These studies look at the links between breastfeeding and mental well-being in mothers.
The differential role of practical and emotional support in infant feeding experience in the UK
Given the vulnerability of postpartum mental health, this paper aims to explore both how support prolongs breastfeeding and which forms of support promote the positive experience of all infant feeding. Using survey data collected online from 515 UK mothers with infants aged 0–108 weeks, Cox regression models assessed the relationship between receiving different types of support, support need and breastfeeding duration. Overall, practical support via infant feeding broadly predicted shorter breastfeeding durations and poorer feeding experience; results in relation to other forms of support were more complex. Our findings indicate different forms of support have different associations with infant feeding experience. They also highlight the wide range of individuals beyond the nuclear family on which postpartum mothers in the UK rely.
Testing the buffering hypothesis: Breastfeeding problems, cessation, and social support in the UK.
This study tests the hypothesis that social support buffers mothers from the negative impact breastfeeding problems have on duration. Cox models were run on a sample of 565 UK mothers who completed a retrospective online survey about infant feeding and social support in 2017–2018, with results indicating that breastfeeding problems were important predictors of cessation; however, the direction of the effect was dependent on the problem type and type of support from a range of supporters. Experiencing breastfeeding problems is the norm, but its impact may be mitigated via social support.
Page, A. et al. 2021. Testing the buffering hypothesis: Breastfeeding problems, cessation, and social support in the UK. Medical Research Council, Grant/Award Number: MR/P014216/1. https://doi.org/10.1002/ajhb.23621
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 Infants: A Randomized Clinical Trial. JAMA 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.
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
Impact of postpartum depression on infant feeding outcomes
This systematic review examining the relationship between postpartum anxiety (PPA) and infant feeding outcomes found that women with symptoms of PPA were less likely to breastfeed exclusively and more likely to terminate breastfeeding earlier. Some evidence also suggests that those experiencing PPA are less likely to initiate breastfeeding and more likely to supplement with formula in the hospital. In those who do breastfeed, PPA reduces self-efficacy, increases breastfeeding difficulties, and may negatively affect breastfeeding behaviors and breast milk composition. Researchers called for increased breastfeeding support for mothers affected by PPA.
Impact of Baby Friendly accreditation on breastfeeding rates, cognitive outcomes and maternal mental health
Using data from the UK Millennium Cohort Study, these researchers found that women giving birth in hospitals that participated in the Baby Friendly Initiative (BFI) were up to 15 percentage points more likely to initiate breastfeeding and between 8 and 9 percentage points more likely to breastfeed exclusively at 4 and 8 weeks than comparable mothers giving birth in non-participating hospitals. Mothers from low income families, and with low levels of education, were more responsive to the BFI programme than highly educated mothers in more affluent families.
They then compared the outcomes of children who were breastfed as a result of the BFI program with those of otherwise similar non-breastfed children. They found significant effects of breastfeeding on cognitive outcomes throughout childhood, and in particular between ages 3 and 7. In contrast to the previous literature, researchers found no statistically significant impact of breastfeeding on a number of health outcomes, but saw an improvement in child emotional development and maternal mental health.
Breastfeeding difficulties and postpartum depression
This study found that, among women with breastfeeding difficulties, those who did not report a negative breastfeeding support experience were at a decreased risk of postpartum depression. A negative breastfeeding support experience was found to have a significant effect on the relationship between breastfeeding difficulties and postpartum depression.
They concluded that the quality of breastfeeding support is important not only for breastfeeding promotion but also for maternal mental health. Educating front-line caregivers to ensure that breastfeeding women have positive experiences of support can reduce the risk of 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
This study found that short breastfeeding duration and stopping breastfeeding for physical difficulty and pain were associated with higher depression score.
The authors conclude that understanding women’s specific reasons for stopping breastfeeding is critical in understanding women’s breastfeeding experience and providing emotional support. They also stress the importance of early breastfeeding support.
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