mum and child

Mental Health

Maternal health research

These studies look at the links between breastfeeding and mental well-being in mothers.

Prenatal depression moderates the relationship between maternal trauma exposure and cortisol production and predicts breastfeeding behavior

Trauma exposure is associated with many negative outcomes for women during the prenatal and postnatal periods, including increased antenatal depressive symptomatology,  dysregulation of the body’s stress responses, and impact on breastfeeding. This study uses data drawn from a community sample of 96 women residing in a health professional shortage area for mental health and primary care to explore prenatal cortisol and depressive symptom severity into models of relations between trauma exposure and breastfeeding. Results suggest that subclinical prenatal depressive symptoms may interact with trauma symptoms to affect women’s stress responses and breastfeeding behaviours, and that women at risk for breastfeeding difficulty may be identified prenatally.

Bengtson L, Aubuchon-Endsley NL. Prenatal depression moderates the relationship between maternal trauma exposure and cortisol production and predicts breastfeeding behavior. Women Health. 2023 Apr 5:1-12. doi: 10.1080/03630242.2023.2195951. Epub ahead of print. PMID: 37020338.

Relationships between postpartum depression, sleep, and infant feeding in the early postpartum: An exploratory analysis

This study explored the relationships between postpartum depression and maternal and infant sleep parameters and the impact of infant feeding method on infant and maternal sleep and postpartum depression symptomatology. Participants were 61 new mothers aged 18-45 and their full-term, normal birth-weight, singleton infants. The study used a prospective longitudinal design, with data collected on total sleep time, longest sleep period, wake after sleep onset, and night waking for mothers and infants. Findings showed that postpartum depression may be associated with disturbed sleep due to negative perception of sleep among depressed women, rather than disrupted sleep causing postpartum depression. Exclusively breastfeeding women are not more likely to suffer from postpartum depression, and different pathways may predict development of postpartum depression symptoms in exclusively breastfeeding and exclusively formula feeding women.

Rudzik AEF, Robinson-Smith L, Tugwell F, Ball HL. Relationships between postpartum depression, sleep, and infant feeding in the early postpartum: An exploratory analysis. Front Psychiatry. 2023 Mar 24;14:1133386. doi: 10.3389/fpsyt.2023.1133386. PMID: 37032920; PMCID: PMC10079948.

Mental Health Benefits of Breastfeeding: A Literature Review

The relationship between postpartum mental health and breastfeeding is not clearly understood. This composite collection of studies clarifies the importance of breastfeeding in reducing the incidence and severity of maternal postpartum depression by reviewing the correlation between lactation and the maternal stress response, the duration of breastfeeding and its importance in limiting PPD symptoms, the psychological aspects of breastfeeding and the danger that early breastfeeding cessation imposes on a mother’s mental health.

Tucker Z, O’Malley C. Mental Health Benefits of Breastfeeding: A Literature Review. Cureus. 2022 Sep 15;14(9):e29199. doi: 10.7759/cureus.29199. PMID: 36258949; PMCID: PMC9572809.

Receiving screened donor human milk for their infant supports parental wellbeing: a mixed-methods study

This questionnaire-based study of 170 UK parents of infants aged 0-12 months highlights the positive effect donor human milk may have in supporting the mental health and wellbeing of mothers for whom their infant receiving human milk is important. Almost all parents who took part agreed that receiving DHM positively impacted infant health and development, their own mental and physical health, and their family’s wellbeing. Parents expressed relief that they were listened to and supported in relation to their infant feeding decisions.

Brown A, Shenker N. Receiving screened donor human milk for their infant supports parental wellbeing: a mixed-methods study. BMC Pregnancy Childbirth. 2022 May 31;22(1):455. doi: 10.1186/s12884-022-04789-7. PMID: 35641919; PMCID: PMC9154035.

Affectionate Touch in the Context of Breastfeeding and Maternal Depression Influences Infant Neurodevelopmental and Temperamental Substrates

Analysis from a study of 113 mothers and infants found that electroencephalogram (EEG) activity and mother-infant affectionate touch differed as a function of mood and feeding method. Breastfeeding was found to have a positive impact and was associated with increased left and decreased right frontal EEG, suggesting that breastfeeding and positive temperament impact affectionate touch and result in neuroprotective outcomes, even when exposed to maternal depression in early development.

Hardin, JS. et al. 2021. Affectionate Touch in the Context of Breastfeeding and Maternal Depression Influences Infant Neurodevelopmental and Temperamental Substrates. Neuropsychobiology 2021;80:158–175. https://doi.org/10.1159/000511604

Self-conscious emotions and breastfeeding support: A focused synthesis of UK qualitative research

This review examines qualitative UK research on breastfeeding support in order to explore the role of self-conscious emotions in interactions with professional and peer supporters. Findings suggest that women may manage interactions carefully in order to minimise emotions and maintain a positive mothering identity. This can negatively affect outcomes, which breastfeeding supporters need to be aware of so as to positively impact on the mothering identity.

Leeming, D. et al. 2021. Self-conscious emotions and breastfeeding support: A focused synthesis of UK qualitative research. https://doi.org/10.1111/mcn.13270

The differential role of practical and emotional support in infant feeding experience in the UK

This paper explores the vulnerability of postpartum mental health and how mothers can be supported to have a positive infant feeding experience. Findings indicate that interventions should focus on improving the quality and quantity of support from whomever is best placed to help, rather than targeting specific individuals. This would create a more inclusive approach which could result in positive outcomes for maternal wellbeing and help women to meet their infant feeding goals.

Myers S., Page A. E. and Emmott E. H. 2021The differential role of practical and emotional support in infant feeding experience in the UKPhil. Trans. R. Soc. B3762020003420200034

Effect of Community-Initiated Kangaroo Mother Care on Postpartum Depressive Symptoms and Stress Among Mothers of Low-Birth-Weight Infants

Evidence from a randomised clinical trial supports kangaroo mother care (KMC) as an intervention to be incorporated into newborn care in low- and middle-income settings, where 1 in 5 women experience postpartum depression. The study revealed that community-initiated KMC may substantially reduce maternal risk of moderate to severe postpartum depressive symptoms, and was shown to impact upon salivary cortisol, which is a biomarker of stress.

Sinha B, Sommerfelt H, Ashorn P, et al. Effect of Community-Initiated Kangaroo Mother Care on Postpartum Depressive Symptoms and Stress Among Mothers of Low-Birth-Weight InfantsA Randomized Clinical TrialJAMA Netw Open. 2021;4(4):e216040. doi:10.1001/jamanetworkopen.2021.604

Parents With PTSD Are More Likely to Struggle With Breastfeeding

This article from Parents explores the author’s experience of breastfeeding while suffering from PTSD and examines the relationship between the Hypothalamic Pituitary Stress (HPA) axis and the Hypothalamic-Pituitary-Prolactin (HPP) axis, and oxytocin’s impact on the HPA’s response to stress.

Igoe, K. Parents with PTSD are more likely to struggle with breastfeeding. April 2021. Parents.com.

Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving

This article discusses how disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers. Researchers held six initial stakeholder meetings with 15 practitioners and 6 parents with an interest in supporting parent-infant sleep needs, to explore existing service provision and identify gaps. The team sourced sleep-related materials and adapted them into ‘Sleep, Baby & You’, an intervention that could be universally delivered in the UK via NHS antenatal and postnatal practitioners. Upon feedback from parents and practitioners of the new tools, it was found that these materials were a promising tool for promoting parental attitude and behaviour-change.

Ball, H., Taylor, C. et al. 2020. Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving. https://doi.org/10.1371/journal.pone.0237240

Older research 

  • Impact of postpartum depression on infant feeding outcomes

Fallon, V, et al (2016), Postpartum Anxiety and Infant-Feeding Outcomes, Journal of Human Lactation, doi: 10.1177/0890334416662241

  • Breastfeeding difficulties and postpartum depression

Chaput, K, et al (2016) Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of women who have given birth in Calgary: a prospective cohort study. CMAJ Open, 10.9778/cmajo.20150009

  • Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties

Brown, A., Rance, J. & Bennett, P. (2015). Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. Journal of Advanced Nursing, DOI: 10.1111/jan.12832

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