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Braithwaite EC, Oftedal A, Kaasen A, Ayorech Z, Bekkhus M. A history of depression and prenatal depression are associated with a lower likelihood of breastfeeding initiation and maintenance, and more breastfeeding problems. Arch Womens Ment Health 2024:10.1007/s00737-024-01479-5. [PMID: 38834917 DOI: 10.1007/s00737-024-01479-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 05/24/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE This study tests the hypotheses that lifetime history of depression, and prenatal depression, are associated with a reduced likelihood of breastfeeding initiation (giving the baby any breastmilk during the first week of life) and breastfeeding maintenance (giving the baby breastmilk for at least 6 months), and a greater likelihood of reporting breastfeeding problems. METHODS We analyzed data from the Norwegian Mother, Father, and Child cohort study (MoBa), N = 78,307. Mothers reported a lifetime history of depression during the second trimester of pregnancy, and current symptoms of depression during the third trimester using the Hopkins Symptoms Checklist short version (SCL-8). At six months postpartum, mothers self-reported breastfeeding initiation, maintenance, and difficulties. RESULTS Using binary logistic regression analyses, we report that a lifetime history of depression is associated with a lower likelihood of breastfeeding initiation (OR = 0.751, 95%CI = 0.650-0.938), breastfeeding maintenance (OR = 0.712, 95%CI = 0.669-0.785), and a greater likelihood of breastfeeding difficulties (OR = 1.86, 95%CI = 1.72-2.06). Similarly, prenatal depression was associated with a lower likelihood of breastfeeding initiation (OR = 0.904, 95%CI = 0.878-0.929), breastfeeding maintenance (OR = 0.929, 95%CI = 0.920-0.938), and a greater likelihood of breastfeeding difficulties (OR = 1.10, 95%CI = 1.09-1.12). Results remained largely unchanged when covaried for several confounding variables, including medication use. CONCLUSION We provide novel evidence that pre-conception and prenatal symptoms of depression are associated with breastfeeding outcomes. This information could be used to identify women very early in pregnancy who may need additional support with breastfeeding. There is also a need to fully understand the biopsychosocial mechanisms that mediate the relationship between depression prior to birth and breastfeeding outcomes.
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Affiliation(s)
- Elizabeth C Braithwaite
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK.
| | - Aurora Oftedal
- Department of Children and Families, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Kaasen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Ziada Ayorech
- Promenta Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Mona Bekkhus
- Promenta Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
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Jacovides C, Papadopoulou SK, Pavlidou E, Dakanalis A, Alexatou O, Vorvolakos T, Lechouritis E, Papacosta E, Chrysafi M, Mitsiou M, Mentzelou M, Kosti RI, Giaginis C. Association of Pregnant Women's Perinatal Depression with Sociodemographic, Anthropometric and Lifestyle Factors and Perinatal and Postnatal Outcomes: A Cross-Sectional Study. J Clin Med 2024; 13:2096. [PMID: 38610861 PMCID: PMC11012430 DOI: 10.3390/jcm13072096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Background: In recent decades, the incidence of depression has gradually increased in the general population globally. Depression is also common during gestation and could result in detrimental gestational complications for both the mother and the fetus. The survey presented aimed to evaluate whether pregnant women's perinatal depression could be associated with socio-demographic, anthropometry and lifestyle factors, and perinatal and postnatal outcomes. Methods: This is a cross-sectional survey conducted on 5314 pregnant women. Socio-demographic and lifestyle factors were recorded by relevant questionnaires via face-to-face interviews. Anthropometric parameters were measured by qualified personnel. Perinatal depressive symptomatology status was evaluated by Beck's Depression Inventory (BDI-II) questionnaire. Results: Depressive symptoms throughout gestation were found in 35.1% of the enrolled women. Perinatal depression was significantly associated with lower educational and economic level, pre-pregnancy regular smoking and reduced levels of Mediterranean diet adherence levels, a higher prevalence of gestational diabetes and preterm birth, as well as a higher incidence of delivering by caesarean section and abnormal childbirth weight. Perinatal depression was also significantly associated with a higher prevalence of maternal postpartum depression and lower prevalence of exclusive breastfeeding practices, as well as with a higher incidence of childhood asthma. Conclusions: Pregnant women's perinatal depression appears to be associated with various socio-demographic, anthropometry, and lifestyle characteristics and with a higher frequency of several adverse pregnancy complications. The present findings emphasize the importance of pregnant women's perinatal mental health, highlighting the need to develop and apply public strategies and policies for psychological counseling and support of future mothers to minimize probable risk factors that may trigger perinatal depression. Novel well-organized, follow-up surveys of enhanced validity are highly recommended to establish more definitive conclusions.
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Affiliation(s)
- Constantina Jacovides
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Antonios Dakanalis
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, School of Health Sciences, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Eleftherios Lechouritis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Elena Papacosta
- Department of Physical Education and Sport Sciences, School of Education and Social Sciences, Frederick University, 3080 Limassol, Cyprus
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Maria Mitsiou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57001 Thessaloniki, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
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Costin MR, Taut D, Baban A, Ionescu T, Murray A, Lindsay C, Secara E, Abbasi F, Sarfo Acheampong I, Katus L, Luong Thanh Bao Y, Hernandez SCLS, Randeny S, Du Toit S, Valdebenito S, Eisner MP. The Role of Maternal Depression Symptoms and Maternal Attachment in Predicting Exclusive Breastfeeding: A Multisite Prospective Study. J Womens Health (Larchmt) 2024; 33:187-197. [PMID: 38011004 DOI: 10.1089/jwh.2023.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Background: Previous research shows that 61% of children younger than 6 months in low- and middle-income countries (LMICs) are not exclusively breastfed. Although data on the role of pre- and postnatal depression on breastfeeding exclusivity is mixed, fetomaternal attachment might foster breastfeeding exclusivity. Thus, we tested the potential mediating role of fetomaternal attachment and postnatal depression in the relationship between maternal prenatal depression and exclusive breastfeeding. Materials and Methods: Data were collected as part of a prospective, cross-cultural project, Evidence for Better Lives Study, which enrolled 1208 expectant mothers, in their third trimester of pregnancy across eight sites, from LMICs. Of the whole sample, 1185 women (mean age = 28.32, standard deviation [SD] = 5.77) completed Computer-Aided Personal Interviews on prenatal depressive symptoms, fetomaternal attachment, and socioeconomic status. A total of 1054 women provided follow-up data at 3-6 months after birth, about postnatal depressive symptoms, exclusive breastfeeding, and infant health indicators. Path analysis was used to assess parallel mediation. Results: In the whole sample, the effect of prenatal depression on breastfeeding exclusivity was completely mediated by postnatal depression, whereas fetomaternal attachment did not mediate the relationship. The full mediation effect was replicated individually in Pakistan and Sri Lanka. Conclusions: The study results indicate that prenatal depression symptoms contributed to the development of depressive symptoms after birth, negatively affecting the probability of exclusive breastfeeding. Future research should explore this in early prevention interventions, increasing the chances of healthy child development in LMICs. Considering the mixed results around the sites, it is important to better understand the relationship between maternal depression, fetomaternal attachment and breastfeeding behavior in each site's socio-cultural context.
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Affiliation(s)
| | - Diana Taut
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Thea Ionescu
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Aja Murray
- Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Carene Lindsay
- Department of Basic Medical Sciences, Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Mona, Kingston, Jamaica
| | - Eugen Secara
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Fahad Abbasi
- Department of Jhpiego-Gender and Research, Fazaia Medical College, Islamabad, Pakistan
| | - Isaac Sarfo Acheampong
- Department of Medical Laboratory Science, Koforidua Technical University, Koforidua, Ghana
| | - Laura Katus
- Institute for Lifecourse Development, School of Human Sciences, University of Greenwich, London, United Kingdom
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom
| | - Yen Luong Thanh Bao
- Department of Epidemiology-Biostatistics and Demography, Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Vietnam
| | | | - Shobhavi Randeny
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Stefani Du Toit
- Department of Global Health, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
| | - Manuel P Eisner
- Institute of Criminology, University of Cambridge, Cambridge, United Kingdom
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
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Bakula DM, Wallisch A, Slosky L, Dean K, Davis A, Edwards S. Prevalence of Parent Mental Health Problems in an Interdisciplinary Feeding Clinic: Short Communication. J Pediatr Gastroenterol Nutr 2023; 77:824-827. [PMID: 37779232 PMCID: PMC10841045 DOI: 10.1097/mpg.0000000000003958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Parents of children with pediatric feeding disorder (PFD) often experience high stress and may be at advanced risk for mental health conditions. We conducted a retrospective chart review of 413 parents who completed intake surveys at an interdisciplinary feeding clinic to determine the prevalence and types of mental health conditions among parents; 41.8% of parents reported a mental health diagnosis among the mother and/or father. Of the parents with mental health conditions, the most prevalent conditions reported were anxiety (71.1% for mothers, 50% for fathers) and mood disorders (62.7% for mothers, 40.9% for fathers). For mothers, 21.1% indicated their mental health disorder had a postpartum onset. Parents of children with birth complications were more likely to have a mental health condition (50.9%) than parents of children without a birth complication (38.7%), and parents reporting mental health conditions had children with significantly more co-occurring medical conditions. Since parent stress and mental health can influence parent-child interactions during mealtime, this study suggests the importance of addressing both parent mental health factors and child factors when treating children for PFD. Future studies are needed to develop novel interventions that support the specific mental health needs of parents of children with PFD.
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Affiliation(s)
- Dana M Bakula
- From Children's Mercy Kansas City, Kansas City, MO
- the School of Medicine, University of Missouri - Kansas City, Kansas City, MO
- the Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
| | - Anna Wallisch
- Juniper Gardens Children's Project, University of Kansas, Kansas City, KS
| | - Laura Slosky
- From Children's Mercy Kansas City, Kansas City, MO
- the School of Medicine, University of Missouri - Kansas City, Kansas City, MO
| | - Kelsey Dean
- the Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
- the Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS
| | - Ann Davis
- the Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
- the Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS
| | - Sarah Edwards
- From Children's Mercy Kansas City, Kansas City, MO
- the School of Medicine, University of Missouri - Kansas City, Kansas City, MO
- the Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO
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Henshaw EJ. Breastfeeding and Postpartum Depression: A Review of Relationships and Potential Mechanisms. Curr Psychiatry Rep 2023; 25:803-808. [PMID: 37906349 DOI: 10.1007/s11920-023-01471-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE OF REVIEW Postpartum depression (PPD) and breastfeeding are important, interrelated health factors. It is established that women who breastfeed exclusively have lowered likelihood of developing significant PPD. Yet, many questions remain around what factors are involved. The purpose of this review is to provide updated information about the relationship between PPD and breastfeeding. RECENT FINDINGS Both psychological and physiological factors have emerged as important moderators and mechanisms of the relationship between postpartum depression and breastfeeding. Breastfeeding self-efficacy, self-compassion, and engagement with the infant during feeding all modify or mediate the relationship, and a complex dynamic relationship among cortisol, oxytocin, progesterone, and estrogen is involved. Importantly, recent intervention studies suggest psychosocial interventions may impact both breastfeeding and mood. Providers and researchers should recognize the interrelationship between the breastfeeding and PPD and apply this understanding to patient care through integrated education and care for both mood and breastfeeding enhancement.
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Affiliation(s)
- Erin J Henshaw
- Department of Psychology, Denison University, 100 West College Street, Granville, OH, 43023, USA.
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Kwon H, Kim J. Effect of Postpartum Depression on Infant Safety Practices in Korea. J Obstet Gynecol Neonatal Nurs 2023; 52:491-500. [PMID: 37659433 DOI: 10.1016/j.jogn.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 09/04/2023] Open
Abstract
OBJECTIVE To describe the prevalence of postpartum depression in a sample of Korean women and to examine the effect of postpartum depression on their adoption of safety practices for their infants. DESIGN Secondary, cross-sectional. SETTING South Korea. PARTICIPANTS A total of 3,127 women who gave birth in 2020. METHODS We applied a complex sample design analysis using the national survey data on postpartum care in South Korea. We analyzed the data using weighted multivariate logistic regression to determine the association between postpartum depression and the adoption of five safety practices for infants. RESULTS A total 42.7% (n = 1,319) of our participants had symptoms of postpartum depression during the initial 7 days after birth. Participants who had postpartum depression were less likely to engage in certain safety practices for infants. CONCLUSION We propose a proactive approach to promote an improved policy for postpartum depression screening alongside a comprehensive program that offers guidance and education to mothers suffering with postpartum depression. The primary objective is to empower these mothers with essential skills that can effectively ensure the safety of their infants.
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Scott A, Kirkland T. Rethinking breastfeeding management: A patient-centered approach based on new guidelines. Nurse Pract 2023; 48:11-19. [PMID: 36811506 DOI: 10.1097/01.npr.0000000000000012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The American Academy of Pediatrics (AAP) now recommends exclusive breastfeeding for the first 6 months of life. Nationally, however, breastfeeding rates are low, with Black infants among the least likely to be breastfed. The updated AAP breastfeeding policy guidelines emphasize an urgent need for a patient-centered approach to cultivate awareness of breastfeeding benefits and promote equitable care.
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Putnick DL, Bell EM, Ghassabian A, Mendola P, Sundaram R, Yeung EH. Maternal antenatal depression's effects on child developmental delays: Gestational age, postnatal depressive symptoms, and breastfeeding as mediators. J Affect Disord 2023; 324:424-432. [PMID: 36565964 PMCID: PMC9885303 DOI: 10.1016/j.jad.2022.12.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Maternal antenatal depression experienced around conception or during pregnancy may adversely affect child development. This study explores three potential mechanisms of the effects of antenatal depression on children's developmental delays at 2-3 years: gestational age of the child, continued depressive symptoms postnatally, and interrupted breastfeeding practices. METHODS Mothers (N = 2888) of 3450 children, including 2303 singletons and 1147 multiples from the Upstate KIDS cohort provided data. Linked hospital discharge data was combined with mothers' reports to identify women with moderate to severe antenatal depression. Gestational age was extracted from birth certificates. Mothers completed a depression screener at 4 months postpartum, reported about their breastfeeding practices from 4 to 12 months postpartum, and completed a developmental delay screener when children were 24, 30, and 36 months. RESULTS In unadjusted path analysis models, mothers with antenatal depression had more postnatal depressive symptoms and breastfed fewer months, which translated into children being more likely to have developmental delays. Gestational age was not a mediator. Effects were similar across girls and boys and singletons and twins, and largely held when adjusting for covariates. LIMITATIONS Main limitations were the relatively advantaged sample and reliance on maternal report. CONCLUSIONS Maternal antenatal depression may impact child development through continued depressive symptoms in the postpartum period and through reduced breastfeeding duration suggesting additional targets for intervention.
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Affiliation(s)
- Diane L Putnick
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA.
| | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, USA
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University Grossman School of Medicine, USA
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, University at Buffalo School of Public Health and Health Professions, USA
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA
| | - Edwina H Yeung
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA
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