'Universidad de Sevilla - Secretariado de Recursos Audiovisuales y Nuevas Tecnologias'
Abstract
Context
The benefits of breastfeeding for both the mother and the child are well documented, as are the
negative health consequences of perinatal depression.
Objective
To explore causality in the relationships between breastfeeding and perinatal depression. In particular
the causal effect of breastfeeding on postpartum maternal mental health was investigated together with
the causal effect of antenatal maternal wellbeing on breastfeeding intentions, prevalence, and duration.
Methods
We used the Avon Longitudinal Study of Parents and Children (ALSPAC) dataset which offers
longitudinal information on mothers and their children. Multivariate linear and logistic regression
analyses were performed to explore the effects of any and exclusive breastfeeding initiation and
duration on postpartum mental health, measured at different time moments (8 weeks, 8 months, 21
months and 32 months post partum) We also explored the effects of antenatal mental health measured
at 18 and 33 weeks pregnancy on the different breastfeeding outcomes.
Results
We found first that, even though there was a strong bivariate relationship between breastfeeding and
maternal wellbeing, once potential confounders were controlled for, especially maternal mental and
physical health during pregnancy, breastfeeding ceased to exert a significant effect on maternal
wellbeing. Therefore apparently breastfeeding did not causally affect maternal postnatal wellbeing.
Second, antenatal mental health was positively related to breastfeeding. This effect remained
statistically significant after all potential confounders were controlled for with respect to breastfeeding
duration, though not for other measures of breastfeeding. Third, the usual screening value for perinatal
depression of EPDS greater than 13 may be unnecessarily high. A value of 14 to 15 EPDS was enough
to capture the negative impact of prenatal depression on breastfeeding duration.
Conclusion
Depressive symptomatology in the perinatal period negatively influences infant-feeding outcomes.
Prenatal identification of depression-prone mothers may allow targeting breastfeeding promotion
interventions to this highly vulnerable grou