Abstract
Objective
Most US women intend and initiate breastfeeding, yet many do not breastfeed as long
as desired. Not meeting one's own prenatal expectations is a plausible mechanism for
the previously observed association between lack of breastfeeding and postpartum depression
(PPD). This study explored whether meeting prenatal expectations for exclusive breastfeeding
was associated with PPD symptoms.
Methods
The 2005 Infant Feeding Practices Study II (IFPSII) followed US mothers, primarily
white women with higher education and income, from midpregnancy to 1 year postpartum.
Depressive symptoms were defined as Edinburgh Postnatal Depression Scale (EPDS) of
10 or higher, measured at 2 months postpartum. Logistic regression analysis evaluated
the odds of maternal depressive symptoms as a function of meeting prenatal expectations
for exclusive breastfeeding, accounting for breastfeeding behavior, demographics,
and postnatal experiences.
Results
Among IFPSII participants, 1501 intended exclusive breastfeeding and completed the
EPDS. At 2 months, 589 (39.2%) had met prenatal expectations for exclusive breastfeeding.
EPDS was 10 or higher for 346 participants (23.1%). Adjusted odds of depressive symptoms
were lower among women meeting prenatal exclusive breastfeeding expectations versus
those who were not (odds ratio 0.71, 95% confidence interval 0.52–0.96). In subgroup
analysis, there was no association between met expectations and depressive symptoms
among women with lower incomes (<200% federal poverty level) or those intending mixed
breast and formula feeding.
Conclusions
Among middle- and higher-income women who intended exclusive breastfeeding, those
meeting prenatal breastfeeding expectations reported fewer PPD symptoms at 2 months
postpartum. Clinician understanding and support of maternal expectations may improve
maternal mental health.
Keywords
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Article Info
Publication History
Accepted:
December 8,
2014
Received:
June 5,
2014
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
