Abstract
INTRODUCTION: Up to 30% of women experience postpartum depression, anxiety, or both. The effect of such maternal mental health issues on breastfeeding is poorly understood. Our objective was to examine relationships between maternal mental health and breastfeeding initiation, exclusivity, and duration. METHODS: This was a cross-sectional study of families with children aged 12 months and younger using the 2011 National Survey of Children's Health (10,024 children). We used logistic and linear regression models to measure associations between self-reported maternal mental health (poor or fair, good, very good, excellent) and ever breastfeeding, exclusive breastfeeding for 6 months, and duration of any breastfeeding. We controlled for maternal (physical health, age, household, smoker, primary language, single mother, parental stress), child (prematurity, race, sex), and socioeconomic (child insured, poverty level, Women, Infants, and Children [WIC]) factors that may affect breastfeeding. RESULTS: Eighty-three percent (95% confidence interval [CI] 81.3–84.5) of children were ever breastfeed of whom 17.4% (95% CI 15.2–19.5) were exclusively breastfed for 6 months. Average duration was 5.6 months (95% CI 5.4–5.8). After adjusting for covariates, the odds of ever breastfeeding were 0.31 lower among mothers reporting poor or fair mental health compared with mothers reporting excellent mental health (95% CI 0.00–0.74, P=.003). The odds of exclusive breastfeeding were not significantly different (OR 0.47, 95% confidence interval 0.00–1.50, P=.28). There was no significant difference in duration of breastfeeding by maternal mental health (P=.78). CONCLUSION AND IMPLICATION: Breastfeeding initiation was strongly associated with maternal mental health, whereas exclusive breastfeeding and duration were not. These findings suggest that breastfeeding may be of good duration if initiation could be improved, indicating a potential role for targeted breastfeeding support for women with mental health concerns.
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