Breastfeeding and Depression

 

Introduction

            Breastfeeding results to changes that occur both physically and biologically to both mother and the baby. Several studies have linked it with reduction in postpartum depression because of its effect in inhibiting release of stress hormones.  Other hormonal changes include release of prolactin hormone in which helps in promoting release of breast milk. There is also stimulation of the nipples by hormone oxytocin which thus promotes breastfeeding.

            Furthermore, it results in changes in body size of the baby because it is there source of nutrients and it has been linked with different benefits, both to the mother and the baby. For the mother it is thought to reduce the amount of blood loss after delivery, it also promotes uterus involution and also associated with decreased postpartum depression (Victora et al., 2016). The changes that occur therefore, have positive results as found by most studies that have been done thus it improves the mood of a mother and reduce the risk for developing postpartum depression

 Breastfeeding therefore, results to changes that will lower postpartum depression, enables mothers deal with issues that may arise as they take care of the baby, reduce the level of anxiety and fear, and also results in changes in the brain that improves readiness for breastfeeding the “next” baby. The benefits that it has to the baby promotes good health and this might reduce postpartum depression that might arise to the mother when the baby is unwell.

            Most of the studies that have been carried out have suggested that breastfeeding lowers the level of depression of women who are in their postpartum period; this thus promotes good health and improves the experience of being a mother.

Breastfeeding and depression

Initially, it was thought that the relationship between postpartum depression and breastfeeding was unidirectional; the postpartum depression was also considered to delay breastfeeding initiation and also cause early cessation of breastfeeding. In more recent studies, it has been shown that the relationship could be bidirectional. This thus indicates that, although postpartum depression may result in reduced rates of breastfeeding, women who do not engage in breastfeeding are at higher risk of developing postpartum depression. Furthermore, evidence suggests that breastfeeding may protect a woman from postpartum depression, and also it hastens recovery from the symptoms after birth.

            Besides, various investigations have been done concerning the relationship between breastfeeding and postpartum depression, but it is not yet clear. However, most of them have come out to support the claim that it lowers depression in their conclusions. This might be due to the interaction between the psychological, physiological and sociocultural mechanisms which significantly affect the relationship.  In the most recent studies, there is connections that have shown that mothers who use formula feed for their babies are at a higher risk of depression than those who breastfeed.

            Studies also on breastfeeding intention and initiation and their relationship with postpartum depression. Breastfeeding intention is the decision to breastfeed upon delivery of the baby while initiation is the actual breastfeeding itself after the birth of the baby. Unfortunately, initiation of breastfeeding has been operationalized differently in various investigations that have been done to include, those women who try to breastfeed and stop immediately after, those who practice exclusive breastfeeding for long periods. It also includes those women supplement formula feed with breastfeeding together with those who used expressed breast milk. This can complicate the interpretation.

            Some of the studies have shown no relationship between intention to breastfeed, and prenatal depressive symptoms but others found that women who had prenatal depression are less likely to have the intention to breastfeed. However, some of the follow-ups that were done revealed that some of the women who had intended not breast initiated breastfeeding (Borra, Iacovou & Sevilla, 2015). This thus shows that, women who did not previously intend to breastfeed changed their minds maybe due to encouragement or even education during their prenatal period.

            In other studies that were done on associations between intention to breastfeed and initiation with postpartum depression, it was found that women who were not depressed before the childbirth, and intended to initiate breastfeeding had decreased risk of developing postpartum depression (Borra, Iacovou & Sevilla, 2015). On the other hand, women who had no intention to breastfeed but changed their mind and started breastfeeding had higher risk for developing postpartum depression. It therefore links depression with actions on breastfeeding not breastfeeding itself. Interestingly, when a mother had tried to breastfeed but failed, it was associated with depressive symptoms (Pope et al., 2016). The mothers who did not initiate breastfeeding had a higher chance of developing depression when compared to those who breastfeed.

            A majority of studies have reported that women who do not breastfeed are at higher risk of developing depressive symptoms than those who breastfeed. An example is a longitudinal study that was done Nishioka and colleagues that revealed that at five months after delivery, higher risk for development of postpartum was associated with women who did not breastfeed and lower for those who breastfeed (Nishioka et al., 2011). This was found to persist even if education, income, age and history of previous depression was controlled.

             Early cessation of breastfeeding has been associated with postpartum depression, but the initial experience that mothers go through during breastfeeding could also cause. Breastfeeding also had protective benefits against postpartum depression, in that those women who had low levels of depressive symptoms reported no symptoms when on exclusive breastfeeding (Dias & Figueiredo, 2015). Besides, the duration of breastfeeding has also been related to decreased depressive symptoms from childbirth to three months. It has also been found that women who breastfeed report a decrease in a negative mood. Breastfeeding, therefore, may provide both acute and long-term improved effects on postpartum depression.

             Other studies also report that postpartum depression results after a mother stops breastfeeding at twelve weeks after delivery. However, most mothers who are at higher levels of depression were likely to stop breastfeeding, but they will also report no satisfaction in the feeding of the infants and others such as breastfeeding difficulties and low levels of breastfeeding self-efficacy (Chaput et al., 2016). Levels of depression are more moderate in those who practice exclusive breastfeeding as compared to those who did partial breastfeeding. There was also a relationship between higher risk for depression in the mothers who practiced partial breastfeeding and those who did an exclusive bottle feeding.

            The way in which breastfeeding affects postpartum depression has been studied in different investigations. Negative breastfeeding symptoms and also self-efficacy of breastfeeding on the women have been linked to playing a key role postpartum depression (Chaput et al., 2016). This is because there are a lot of difficult experiences that the woman goes through during there early weeks after delivery, it is also linked with lack of satisfaction of breastfeeding. Besides, in other studies that never found a relation between breastfeeding and postpartum depression, depression was linked with fear of the mothers to breastfeed. This was because the woman who never feared to breastfeed had a lower possibility to get depressed.

            The difficulties in breastfeeding and lack of confidence to breastfed are the most common concern for women who have postpartum depression (Chaput et al., 2016). The relationship between duration of breastfeeding and postpartum depression has been related to other factors. These factors include negative symptoms of the mother, impaired interaction between the mother and the infant, and physiological processes, these factors are also associated with maternal postpartum depression. In addition, depressive symptoms that come in the early postpartum period increased the feelings of low self-esteem and self-efficacy.

             Breastfeeding has also been suggested to weaken the body neuroendocrine response to stress and thus can enhance the mood of the mother. Hormones which are involved in lactation, oxytocin and prolactin are also suggested to have mood improving effects. Oxytocin act by facilitating the feeling of relation and nurturance during breastfeeding (Dias & Figueiredo, 2015). Lactation even is thought to attenuate a cortisol stress response through the reduction of the stress hormone levels.

Midwifery application

             Midwifery is a health profession that takes part in pregnancy, the act of assisting in the delivery of the baby and even in the postpartum period which includes the care of the newborn. Breastfeeding, which is feeding a child with breast milk has been associated with numerous benefits which are both for the baby and the child. The studies that have been done concerning the effects of breastfeeding on postpartum depression is essential in aiding in the management of the condition in mothers who just gave birth to their babies (Wambach & Riordan, 2016). This is because of a better understanding of the effects that the breast milk will help in coming up with the best intervention that will promote better delivery of care.

             Postpartum depression has been associated with other factors such as the breastfeeding difficulties and low self-efficacy to mothers. Midwifery deals with postpartum care of the mothers, understanding these factors will enable midwives to see the gap that may be there concerning dealing with the difficulties in breastfeeding. This will thus foster a better education to the woman, for example, teaching the women on the ways of attaching the child to the breast, will enable the infant suck well and thus reduce depression that may result from the experiences.

             Furthermore, women who have a fear of breastfeeding as found by some studies need to be well explained and taught. It is essential to remove the fear they have to improve their experience during breastfeeding. The women should be instructed on how to breastfeed the baby, for example, the attachment of the baby to the breast, duration on each breast and the frequency of breastfeeding (Wambach & Riordan, 2016). They should also be taught on the benefits of breastfeeding to them and their child; this might help them understand and have more knowledge and thus reduce the fear which in the long run will decrease the risk of postpartum depression.

            Breastfeeding is a natural process, and it has more benefits both to mother and child. It is, therefore, appropriate to advice mothers who attend an antenatal clinic and after delivery to breastfeeding their children if it is not contraindicated. The benefits for the mother such as reduction in the blood flow and hastening recovery of symptoms promotes good health and also reduces the effects that may have on meeting the daily needs (Wambach & Riordan, 2016). It is thus important for the midwives to provide the necessary information for the mothers to make informed decisions.

            The midwives should also help the mothers prepare well before birth. Assisting mothers to make an informed decision on intention to breastfeed and initiation of breastfeeding early will reduce confusion that may result after delivery (Wambach & Riordan, 2016). This will reduce the risk of developing postpartum depression which may arise when women who did not want to breastfeed, finally breastfeeds unintentionally.it is also necessary for the midwives to address issues that are likely to make the women stop breastfeeding.

Conclusion

             Breastfeeding has been linked to lower postpartum depression which is a benefit to a mother while feeding her baby. The benefits that a woman gets through breastfeeding are numerous, and it includes reducing flow after delivery and promotion of the recovery from the symptoms (Victora et al., 2016). The researches that have been done concerning the relationship between breastfeeding and postpartum depression has come out with various reports. There studies that had been done and those recently done have found that breastfeeding lowers postpartum depression. Breastfeeding has been linked with a reduction in postpartum depression in most of the studies, and this thus shows that breastfeeding plays a role in the reduction of depression in mothers in their postpartum period.

References

Borra, C., Iacovou, M., & Sevilla, A. (2015). New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions. Maternal and child health journal, 19(4), 897-907.

Chaput, K. H., Nettel-Aguirre, A., Musto, R., Adair, C. E., & Tough, S. C. (2016). Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of womenwho have given birth in Calgary: a prospective cohort study. CMAJ open, 4(1), E103.

Dias, C. C., & Figueiredo, B. (2015). Breastfeeding and depression: a systematic review of the literature. Journal of affective disorders, 171, 142-154.

Nishioka, E., Haruna, M., Ota, E., Matsuzaki, M., Murayama, R., Yoshimura, K., & Murashima, S. (2011). A prospective study of the relationship between breastfeeding and postpartum depressive symptoms appearing at 1–5 months after delivery. Journal of affective disorders, 133(3), 553-559.

Pope, C. J., Mazmanian, D., Bédard, M., & Sharma, V. (2016). Breastfeeding and postpartum depression: Assessing the influence of breastfeeding intention and other risk factors. Journal of Affective Disorders, 200, 45-50.

Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., ... & Group, T. L. B. S. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490.

Wambach, K., & Riordan, J. (Eds.). (2016). Breastfeeding and human lactation. Jones & Bartlett Learning.