Nutrition-Related Challenges and Needs of Women With Perinatal Depression: Perspectives of Women With Perinatal Depression and Healthcare Providers

Abstract

ObjectivesWomen with perinatal depression (WWPD) are at high risk for unhealthy dietary behaviors and suboptimal child feeding practices. Despite mounting evidence supporting the importance of healthful nutrition-related behaviors during and after pregnancy, few behavioral nutrition interventions for WWPDs have been developed. The objectives of this study were to identify nutrition-related challenges and needs among WWPD, and to elucidate the role that feeding plays in mother-infant interaction.MethodsUsing a qualitative research design, in-depth interviews were conducted with 18 WWPDs and 10 healthcare professionals (HCPs) who work with WWPD. Interviews were audio recorded and transcribed verbatim. Data was thematically analyzed. Transcripts were coded by two research team members and a third member ensured accuracy and resolved discrepancies. Deductive and inductive coding was performed, and codes were refined and subsequently organized into themes.ResultsWWPD had a mean age of 31 ± 6 years and between 2–4 children. 89% reported college-level education, 56% were non-Hispanic white, and 33% were Black/African American. HCPs were in various specialties related to maternal mental health; 80% had practiced for > 5years. Seven themes with up to three subthemes were identified from interviews with HCPs and WWPDs: 1) Prioritizing mom - institutional and personal; 2) Scarce resources; 3) Body changes - body image and appetite; 4) Importance of support - source of affirmation and greater reliance; 5) Sense of fulfilment associated with infant and young child feeding - bonding and pride; 6) Challenges with breastfeeding - difficult experiences and need for liberalizing recommendations; and 7) Great expectations of motherhood - guilt and shame, overwhelm, and high anxiety.ConclusionsWWPD face several barriers to their own healthful nutrition and that of their children, and findings from this study illustrate key considerations for tailoring dietary guidance to meet the unique needs of WWPD. Further, a person-centered approach for breastfeeding guidance is recommended.Funding SourcesDrexel University College of Nursing and Health Professions, Dean's Rapid Response Relevant (R3) Grant.