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Does breastfeeding offer protection against maternal depressive symptomatology?

A prospective study from pregnancy to 2 years after birth

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Abstract

Mothers who breastfeed typically exhibit lower levels of depressive symptomatology than mothers who do not. However, very few studies have investigated the directionality of this relationship. Of the prospective studies published, all but one focus exclusively on whether maternal depression reduces rates of subsequent breastfeeding. This study again examines this relationship, but also the reverse—that breastfeeding might predict lower levels of later depression. Using multilevel modeling, we investigated the relationship between breastfeeding and self-reported depressive symptomatology in 205 women followed prenatally and at 3, 6, 12, and 24 months after birth. Consistent with previous research, women with prenatal depressive symptomatology weaned their infants 2.3 months earlier, on average, than women without such symptomatology. We also found, however, that women who breastfed more frequently at 3 months postpartum showed greater subsequent declines in depressive symptomatology over time compared to women who breastfed less frequently, resulting in lower absolute levels of depressive symptoms by 24 months postpartum, controlling for important confounds. In sum, these findings are consistent with a bidirectional association between breastfeeding and depression, with prenatal depression predicting less breastfeeding soon after birth and breastfeeding predicting declines in maternal depression up to 2 years after birth. We discuss mechanisms that could potentially explain these associations and avenues for future research.

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References

  • Baranowski T, Bee DE, Rassin DK, Richardson CJ, Brown JP, Guenther N, Nader PR (1983) Social support, social influence, ethnicity and the breastfeeding decision. Soc Sci Med 17:1599–1611

    Article  PubMed  CAS  Google Scholar 

  • Beck CT (1996a) A meta-analysis of the relationship between postpartum depression and infant temperament. Nurs Res 45:225–230

    Article  PubMed  CAS  Google Scholar 

  • Beck CT (1996b) A meta-analysis of predictors of postpartum depression. Nurs Res 45:297–303

    Article  PubMed  CAS  Google Scholar 

  • Beck CT (2001) Predictors of postpartum depression: an update. Nurs Res 50:275–285

    Article  PubMed  CAS  Google Scholar 

  • Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103:698–709

    Article  PubMed  Google Scholar 

  • Bernier MO, Plu-Bureau G, Bossard N, Ayzac L, Thalabard JC (2000) Breastfeeding and risk of breast cancer: a metaanalysis of published studies. Hum Reprod Updat 6(4):374–386

    Article  CAS  Google Scholar 

  • Chaudron LH, Klein MH, Remington P, Palta M, Allen C, Essex MJ (2001) Predictors, prodromes and incidence of postpartum depression. J Psychosom Obstet Gynaecol 22:103–112

    Article  PubMed  CAS  Google Scholar 

  • Cooper PJ, Murray L, Stein A (1993) Psychosocial factors associated with the early termination of breast-feeding. J Psychosom Res 37:171–176

    Article  PubMed  CAS  Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item postpartum depression scale. Br J Psychiatry 150:782–786

    Article  PubMed  CAS  Google Scholar 

  • Dai X, Dennis CL (2003) Translation and validation of the breastfeeding self-efficacy scale into Chinese. J Midwifery Womens Health 48:350–356

    Article  PubMed  Google Scholar 

  • Dantzer R, O'Conner JC, Freund GG, Johnson RW, Kelley KW (2008) From inflammation to sickness and depression: when the immune system subjugates the brain. Nat Rev Neurosci 9:46–56

    Article  PubMed  CAS  Google Scholar 

  • Dennis C-L, McQueen K (2007) Does maternal postpartum depressive symptomatology influence infant feeding outcomes? Acta Paediatr 96:590–594

    Article  PubMed  Google Scholar 

  • Dennis C-L, McQueen K (2009) The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review. Pediatrics 123:e736–e751. doi:10.1542/peds.2008-1629

    Article  PubMed  Google Scholar 

  • Dewey KG (2001) Maternal and fetal stress are associated with impaired lactogenesis in humans. J Nutr 131:30125–30155

    Google Scholar 

  • Edhborg M, Friberg M, Lundh W, Widstrom A (2005) “Struggling with life”: narratives from women with signs of postpartum depression. Scand J Public Health 33:261–267

    Article  PubMed  Google Scholar 

  • Else-Quest NM, Shibley Hyde J, Clark R (2003) Breastfeeding, bonding, and the mother–infant relationship. Merrill-Palmer Q 49:495–517

    Article  Google Scholar 

  • Feldman R, Weller A, Zagoory-Sharon O, Levine A (2007) Evidence for a neuroendocinological foundation for human affiliation: plasma oxytocin levels across pregnancy and the postpartum period predict mother–infant bonding. Psychol Sci 18:965–970

    Article  PubMed  Google Scholar 

  • Fergerson SS, Jamieson DJ, Lindsay M (2002) Diagnosing postpartum depression: can we do better? Am J Obstet Gynecol 186:899–902

    Article  PubMed  Google Scholar 

  • Field T (2010) Postpartum depression effects on early interactions, parenting and safety practices: a review. Infant Behav Dev 33:1–6

    Article  PubMed  Google Scholar 

  • Field T, Hernandez-Reif M, Feijo L (2002) Breastfeeding in depressed mother–infant dyads. Early Child Dev Care 172:539–545

    Article  Google Scholar 

  • Galler J, Harrison RH, Biggs MA, Ramsey F, Forde V (1999) Maternal moods predict breastfeeding in Barbados. J Dev Behav Pediatr 20:80–87

    Article  PubMed  CAS  Google Scholar 

  • Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, Brody S, Miller WC (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Reprod Technol Assess 119:1–8

    Google Scholar 

  • Grace SL, Evindar A, Stewart DE (2003) The effect of postpartum depression on child and cognitive development and behavior: a review and critical analysis of the literature. Arch Women's Ment Heal 6:263–274

    Article  CAS  Google Scholar 

  • Green J, Murray D (1994) The use of the Edinburgh Postnatal Depression Scale in research to explore the relationship between antenatal and postnatal dysphoria. In: Cox J, Holden J (eds) Perinatal psychiatry: use and misuse of the Edinburgh Postnatal Depression Scale. Gaskell, London, pp 180–198

    Google Scholar 

  • Groer MW, Davis MW (2006) Cytokines, infections, stress, and dysphoric moods in breastfeeders and formula feeders. J Obstet Gynecol Neonatal Nurs 35:599–607

    Article  PubMed  Google Scholar 

  • Hahn-Holbrook J, Dunkel Schetter C, Haselton M (2013) Breastfeeding and maternal mental and physical health: Is breast best for mom too? In: Spiers M, Geller P, Kloss J (eds) Women's Health Psychology. Wiley, New Jersey

    Google Scholar 

  • Hannah P, Adams D, Lee A, Glover V, Sandler M (1992) Links between early post-partum mood and postnatal depression. Br J Psychiatry 160:777–780

    Article  PubMed  CAS  Google Scholar 

  • Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J (2007) Breastfeeding and maternal and infant health outcomes in developed countries (AHRQ 07-E007). Tufts-New England Medical Center Evidence-based Practice, Center for Healthcare Research and Quality, Rockville, MD

    Google Scholar 

  • Jaedicke KM, Fuhrmann MD, Stefanski V (2009) Lactation modifies stress-induced immune changes in laboratory rats. Brain Behav Immun 23:700–708

    Article  PubMed  CAS  Google Scholar 

  • Jansen J, de Weerth C, Riksen-Walraven M (2008) Breastfeeding and the mother–infant relationship—a review. Dev Rev 28:503–521

    Article  Google Scholar 

  • Jones NA, McFall BA, Diego MA (2004) Patterns of brain electrical activity in infants of depressed mothers who breastfeed and bottle feed: the mediating role of infant temperament. Biol Psychol 67:103–124

    Article  PubMed  Google Scholar 

  • Kendall-Tackett KM (2007) A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health. Int Breastfeed J 2:2–41

    Article  Google Scholar 

  • Kendrick KM (2000) Oxytocin, motherhood and bonding. Exp Physiol 85:111–124

    Article  Google Scholar 

  • Labbok M (2001) Effects of breastfeeding on the mother. Pediatr Clin N Am 48:143–158

    Article  CAS  Google Scholar 

  • Labbok M, Krasocvec K (1990) Towards consistency in breastfeeding definitions. Stud Fam Plan 21:226–230

    Article  CAS  Google Scholar 

  • Light KC, Smith TE, Johns JM, Brownley KA, Hofheimer JA, Amico JA (2000) Oxytocin responsivity in mothers of infants: a preliminary study of relationships with blood pressure during laboratory stress and normal ambulatory activity. Heal Psychol 19:560–567

    Article  CAS  Google Scholar 

  • Matthey S, Henshaw C, Elliot S, Barnett B (2006) Variability in use of cut-off scores and formats on the Edinburgh postnatal depression scale: implications for clinical and research practice. Br J Psychiatry 9:309–315

    CAS  Google Scholar 

  • Merewood A, Brooks D, Bauchner H, MacAuley L, Metha S (2006) Maternal birthplace and breastfeeding initiation among term and preterm infants: a statewide assessment for Massachusetts. Pediatrics 118:1048–1054

    Article  Google Scholar 

  • Merjonen P, Jakela M, Palkki-Raback L, Hintsanen M, Raitakari OT, Viikari J, Keltikangas-Jarvinen L (2011) Breastfeeding and offspring hostility in adulthood. Psychother Psychosom 80:371–373

    Article  PubMed  Google Scholar 

  • Mezzacappa ES, Katlin ES (2002) Breast-feeding is associated with reduced perceived stress and negative mood in mothers. Heal Psychol 21(2):187–193

    Article  Google Scholar 

  • Murray L, Fiori-Cowley A, Hooper R, Cooper P (1996) The impact of postnatal depression and associated adversity on early mother–child interactions and later infant outcomes. Child Development 67:2512–2526

    Google Scholar 

  • Neigel S, Ystrom E, Hagtvet K, Vollrath M (2008) Difficult temperament, breastfeeding and their mutual prospective effects: the Norwegian mother and child cohort study. J Dev Behav Pediatr 29:458–462

    Article  Google Scholar 

  • Nishioka E, Haruna M, Ota E, Matsuzaki M, Murayama R, Yoshimura K, Murashima S (2011) A prospective study of the relationship between breastfeeding and postpartum depressive symptoms appearing at 1–5 months after delivery. J Affect Disord 133(3):553–559

    Article  PubMed  Google Scholar 

  • Nissen E, Gustavsson P, Widström AM, Uvnäs-Moberg K (1998) Oxytocin, prolactin, milk production and their relationship with personality traits in women after vaginal delivery or Cesarean section. J Psychosom Obstet Gynecol 19:49–58

    Article  CAS  Google Scholar 

  • Nobel RE (2005) Depression in women. Metab Clin Exp 54:49–52

    Article  Google Scholar 

  • O'Hara M, Swain A (1996) Rates and risk of postpartum depression: a meta-analysis. Int Rev Psychiatry 8:37–54

    Article  Google Scholar 

  • Pan A, Lucas M, Sun Q, van Dam RM, Franco OH, Manson JE, Willett WC, Ascherio A (2010) Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med 170:1884–1891

    Article  PubMed  Google Scholar 

  • Paulson JF, Dauber S, Leiferman JA (2006) Individual and combined effects of postpartum depression in mothers and fathers on parenting behaviors. Pediatrics 118:659–668

    Article  PubMed  Google Scholar 

  • Radloff LS (1977) The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  • Raudenbush SW, Bryk AS (2002) Hierarchical linear models: applications and data analysis method. Sage, London

    Google Scholar 

  • Rea MF (2004) Benefits of breastfeeding and women's health. J Pediatr 80:142–146

    Google Scholar 

  • Riordan J (2005) Breastfeeding and human lactation, 3rd edn. Jones and Bartlett, Sudbury

    Google Scholar 

  • Rugulies R (2002) Depression as a predictor for coronary heart disease: a review and meta-analysis. Am J Prev Med 23:51–61

    Article  PubMed  Google Scholar 

  • Santer DA, Coyne JC (1997) Shortening the CES-D to improve its ability to detect cases of depression. Psychol Assess 9:233–243

    Article  Google Scholar 

  • Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, Cauley JA (2009) Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol 113:974–982

    PubMed  Google Scholar 

  • Scott JA, Binns CW, Oddy WH (2006) Predictors of breastfeeding duration: evidence from a cohort study. Pediatrics 117:646–655

    Article  Google Scholar 

  • Seimyr L, Edhborg M, Lundh W, Sjogren B (2004) In the shadow of maternal depressed mood: experiences of parenthood during the first year after childbirth. J Psychosom Obstet Gynecol 25:23–34

    Article  CAS  Google Scholar 

  • Sherbourne CD, Stewart AL (1991) The MOS social support survey. Soc Sci Med 32:705–714

    Article  PubMed  CAS  Google Scholar 

  • Skrundz M, Bolten M, Nast I, Hellhammer DH, Meinlschmidt G (2011) Plasma oxytocin concentration during pregnancy is associated with development of postpartum depression. Neuropsychopharmacology 36:1886–1893

    Article  PubMed  CAS  Google Scholar 

  • Stuebe AM, Rich-Edwards JW (2009) The reset hypothesis: lactation and maternal metabolism. Am J Perinatol 26(1):81–88

    Article  PubMed  Google Scholar 

  • Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB (2005) Duration of lactation and incidence of type 2 diabetes. JAMA 294:2601–2610

    Article  PubMed  CAS  Google Scholar 

  • Stuebe AM, Grewen K, Pedersen CA, Propper C, Meltzer-Brody S (2012) Failed lactation and perinatal depression: common problems with shared neuroendocrine mechanisms? J Women's Heal 21:264–272

    Article  Google Scholar 

  • Tamminen T (1988) The impact of mother's depression on her nursing experiences and attitudes during breastfeeding. Acta Paediatr Scand Suppl 77:87–94

    Article  Google Scholar 

  • Taveras EM, Capra AM, Braveman PA, Jensvold NG, Escobar GJ, Lieu TA (2003) Clinician support and psychosocial risk factors associated with breastfeeding discontinuation. Pediatrics 112:108–115

    Article  PubMed  Google Scholar 

  • Uvnäs-Moberg K, Eriksson M (1996) Breastfeeding: physiological, endocrine and behavioral adaptations caused by oxytocin and local neurogenic activity in the nipple and mammary gland. Acta Peadiatr 85:525–530

    Article  Google Scholar 

  • Vandiver TA (1997) Relationship of mother's perceptions and behavior to the duration of breastfeeding. Psychol Rep 80:1375–1384

    Article  PubMed  CAS  Google Scholar 

  • Worobey J (1992) Development milestones related to feeding status: evidence from the Child Health Supplement to the 1981: National Health Interview Survey. J Hum Nutr Diet 5:363–369

    Article  Google Scholar 

  • Zelkowitz P, Milet TH (1996) Postpartum psychiatric disorders: their relationship to psychological adjustment and marital satisfaction in the spouses. J Abnorm Psychol 105:281–285

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology and the Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, USA

    Jennifer Hahn-Holbrook & Christine Dunkel Schetter

  2. Department of Psychology and Communications Studies and the Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, USA

    Martie G. Haselton

  3. Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA

    Christine Dunkel Schetter

  4. University of California, Irvine, Irvine, CA, USA

    Laura M. Glynn

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  1. Jennifer Hahn-Holbrook
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  2. Martie G. Haselton
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  3. Christine Dunkel Schetter
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  4. Laura M. Glynn
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Correspondence to Jennifer Hahn-Holbrook.

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Hahn-Holbrook, J., Haselton, M.G., Dunkel Schetter, C. et al. Does breastfeeding offer protection against maternal depressive symptomatology?. Arch Womens Ment Health 16, 411–422 (2013). https://doi.org/10.1007/s00737-013-0348-9

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