Breastfeeding and Postnatal Depression: A Prospective Cohort Study in Sabah, Malaysia

BACKGROUND: Postnatal depression is a disorder that can lead to serious consequences for both the mother and infant. Despite the extensively documented health benefits of breastfeeding, its association with postnatal depression remains uncertain. OBJECTIVE: To investigate the relationship between full breastfeeding at 3 months postpartum and postnatal depressive symptoms among mothers in Sabah, Malaysia. METHODS: A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36 to 38 weeks of gestation and followed up at 1 and 3 months postpartum. Depressive symptoms were assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale (EPDS). Repeated-measures analyses of variance was performed to compare the depression scores over time and between subgroups of breastfeeding mothers. RESULTS: Approximately 46% of women were fully breastfeeding their infants at 3 months postpartum. These mothers had significantly (P < .001) lower mean EPDS scores at both 1 and 3 months postpartum (mean ± SD, 4.14 ± 4.12 and 4.27 ± 4.12, respectively) than others who did not initiate or maintain full breastfeeding for 3 months (4.94 ± 4.34 and 5.25 ± 4.05, respectively). After controlling for the effects of covariates, the differences in EPDS scores remained statistically significant (P = .001) between the 2 breastfeeding groups. CONCLUSION: Full breastfeeding appeared to be negatively associated with postnatal depressive symptoms for mothers residing in Sabah

Swyer syndrome in a woman with pure 46, XY gonadal dysgenesis and a hypoplastic uterus

Swyer syndrome or pure 46, XY gonadal dysgenesis is a condition in which the individuals have female appearance. They classically present as sexually infantile phenotypic females with primary amenorrhoea. People with this disorder have female external genitalia but the uterus and fallopian tubes are underdeveloped. However, they do not have functional gonads (ovaries or testes). Instead, they have streak gonads. We are reporting a case of Swyer syndrome with partially developed breasts, hypoplastic uterus, and absent streak gonads. The patient was treated with hormonal therapy and few years after her presentation, breast and uterine development were noted. In view that the patient is already married, the option of fertility was discussed with her. This case illustrates a rare case of gonadal dysgenesis and demonstrates the importance of counseling on the options of treatment, especially regarding fertility