A history of depression and prenatal depression are associated with a lower likelihood of breastfeeding initiation and maintenance, and more breastfeeding problems

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 breast-feeding 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.