Prenatal depression and successful lactation

Abstract

ObjectivesPostpartum depression and breastfeeding are two complex situations regulated by neuroendocrine system, primarily cortisol and prolactin. These two hormones play a role in different ways through stress environment. Thus, this study aims to analysed cortisol and prolactin levels, milk volume, and weaning time in breastfeeding mothers with depressive symptoms. MethodsA longitudinal study conducted to 92 mothers in Makassar, South Sulawesi, Indonesia. Baseline information related to socio-demography, parity, body mass index, tobacco exposure, trauma history collected at enrolment, later depressive symptoms, cortisol and prolactin levels, milk volume, collected at postpartum. Follow-up ended at the time of each subject's weaning. This study performed Chi-square test for baseline data, Mann–Whitney U-Test for cortisol, prolactin, milk volume, and Survival Test Cox Proportional Hazard Model for weaning time. Resultsshowed that low cortisol (p=0.973) and prolactin (p<0.040) levels were higher in mothers with depressive symptoms. The mean volume of milk (p<0.001) was higher, and the weaning time (p<0.001) was longer in mothers without depressive symptoms. The Cox proportional hazard regression test results p<0.000, OR: 0.134, 95% CI 0.07–0.25, showed that mothers with symptoms of depression in the second week had the potential to wean 13.4% faster. ConclusionsThis study confirms the difference between prolactin and postpartum depression symptoms. Milk volume produced at second week postpartum highly related to longer duration of breastfeeding.Further study need to consider in understanding transcription pathway of prolactin and cortisol in breastfeeding mothers with acute and chronic stress symptoms. Primary depression screening should be performed prenatal and postpartum more frequently, to prevent the possibility of early weaning.