Effects of Breastfeeding on Postpartum Depression and Anxiety Open Access
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Postpartum depression (PPD) is a serious mental health condition that affects an estimated 13 – 19% of mothers, with well documented negative consequences on maternal and infant health (O’Hara & McCabe, 2013). Research has explored risk factors for PPD, including depression history and social support. However, breastfeeding as a risk factor remains understudied. Recent research has found mixed findings on the relationship between breastfeeding and PPD, in part due to varying operationalization of breastfeeding and depression. Breastfeeding difficulties may not only be due to depression but also anxiety, but anxiety has not been measured as much as depression. To address these research gaps, the present study evaluated the association between breastfeeding and PPD and between breastfeeding and postpartum anxiety. Given that depression and anxiety are highly comorbid (Austin et al., 2010), we hypothesized that there will be a negative relationship between breastfeeding and depression, and between breastfeeding and anxiety. We reviewed medical charts from 283 postpartum mothers who received OBGYN services at 6-weeks postpartum. The sample included predominantly married (58.3%), African American (46.4%) women. The Edinburg Postnatal Depression Scale (EPDS) was used to identify women with symptoms of both depression and anxiety, with higher scores indicating higher severity. Postpartum mothers were separated into two groups: (1) Breastfeeding group (n= 224), who reported breastfeeding exclusively breastfeeding or combined breastfeeding and formula feeding; and (2) Formula feeding group (n= 58), who reported exclusively formula feeding or formula feeding due to early cessation of breastfeeding. Results indicate no significant difference in depression scores between breastfeeding (M= 0.37, SD= 0.42) and formula feeding groups (M= 0.37, SD= 0.55); t(280)= -0.07, p= 0.95. There was a marginally significant difference in the anxiety subscale, in which the breastfeeding group reported having more anxiety symptoms (M= 0.87, SD= 0.66) than the formula feeding group (M= 0.67, SD= 0.72); t(280)= 1.97, p= 0.050. These findings suggest a mixed relationship between breastfeeding and PPD, and breastfeeding and postpartum anxiety. Future research should be conducted to understand the extent of comorbidity between anxiety and depression. Additionally, research should focus on the role of anxiety in PPD to understand why higher anxiety scores on the EPDS may occur for postpartum mothers who either breastfeed or formula feed their infant. Our results suggest the importance of screening for both PPD and anxiety, and encouraging mothers to make decisions about breastfeeding that are best for them to decrease risk for maternal depression and anxiety.