Association of Breastfeeding with Maternal Depressive Symptoms
Abstract
PURPOSE: To identify risk factors for lack of breastfeeding initiation and duration of <1 month among a racially diverse cohort of women. In particular, our interest was to examine depressive symptoms during pregnancy as a potential risk factor for not initiating or continuing breastfeeding. METHODS: Survey and medical record data from a cohort of pregnant women from the San Francisco Bay area who delivered a singleton infant (n = 1448) were analyzed to examine lack of breastfeeding initiation and duration of <1 month. RESULTS: In this study, 5.6% of women did not initiate breastfeeding, and 11.1% of women who initiated breastfeeding had a duration of breastfeeding of <1 month. There were no racial or ethnic differences in initiation of breastfeeding after adjusting for demographic and clinical characteristics. At 1 month postpartum, African American women were more likely than white women to have a duration of breastfeeding lasting <1 month. Depressive symptoms during or prior to pregnancy had no effect on initiation of breastfeeding even when symptoms were persistent. Women with persistent depressive symptoms (symptoms at two time points, including one prior to delivery) were more likely to have breastfeeding duration of <1 month (odds ratio [OR] 1.77, 95% confidence interval [95% CI] 1.10-2.86), whereas depressive symptoms at a single time point were not associated with breastfeeding duration of <1 month. CONCLUSIONS: Addressing depressive symptoms experienced by women both during and after pregnancy may improve the duration of breastfeeding.
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Research suggests a relation between breastfeeding and depressive symptoms.
“Research suggests a relation between breastfeeding and depressive symptoms [51-55].”
From Mamma mia: A feasibility study of a web-based intervention to reduce the risk of postpartum depression and enhance subjective well-being (2013) · cites this paper as [54]
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“, 2005) even if mothers attempted to breastfeed only once (Pippins et al., 2006) or if the infant received ‘any breast milk during the hospital stay’ (Merewood et al.”
BackgroundDoma, H., Tran, T. D., Tran, T., Hanieh, S., Tran, H., Nguyen, T. T., Biggs, B., & Fisher, J. (2021) · International Breastfeeding Journal · doi:10.1186/s13006-021-00427-8 · Cited by 10 · see citing works
“Evidence also suggests that psychosocial characteristics such as depression throughout pregnancy [16, 17] and prenatal exposure to intimate partner violence [18] can predict early cessation of breastfeeding.”
BackgroundBreastfeeding Initiation in the Context of a Home Intervention to Promote Better Birth Outcomes
Karp, S. M., Howe‐Heyman, A., Dietrich, M. S., & Lutenbacher, M. (2013) · Breastfeeding Medicine · doi:10.1089/bfm.2012.0151 · Cited by 10 · see citing works
“Some results suggest that women with higher prenatal depressive symptoms are less likely to plan and/or initiate breastfeeding,13–15 whereas others report no association with breastfeeding initiation, but rather an association with a shorter duration of breastfeeding.(16,17) From recent meta-analyses and systematic re…”
BackgroundMedina, J., Guzman, R. M. D., & Workman, J. L. (2021) · Hormones and Behavior · doi:10.1016/j.yhbeh.2021.105035 · Cited by 9 · see citing works
Maternal Well-Being in Pregnancy and Breastfeeding Practices: Findings from the ROLO Study
Yelverton, C. A., Geraghty, A. A., O’Brien, E. C., Killeen, S. L., Larkin, E., Mehegan, J., Cronin, M., & McAuliffe, F. M. (2023) · American Journal of Perinatology · doi:10.1055/s-0043-1772230 · Cited by 5 · see citing works
Postpartum Depression and the Role of Nutritional Factors
Judge, M. P., & Beck, C. T. (2008) · Humana Press eBooks · doi:10.1007/978-1-59745-112-3_19 · Cited by 5 · see citing works
Weaver, S. R., & Hernandez, L. L. (2018) · Journal of Mammary Gland Biology and Neoplasia · doi:10.1007/s10911-018-9390-6 · Cited by 5 · see citing works
Haga, S. M. (2011) · NORA - Norwegian Open Research Archives · Cited by 5 · see citing works
Development and validation of the Cannabis Exposure in Pregnancy Tool (CEPT): a mixed methods study
Chaput, K. H., McMorris, C. A., Metcalfe, A., Ringham, C., McNeil, D. A., Konschuh, S., Sycuro, L. K., McDonald, S., & McDonald, S. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-06485-0 · Cited by 6 · see citing works
Singh, S. P., Mukadam, S. S., & Bisht, A. (2024) · The Journal of Phytopharmacology · doi:10.31254/phyto.2024.13205 · Cited by 3 · see citing works
Resiliency in the midst of risk: retention of women with limited resources in prenatal care
Tough, S., Siever, J. E., Johnston, D. W., & Clarke, D. (2007) · Expert Review of Obstetrics & Gynecology · doi:10.1586/17474108.2.5.631 · Cited by 3 · see citing works
Postpartum Depression and the Role of Nutritional Factors
Judge, M. P., & Beck, C. T. (2018) · Springer eBooks · doi:10.1007/978-3-319-90988-2_19 · Cited by 3 · see citing works
Effect of gestational anemia on breastfeeding– a prospective follow-up -study
Kemppinen, L., Mattila, M., Ekholm, E. M. K., Perasto, L., Karlsson, H., Mäkikallio, K., & Karlsson, L. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07775-x · Cited by 2 · see citing works
“The covariates included in Step 1 were mode of delivery, parity, level of education, which are all known to affect the duration of breastfeeding [22–24].”
Jafar, N. K. A., Tham, E. K. H., Fok, D., Chua, M. C., Teoh, O. H., Goh, D. Y. T., Shek, L. P., Yap, F. K. P., Tan, K. H., Gluckman, P. D., et al. (2026) · Nutrients · doi:10.3390/nu18030405 · Cited by 2 · see citing works
“Similar null associations have been observed in other low-risk or non-clinical populations [53,54] like our sample population, suggesting that the influence of depressive symptoms on breastfeeding may be more pronounced in high-risk populations or when symptoms are clinically significant.”
Haight, S. C., Bates, L. M., Chung, E. O., Collins, A. J., Frost, A., Kachoria, A. G., Shartle, K., Sikander, S., & Maselko, J. (2026) · Archives of Women s Mental Health · doi:10.1007/s00737-026-01722-1 · Cited by 2 · see citing works
“Longitudinal studies have been conducted, but mostly in high-income countries like the U.S. and U.K. (Henderson et al. 2003; Pippins et al. 2006; Cooke et al. 2007; McCarter-Spaulding and Horowitz 2007; Dennis and McQueen 2007; Fairlie et al. 2009; Bogen et al. 2010; Hamdan and Tamim 2012; Ystrom…”
Effet d’une interruption précoce de l’allaitement sur le vécu maternel
Walburg, V., Conquèt, M., & Callahan, S. (2009) · Journal de Pédiatrie et de Puériculture · doi:10.1016/j.jpp.2009.06.004 · Cited by 2 · see citing works
Breastfeeding and postnatal depression in Sabah, Malaysia
Yusuff, M. K. M., & Yusuff, A. S. M. (2013) · eSpace (Curtin University) · Cited by 2 · see citing works
Development and Validation of the Cannabis Exposure in Pregnancy Tool (CEPT)Preprint
Chaput, K. H., McMorris, C. A., Metcalfe, A., Ringham, C., Wood, S., McNeil, D. A., Konschuh, S., Sycuro, L. K., & McDonald, S. (2022) · medRxiv · doi:10.1101/2022.09.09.22279777 · Cited by 2 · see citing works
Ogah, A. O., & Ogah, J.-A. O. (2023) · medRxiv · doi:10.1101/2023.08.26.23294662 · Cited by 2 · see citing works
“35 The discrepancies in these study reports may likely be as a result of the interactions between the numerous and complex physiological, psychological, and sociocultural mechanisms and the different study methodology employed.”
BackgroundLucas, R. (2011) · 41st Biennial Convention (29 October - 2 November 2011) · Cited by 1 · see citing works
Does Providing Human Milk for Her Very Low-birthweight Infant Help the Mother?
Furman, L. (2007) · NeoReviews · doi:10.1542/neo.8-11-e478 · Cited by 1 · see citing works
Breastfeeding experiences of low-income women in the city of Winnipeg: a qualitative study
Pierce, L. (2014) · Mspace (University of Manitoba) · Cited by 1 · see citing works
Barseldepresjon: En kryss-seksjonell studie av psykososiale risikofaktorer
Kalkvik, H. (2009) · NORA - Norwegian Open Research Archives
Breastfeeding and Contraceptive Use: Analysis of a Statewide Survey
Murdock, A. E. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/n04g-1953
Mehta, U. J. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/hdgw-8570
Clark, E. L. (2021) · cIRcle (University of British Columbia) · doi:10.14288/1.0400894
(2021) · Elsevier eBooks · doi:10.1016/b978-0-323-68013-4.00080-8
Pharmacognostic evaluation and development of quality control parameters for Fufal (Areca nut)
Devi, U., Ansari, S. A., Khan, A. S., Ahmad, A., Ahmed, M. W., & Meena, R. (2024) · The Journal of Phytopharmacology · doi:10.31254/phyto.2024.13305
Salud materna asociada a la lactancia materna exclusiva ENDES 2021-2023
Huapaya, M. A., Campaña-Acuña, A. A., & Castillo, F. L. (2024) · Revista Peruana de Investigación Materno Perinatal · doi:10.33421/inmp.2024441
Doma, H., Tran, T. D., Tran, T., Hanieh, S., Tran, H., Nguyen, T. T., Biggs, B.-A., & Fisher, J. (2021) · Figshare · doi:10.6084/m9.figshare.16800271
GÖKMEN, Ö. Ö., & Sözbir, Ş. Y. (2026) · International Journal of Disabilities Sports & Health Sciences · doi:10.33438/ijdshs.1947835
- Authors
- Pippins, J. R., Brawarsky, P., Jackson, R. A., Fuentes-Afflick, E., & Haas, J. S.
- Affiliations
- Brigham and Women's Hospital (US)
- University of California, San Francisco (US)
- Departments of Pediatrics and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.
- Venue
- Journal of Women's Health
- Publisher
- SAGE Publications
- Published
- 2006-07
- Volume
- 15
- Issue
- 6
- Pages
- 754-762
- ISSN
- 1059-7115 (ISSN-L)
- 1540-9996
- 1931-843X
- OpenAlex
- W2004839259
- Cited by
- 76
- References
- 46
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 7 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 4 · 2016: 6 · 2015: 1 · 2014: 3 · 2013: 8 · 2012: 6
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Women s Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD037389, R01 HD37389)
- Topics
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Keywords
- breastfeeding initiation, breastfeeding duration, maternal depressive symptoms, perinatal depression, pregnancy, African American women, racial and ethnic differences, postpartum depression
- MeSH terms
- Adult, Attitude to Health, Black or African American, Breast Feeding, California, Female, Humans, Infant, Newborn, Maternal Behavior, Mothers, Surveys and Questionnaires, Risk Factors, Cohort Studies, Confidence Intervals, Odds Ratio, Women's Health, Depression, Postpartum, White People
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