Three spirals: Breastfeeding problems, growth spurts, and postpartum depression

The Associations of Breastfeeding and Postnatal Experiences With Postpartum Depression Among Mothers of Hospitalized Infants in Tertiary Hospitals

Background

Postpartum depression has been linked to undesirable outcomes for mother-infant dyads, interfering with childcare and breastfeeding practices. This study aimed to determine the prevalence of depressive symptoms among mothers during the postpartum period and its association with breastfeeding and postpartum experiences.

Methodology

This cross-sectional study involved mothers of hospitalized infants (n = 219) at two tertiary hospitals in Klang Valley, Malaysia. Mothers were screened for postpartum depression using the Edinburgh Postnatal Depression Scale with a cut-off of ≥12 for positive screening for depression. Mothers were asked to complete questionnaires on breastfeeding experience, which included breastfeeding self-efficacy and challenges. The questionnaires also collected information on postnatal experiences, including birth outcomes, anxiety and stress levels, and social support. Multiple linear regression was used to ascertain the association of postpartum depression levels with breastfeeding and postnatal experiences.

Results

Overall, 30% of mothers in this study screened positive for depression. Based on multiple linear regression, a higher score of postpartum depression was significantly associated with unpleasant breastfeeding and postnatal experiences reflected by increased scores of anxiety and stress, lower infant birth weight, increased breastfeeding problems, and lower level of social support (p < 0.005).

Conclusions

Maternal emotions, birth outcomes, breastfeeding issues, and social support were associated with postpartum depression. Efforts should be made to increase maternal support, and screening for maternal depression during infant hospital stays should be encouraged.

Is the Association between Postpartum Depression and Early Maternal-Infant Relationships Contextually Determined by Avoidant Coping in the Mother?

This study analyzes the moderating role of avoidant coping (in early pregnancy) in the relationship between postpartum depressive (PPD) symptoms and maternal perceptions about mother-baby relations and self-confidence. Participants were 116 low-risk obstetric mothers (mean age = 31.2 years, SD = 3.95, range 23-42) who received care and gave birth at a Spanish public hospital. Measurements were made at two points in time: at first trimester of pregnancy (maternal avoidance coping) and four months after childbirth (PPD and maternal perceptions). Avoidant coping was associated with the perception of the baby as irritable and unstable (p = 0.003), including irritability during lactation (p = 0.041). Interaction effects of avoidant coping and postpartum depression were observed on the perception of the baby as irritable (p = 0.031) and with easy temperament (p = 0.002). Regarding the mother's self-confidence, avoidant coping was related to a lack of security in caring for the baby (p < 0.001) and had a moderating effect between PPD and mother's self-confidence (i.e., lack of security in caring for the baby, p =0.027; general security, p = 0.007). Interaction effects showed that the use of avoidant coping in the mother exacerbated the impact of PPD on the early mother-infant relationship.