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. 2017 Mar;21(3):636-647.
doi: 10.1007/s10995-016-2150-6.

Postpartum Mental Health and Breastfeeding Practices: An Analysis Using the 2010-2011 Pregnancy Risk Assessment Monitoring System

Kathryn Wouk  1 , Alison M Stuebe  2   3 , Samantha Meltzer-Brody  4
Affiliations

Postpartum Mental Health and Breastfeeding Practices: An Analysis Using the 2010-2011 Pregnancy Risk Assessment Monitoring System

Kathryn Wouk et al. Matern Child Health J. 2017 Mar.

Abstract

Objective Evidence suggests that women with postpartum depression (PPD) are at risk for early breastfeeding cessation, but previous studies have been limited by small samples. The objective of this analysis is to estimate the association between PPD symptoms and breastfeeding using a national, stratified, random sample of U.S. mothers. Methods Data from the 2010-2011 Pregnancy Risk Assessment Monitoring System were analyzed for New York City and the 29 states for which data were available. Multivariable logistic regression was used to explore the association between a pre-pregnancy mental health visit and subsequent breastfeeding initiation as well as PPD and 3-month any and exclusive breastfeeding. To identify state-level variation, we created maps of prevalence and adjusted odds of breastfeeding by PPD and pre-pregnancy mental health status. Results Women reporting a pre-pregnancy mental health visit had 0.61 (95 % CI 0.56, 0.67) times the odds of initiating breastfeeding compared with women who reported no pre-pregnancy visit. At 3 months postpartum, women with PPD symptoms since birth had 0.79 (95 % CI 0.70, 0.88) times the odds of any breastfeeding and reduced odds of exclusive breastfeeding modified by race/ethnicity. We found variation in state-level PPD symptoms and pre-pregnancy mental health prevalence and adjusted odds of breastfeeding. Conclusions for Practice Our results highlight the importance of providing targeted breastfeeding support to women with PPD symptoms, because they are at risk of early breastfeeding cessation. Given the cross-sectional nature of these data, women with early breastfeeding cessation may also be at risk for PPD, requiring screening and treatment.

Keywords: Breastfeeding; Maps; PRAMS; Perinatal depression.

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Figures

Figure 1
Figure 1
top. Map of pre-pregnancy mental health visit prevalence, PRAMS states and New York City, 2010–2011
Figure 2
Figure 2
top. Map of the adjusted odds of breastfeeding initiation between women with and without a pre-pregnancy mental health visit, PRAMS states and New York City, 2010–2011
Figure 3
Figure 3
top. Map of postpartum depression (PPD) symptom prevalence since birth, PRAMS states and New York City, 2010–2011
Figure 4
Figure 4
top. Map of the adjusted odds of 3-month any breastfeeding (ABF) between women responding at or after 3 months with and without postpartum depression (PPD) symptoms, PRAMS states and New York City, 2010–2011
Figure 5
Figure 5
top. Map of the adjusted odds of 3-month exclusive breastfeeding (EBF) between women responding at or after 3 months with and without postpartum depression (PPD) symptoms, PRAMS states and New York City, 2010–2011
See this image and copyright information in PMC

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