Learning Objective #1: Recognize the difference between women who experience postpartum depression and those who do not with respect to breastfeeding duration

Learning Objective #2: Articulate appropriate interventions for women who are symptomatic for depression and are breastfeeding

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The purpose of the study was to compare the incidence of breast-feeding among women who obtained clinically significant scores on a standardized depression screening measures compared with those who obtained scores within the normal range.

Two standardized screening instruments, the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Depression Scale (PPDS), were used to screen for post partum depression (PPD). Mothers (N=117;) ranging in age from 17-43 were recruited from a midwestern community hospital. Demographic data was obtained before hospital discharge. The EPDS was administered at two weeks postpartum and the PPDS was administered between six to eight weeks.

The alpha coefficient for the EPDS was .86, and the reliability coefficient for the PDSS within this sample was .94. At two weeks postpartum, twelve percent of the women had clinically significant scores indicating moderate to severe depression. The number of women obtaining clinically significant scores at eight weeks was 24%, with 9% of these women scoring in the severely depressed range. Among the women who obtained scores in the depressed range, 75% had iniated breastfeeding in the hospital compared with 60% of non-depressed mothers. At two weeks postpartum 43% of depressed mothers continued to breastfeed compared with 54% of non-depressed mothers. Thirty-two percent of depressed mothers continued to breastfeed compared with 43% of non-depressed mothers at eight weeks postpartum. Forty-two percent of depressed mothers discontinued breastfeeding at 8 weeks post partum compared with 17% of non-depressed mothers. No differences were found between the infants of either group with regard to infant apgars, weight gain, or newborn problems.

The 43% decline in breastfeeding among women who obtained a score in the clinically significant range for depression is a concern. Screening of all women is suggested. Additionally, lactation support is needed for those who are attempting to breastfeed.