Open AccessThe impact of perinatal depression on exclusive breastfeeding: a cohort study
Author(s) -
Rahman Atif,
Hafeez Assad,
Bilal Rakshanda,
Sikander Siham,
Malik Abid,
Minhas Fareed,
Tomenson Barbara,
Creed Francis
Publication year - 2016
Publication title -
maternal and child nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 63
eISSN - 1740-8709
pISSN - 1740-8695
DOI - 10.1111/mcn.12170
Subject(s) - medicine , breastfeeding , depression (economics) , breast milk , cohort , population , prospective cohort study , cohort study , obstetrics , pregnancy , breast feeding , edinburgh postnatal depression scale , pediatrics , depressive symptoms , psychiatry , anxiety , biochemistry , chemistry , genetics , environmental health , biology , economics , macroeconomics
Perinatal depression is associated with infant undernutrition. We hypothesised that perinatal depression was associated with early cessation of exclusive breastfeeding and reduced quantity of breast milk in rural P akistan. We used a prospective cohort design to study a population‐based sample of 132 depressed and 147 non‐depressed women from the third trimester of pregnancy to 6 months post‐natal. Current major depressive episode was measured in the third trimester and 6 months post‐natal using the S tructured C linical I nterview for DSM ‐ IV D iagnosis. In a convenience sample of 24 depressed and 31 non‐depressed exclusively breastfeeding mothers, breast milk quantity was assessed (mL kg −1 infant weight per 24 h) at 4 months using the dose‐to‐mother deuterium dilution method. We administered also the P erception of I nsufficient M ilk questionnaire at 6 months post‐natal. Depression was associated with fewer days of exclusive breastfeeding (91.8 (SD = 47.1) vs. 108.7 days (SD = 54.3) (95% CI: 3.4 to 30.3 P = 0.014). Women with persistent depression ceased exclusive breastfeed earliest. There was no difference in the quantity of breast milk produced by depressed and non‐depressed mothers: 89.3 (SD = 38.1) vs. 83.9 (29.0) ml/kg infant wt/24 hours, P = 0.57. Depressed mothers were significantly more likely to report insufficient milk: PIM scores were 34.4 (SD = 14.3) for depressed and 39.7 (SD = 10.4) for non‐depressed women ( P = 0.004). In Cox regression PIM score mediated the association between depression and early cessation of breastfeeding. In this area of rural P akistan, perinatal depression is associated with early cessation of exclusive breastfeeding and this is associated with mothers' perceptions of insufficiency of breast milk but not reduced milk production.