These studies look at the links between breastfeeding and mental well-being in mothers.
Affectionate Touch in the Context of Breastfeeding and Maternal Depression Influences Infant Neurodevelopmental and Temperamental Substrates
Data analysis from a study of 113 mothers and their infants found that EEG activity and mother-infant affectionate touch differed as a function of mood and feeding method. Breastfeeding positively impacted affectionate touch behaviors and was associated with increased left and decreased right frontal EEG activation even for depressed groups, suggesting that breastfeeding and the infant’s positive temperament influence mother-infant affectionate touch patterns and result in neuroprotective outcomes for infants, even those exposed to maternal depression within early development.
Hardin, JS. et al. 2021. Affectionate Touch in the Context of Breastfeeding and Maternal Depression Influences Infant Neurodevelopmental and Temperamental Substrates. Neuropsychobiology 2021;80:158–175. https://doi.org/10.1159/000511604
Self-conscious emotions and breastfeeding support: A focused synthesis of UK qualitative research
This review re-examines qualitative UK research on breastfeeding support conducted between 2007 and 2020 in order to explore the role of self-conscious emotions and related appraisals in interactions with professional and peer supporters. Key findings suggest that women may manage interactions with breastfeeding supporters carefully to minimise emotions including shame, guilt, embarrassment and humiliation in order to maintain a positive mothering identity. This can reduce the effectiveness of support, and breastfeeding supporters need to be emotionally aware and self-conscious so as to positively impact women’s development of a positive mothering identity.
The differential role of practical and emotional support in infant feeding experience in the UK
This paper explores the vulnerability of postpartum mental health and which forms of support can prolong breastfeeding and help to promote a positive infant feeding experience. Findings indicate that the type of support received has important relationships with infant feeding outcomes and that interventions should focus on improving the quality and quantity of support from whomever is best placed to help, rather than targeting specific individuals. This would create a more inclusive approach which could be even more effective in supporting maternal wellbeing and helping women meet their infant feeding goals.
Effect of Community-Initiated Kangaroo Mother Care on Postpartum Depressive Symptoms and Stress Among Mothers of Low-Birth-Weight Infants
Evidence from a randomised clinical trial supports kangaroo mother care (KMC) as an intervention to be incorporated into newborn care in low- and middle-income settings, where 1 in 5 women experience postpartum depression. The study revealed that community-initiated KMC may substantially reduce maternal risk of moderate to severe postpartum depressive symptoms, and was shown to impact upon salivary cortisol, which is a biomarker of stress.
Sinha B, Sommerfelt H, Ashorn P, et al. Effect of Community-Initiated Kangaroo Mother Care on Postpartum Depressive Symptoms and Stress Among Mothers of Low-Birth-Weight Infants: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(4):e216040. doi:10.1001/jamanetworkopen.2021.604
Parents With PTSD Are More Likely to Struggle With Breastfeeding
This article from Parents explores the author’s experience of breastfeeding while suffering from PTSD and examines the relationship between the Hypothalamic Pituitary Stress (HPA) axis and the Hypothalamic-Pituitary-Prolactin (HPP) axis, and oxytocin’s impact on the HPA’s response to stress.
Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving
This article discusses how disrupted parental sleep, presenting as post-partum fatigue and perceived as problematic infant sleep, is related to increased symptoms of depression and anxiety among new mothers and fathers. Researchers held six initial stakeholder meetings with 15 practitioners and 6 parents with an interest in supporting parent-infant sleep needs, to explore existing service provision and identify gaps. The team sourced sleep-related materials and adapted them into ‘Sleep, Baby & You’, an intervention that could be universally delivered in the UK via NHS antenatal and postnatal practitioners. Upon feedback from parents and practitioners of the new tools, it was found that these materials were a promising tool for promoting parental attitude and behaviour-change.
Ball, H., Taylor, C. et al. 2020. Development and evaluation of ‘Sleep, Baby & You’—An approach to supporting parental well-being and responsive infant caregiving. https://doi.org/10.1371/journal.pone.0237240
Impact of postpartum depression on infant feeding outcomes
This systematic review examining the relationship between postpartum anxiety (PPA) and infant feeding outcomes found that women with symptoms of PPA were less likely to breastfeed exclusively and more likely to terminate breastfeeding earlier. Some evidence also suggests that those experiencing PPA are less likely to initiate breastfeeding and more likely to supplement with formula in the hospital. In those who do breastfeed, PPA reduces self-efficacy, increases breastfeeding difficulties, and may negatively affect breastfeeding behaviors and breast milk composition. Researchers called for increased breastfeeding support for mothers affected by PPA.
Impact of Baby Friendly accreditation on breastfeeding rates, cognitive outcomes and maternal mental health
Using data from the UK Millennium Cohort Study, these researchers found that women giving birth in hospitals that participated in the Baby Friendly Initiative (BFI) were up to 15 percentage points more likely to initiate breastfeeding and between 8 and 9 percentage points more likely to breastfeed exclusively at 4 and 8 weeks than comparable mothers giving birth in non-participating hospitals. Mothers from low income families, and with low levels of education, were more responsive to the BFI programme than highly educated mothers in more affluent families.
They then compared the outcomes of children who were breastfed as a result of the BFI program with those of otherwise similar non-breastfed children. They found significant effects of breastfeeding on cognitive outcomes throughout childhood, and in particular between ages 3 and 7. In contrast to the previous literature, researchers found no statistically significant impact of breastfeeding on a number of health outcomes, but saw an improvement in child emotional development and maternal mental health.
Breastfeeding difficulties and postpartum depression
This study found that, among women with breastfeeding difficulties, those who did not report a negative breastfeeding support experience were at a decreased risk of postpartum depression. A negative breastfeeding support experience was found to have a significant effect on the relationship between breastfeeding difficulties and postpartum depression.
They concluded that the quality of breastfeeding support is important not only for breastfeeding promotion but also for maternal mental health. Educating front-line caregivers to ensure that breastfeeding women have positive experiences of support can reduce the risk of postpartum depression.
Chaput, K, et al (2016) Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of women who have given birth in Calgary: a prospective cohort study. CMAJ Open, 10.9778/cmajo.20150009
Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties
This study found that short breastfeeding duration and stopping breastfeeding for physical difficulty and pain were associated with higher depression score.
The authors conclude that understanding women’s specific reasons for stopping breastfeeding is critical in understanding women’s breastfeeding experience and providing emotional support. They also stress the importance of early breastfeeding support.
Brown, A., Rance, J. & Bennett, P. (2015). Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. Journal of Advanced Nursing, DOI: 10.1111/jan.12832