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Go Ask Mom

Mothers with breastfeeding difficulties more likely to suffer postpartum depression

Posted July 19, 2011

Women who experience troubles breastfeeding in the first two weeks after giving birth are more likely to suffer postpartum depression two months later compared to women without similar difficulties, according to a new study from the University of North Carolina at Chapel Hill.

The study recommends that women who have trouble breastfeeding during those early weeks be screened for depressive symptoms.

“We found that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months compared to women who liked breastfeeding. We also found that women with severe breast pain at day one and also at two weeks postpartum were twice as likely to be depressed compared to women that did not experience pain with nursing,” said Stephanie Watkins, lead author of the study and a doctoral student in the UNC Gillings School of Global Public Health, in a press release.

The study has been published online and will be printed in the journal Obstetrics & Gynecology next month. The idea for it came from the experience that senior author Dr. Alison Stuebe, an assistant professor in the Department of Obstetrics and Gynecology in the UNC School of Medicine, had seeing patients.

“We found that very commonly the same moms who were struggling with breastfeeding were also depressed,” she said in a press release. “There was a tremendous clinical overlap.”

In the study, researchers set out to determine if the anecdotes they were hearing from new moms could be backed up with real numbers.  They used data collected as part of the Infant Feeding Practices Study II, and assessed the postpartum depression status of the 2,586 women in that study with the Edinburgh Postnatal Depression Scale. The study is a national survey of infant feeding practices and the diets of women from their third trimester to 12 months postpartum.

Of those women, 8.6 percent met the criteria for major depression two months after giving birth, according to the release. Women who reported disliking breastfeeding during the first week were 1.42 times as likely to be depressed at two months. Women who reported severe breastfeeding pain on their first day were 1.96 times as likely to be depressed at two months.

Researchers recommend that health care providers make sure that mothers with breastfeeding difficulties be screened for depression and referred to counseling when depression is confirmed. But the study also provides a message for mothers, Stuebe said.

“If they’re struggling with breastfeeding, they should seek help and tell their provider. If they don’t have joy in their life, if they wake up in the morning and think, ‘I just can’t do this another day’ – that’s a medical emergency. They shouldn’t just say, ‘I’m going to power through this and snap out of it.’ They should call their provider and say, ‘I just don’t feel right, I’m wondering if I could be depressed, can I come in and talk to you about it?’ ”

And let me veer a bit here from the press release ... That's a great message from Dr. Stuebe to all moms out there. As our own Kira wrote last week in her update on her struggle with postpartum anxiety, it can get better.

And if you are struggling with breastfeeding, we also have some resources here. Check our breastfeeding resources page for details and links on groups and individuals who can help. I know from experience that breastfeeding during those early weeks (and months for me) breastfeeding can be very trying.

There are a lot of people out there who want to help you through it.


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  • kalandyt Jul 20, 2011

    We should look at the big picture that interventions in labor interfere with breastfeeding. If the outcome of delivery was not what the mother wanted due all the unnecessary interventions also increases PPD. Women should educate themselves, take Childbirth Education classes and have support people with them. If there is not family help there are Doulas and Postpartum Doulas to help women. As a society women should be more supportive of each other whatever their decision is.

  • bcmom Jul 19, 2011

    I think we all go through some degree of "I just can't do this" especially with our first child. There should be a study done on couples preparing for kids. Wake the mom up every 2 hours for at least 2 months to get the breastfeeding thing down, make sure the house isn't cleaned much, a CD that plays crying baby sounds randomly, somehow have sore breasts (that may be a tough one) ...etc...and then see if she's somewhat depressed after a 60+ days of that. I LOVE my kids dearly, but really those first 3 months are a complete blur! I did a nice mix of formula and breastfeeding. This was a happy medium for me.

  • UrMom3040 Jul 19, 2011

    As a mom of a 3 yr old and a 3 month old, I have experienced tremendous pressure to breastfeed but it has not been possible. No one ever talks about how much it hurts and all the things that can go wrong. My nurse even told me that the hospital gets "docked" for every formula feeding patient. It is ridiculous.

  • cmk617 Jul 19, 2011

    Wish I had known this when I had both of my babies. Lots of trouble breastfeeding after MANY attempts with a lactation consultant, infections and multiple rounds of antibiotics. In retrospect, I felt exactly like Kira described in her post. Interesting that there could be a link.

  • fmpinkham Jul 19, 2011

    This is an interesting study, and certainly true for me. I think it should serve as a precaution to overly enthusiastic supporters of breastfeeding. While it is certainly the best option, it doesn't always work for whatever reason, and the strong public push to breastfeed creates a great deal of guilt in the mother who can't. I'm not saying we shouldn't encourage it, but temper it with understanding.