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. 2016 Mar 21;4(1):E103-9.
doi: 10.9778/cmajo.20150009. eCollection 2016 Jan-Mar.

Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of womenwho have given birth in Calgary: a prospective cohort study

Kathleen H Chaput  1 , Alberto Nettel-Aguirre  1 , Richard Musto  1 , Carol E Adair  1 , Suzanne C Tough  1
Affiliations

Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of womenwho have given birth in Calgary: a prospective cohort study

Kathleen H Chaput et al. CMAJ Open. .

Abstract

Background: A link exists between breastfeeding difficulties and postpartum depression, and evidence shows that some breastfeeding promotion initiatives may increase maternal stress and contribute to risk of the condition. We conducted a prospective cohort study to determine whether breastfeeding difficulties affect the risk of postpartum depression and whether breastfeeding support modifies the relationship between breastfeeding difficulties and postpartum depression.

Methods: Between June and October 2010, we recruited 442 women who intended to breastfeed from all maternity hospitals in Calgary within 72 hours of giving birth to full-term, singleton infants. We administered questionnaires at birth and 6 weeks and 6 months postpartum, measuring breastfeeding difficulties, exposure to breastfeeding supports and postpartum depression. We used qualitative inquiry to measure breastfeeding support experiences. Postpartum depression was defined as a score of 10 or greater on the Edinburgh Postnatal Depression Scale or a self-reported diagnosis of depression in the first 6 months postpartum.

Results: A total of 386 women (87.3%) reported moderate to severe breastfeeding difficulties and 437 (98.9%) received some form of breastfeeding advice, help or support. Among women with breastfeeding difficulties, those who did not report a negative breastfeeding support experience were at decreased risk of postpartum depression (risk ratio 0.36). In the final regression model a negative breastfeeding support experience was a significant effect modifier of the relationship between breastfeeding difficulties and postpartum depression.

Interpretation: The quality of breastfeeding support is important not only for breastfeeding promotion but also for maternal mental health. Educating front-line caregivers to ensure that support experiences of breastfeeding women are positive can reduce the risk of postpartum depression.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow diagram of the selection of study participants. NICU = neonatal intensive care unit.
Figure 2
Figure 2
Comparison of study sample maternal characteristics to population averages in Calgary, in Alberta and in Canada.-
See this image and copyright information in PMC

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