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Chaput KH, Nettel-Aguirre A, Musto R, et al. 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. 2016;4(1):E103-9doi: 10.9778/cmajo.20150009.
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), E103-9. https://doi.org/10.9778/cmajo.20150009
Chaput, Kathleen H, et al. "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 vol. 4,1 (2016): E103-9. doi: https://doi.org/10.9778/cmajo.20150009
Chaput KH, Nettel-Aguirre A, Musto R, Adair CE, Tough SC. 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. 2016 Mar 21;4(1):E103-9. doi: 10.9778/cmajo.20150009. eCollection 2016. PMID: 27280109; PMCID: PMC4866929.
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CMAJ Open. 2016 Mar 21;4(1):E103-9. doi: 10.9778/cmajo.20150009. eCollection 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

Kathleen H Chaput, Alberto Nettel-Aguirre, Richard Musto, Carol E Adair, Suzanne C Tough

Affiliations

  1. Department of Community Health Sciences (Chaput, Nettel-Aguirre, Musto, Adair, Tough), Cumming School of Medicine; Department of Paediatrics (Chaput, Nettel-Aguirre, Tough), Cumming School of Medicine, University of Calgary; Alberta Health Services - Calgary Zone (Musto); Department of Psychiatry (Adair), Cumming School of Medicine, University of Calgary, Calgary, Alta.

PMID: 27280109 PMCID: PMC4866929 DOI: 10.9778/cmajo.20150009

Abstract

BACKGROUND: A link exists between breastfeeding difficulties and postpartum depression, and evidence shows that some breastfeeding promotion initiatives may increase maternal stress and contribute to risk of the condition. We conducted a prospective cohort study to determine whether breastfeeding difficulties affect the risk of postpartum depression and whether breastfeeding support modifies the relationship between breastfeeding difficulties and postpartum depression.

METHODS: Between June and October 2010, we recruited 442 women who intended to breastfeed from all maternity hospitals in Calgary within 72 hours of giving birth to full-term, singleton infants. We administered questionnaires at birth and 6 weeks and 6 months postpartum, measuring breastfeeding difficulties, exposure to breastfeeding supports and postpartum depression. We used qualitative inquiry to measure breastfeeding support experiences. Postpartum depression was defined as a score of 10 or greater on the Edinburgh Postnatal Depression Scale or a self-reported diagnosis of depression in the first 6 months postpartum.

RESULTS: A total of 386 women (87.3%) reported moderate to severe breastfeeding difficulties and 437 (98.9%) received some form of breastfeeding advice, help or support. Among women with breastfeeding difficulties, those who did not report a negative breastfeeding support experience were at decreased risk of postpartum depression (risk ratio 0.36). In the final regression model a negative breastfeeding support experience was a significant effect modifier of the relationship between breastfeeding difficulties and postpartum depression.

INTERPRETATION: 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 support experiences of breastfeeding women are positive can reduce the risk of postpartum depression.

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