Initiation and exclusivity of breastfeeding: association with mothers' and fathers' prenatal and postnatal depression and marital distress

Jan 31, 2016Acta obstetricia et gynecologica Scandinavica

Breastfeeding start and exclusivity linked to depression and relationship problems in mothers and fathers before and after birth

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Abstract

Mothers experiencing depressive symptoms both prenatally and postnatally reported an average exclusive breastfeeding duration of 1.54 months.

Prenatal depressive symptoms did not predict breastfeeding initiation or exclusive breastfeeding (EBF) duration.
Postnatal depressive symptoms were associated with shorter EBF duration.
Mothers with both prenatal and postnatal depressive symptoms had the shortest EBF duration compared to those with symptoms at only one time point.
Higher prenatal marital distress was linked to longer EBF duration.
Continuity of maternal depressive symptoms throughout the perinatal period may adversely affect EBF duration.

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INTRODUCTION: This study explored the effects of mothers' and fathers' prenatal and postnatal depressive symptoms and marital distress on breastfeeding initiation and exclusive breastfeeding (EBF) duration.

MATERIAL AND METHODS: This was a prospective follow-up of a cohort sample of 873 families participating to an intensive follow-up cohort of longitudinal Steps to the Healthy Development and Well-being of Children study (The STEPS study) in Southwestern Finland. The depressive symptoms were evaluated by The Edinburgh Postpartum Depression Scale and marital distress by the Revised Dyadic Adjustment Scale at 20th gestational week and at 4 months postpartum. EBF was self-reported real-time and defined as an infant receiving no food or drink other than mother's breast milk since birth, except occasionally water.

RESULTS: Neither parents' prenatal depressive symptoms predicted breastfeeding initiation or EBF duration. The mothers' prenatal depressive symptoms, in turn, predicted their postnatal depressive symptoms, which were associated with shorter duration of EBF. The EBF duration was shortest amongst the mothers who had depressive symptoms both pre- and postnatally compared to mothers who had depressive symptoms only in either time point alone (M = 1.54, 2.06 and 2.04 months, respectively). Higher prenatal maternal marital distress was associated with longer EBF duration.

CONCLUSIONS: The findings suggest that the continuity of maternal depressive symptoms throughout the perinatal period has adverse effect on EBF duration. Identification and treatment of mothers' depressive symptoms already during the prenatal period may improve breastfeeding practices. The finding of mothers' marital distress having positive impact on breastfeeding practices requires further investigation.

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Initiation and exclusivity of breastfeeding: association with mothers' and fathers' prenatal and postnatal depression and marital distress

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