, education, marital status, employment status, race/ethnicity, maternal age, parity, and breastfeeding intentions, presence of PDS significantly predicted higher odds of reporting "too many household duties" (OR = 1.90, P = .011) as a primary reason for breastfeeding cessation among women who stopped breastfeeding before 6 months. After controlling for these same covariates, women with PDS had, on average, 2.4 weeks shorter breastfeeding duration than women without PDS (P = .025).

Conclusion: There is a high prevalence of depressive symptoms among new mothers, and most do not breastfeed for recommended time periods. Increased PDS screening during prenatal and postpartum visits and promotion of lactation support services may better address the high rates of PDS and suboptimal breastfeeding behavior.

Keywords: breastfeeding; breastfeeding duration; mental health; postpartum depression.