Breastfeeding problems tied to moms’ depression

NEW moms who have particular difficulty breastfeeding may be at greater risk of postpartum depression, a new study suggests. 

The findings, reported in the journal Obstetrics & Gynecology, do not prove that breastfeeding problems are the cause of depression symptoms. But researchers say that new mothers and their doctors should be aware that the two can go hand-in-hand. 

The study found that of nearly 2,600 mothers who had ever breastfed, just less than eight percent screened positive for major depression two months after giving birth. And that risk was higher among women who either had severe breast pain or generally “disliked” breastfeeding during their baby’s first weeks of life. 

Whether the breastfeeding difficulties are to blame is not clear, according to lead researcher Stephanie Watkins, an epidemiologist at the University of North Carolina, Chapel Hill. A limit of the study, she said, is that there was no information on whether mothers had suffered depression during pregnancy. 

So it could be that women who were already depressed had a tougher time with breastfeeding. “Everything is harder when you’re depressed,” said Dr. Alison Stuebe, an obstetrician/gynecologist at UNC who also worked on the study. “It may be that some women were depressed during pregnancy, and that made breastfeeding harder.” 

On the other hand, she said in an interview, it’s possible that underlying hormonal factors contribute to both breastfeeding issues and depression. Stuebe and her colleagues are doing further studies to look into that question. Whatever the reasons for the connection, the researchers said the main message is that early breastfeeding problems could serve as a warning sign of postpartum depression in some women. 

Both Watkins and Stuebe suggested that new moms talk with their doctor about any breastfeeding problems they are having. And doctors, they said, might think about screening those women for postpartum depression. The American College of Obstetricians and Gynecologists (ACOG) says there is not enough evidence to support routinely screening all new mothers for postpartum depression. (The major downside of any medical screening is that it can lead to over-diagnosis, and treatment of people who do not need it.) 

On the other hand, ACOG also says that depression screening can benefit new mothers and their families, and “should be strongly considered.” Focusing screening on women with risk factors for postpartum depression could be the best route, Stuebe noted. “And our study suggests that this (breastfeeding difficulties) may be a risk factor,” she said.
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