Elsevier

Journal of Pediatric Health Care

Volume 28, Issue 1, January–February 2014, Pages 43-50
Journal of Pediatric Health Care

Article
Postpartum Depression, Infant Feeding Practices, and Infant Weight Gain at Six Months of Age

https://doi.org/10.1016/j.pedhc.2012.10.005Get rights and content

Abstract

Introduction

This study examined postpartum depression (PPD) as a potential risk factor for non-adherence to infant feeding guidelines and subsequent infant weight gain.

Methods

Participants were mother-infant dyads from the Infant Feeding Practices Study II (N = 1447). Main study variables were PPD, breastfeeding intensity, addition of cereal to infant formula, and age of introduction to solid foods.

Results

In logistic models adjusted for sociodemographic factors, mothers with PPD were 1.57 times (95% confidence interval [CI]: 1.16, 2.13) more likely to breastfeed at low intensity and 1.77 times (95% CI: 1.16, 2.68) more likely to add cereal to infant formula. Although PPD was associated with the early introduction to solid foods (odds ratio: 1.42; 95% CI: 1.07, 1.89), this relationship was not significant after adjusting for potential confounders. A small but significantly greater average weight gain at 6 months was observed among infants of mothers with PPD (10.15 lb, SD = 2.32 vs. 9.85 lb, SD = 2.32).

Discussion

Screening for PPD at well-child visits may lead to improved maternal health outcomes and the prevention of early life risk factors for childhood obesity.

Section snippets

Sample

The Infant Feeding Practices Study II (IFPS II; www.cdc.gov/ifps), which is the source of data for the current study, was conducted by the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention. IFPS II data were collected longitudinally between May 2005 and June 2007, using a survey format with one prenatal and 10 postnatal mailings. Questionnaires were mailed to mothers approximately monthly, and mothers were asked to provide information on their infant feeding

Main Exposure

PPD was measured using the 10-item Edinburgh Postnatal Depression Scale (EDPS) that was incorporated into the IFPS II 2-month postpartum survey. Each item of the EDPS describes a depressive symptom. Mothers rated the extent to which the symptom matched their feelings during the past several days. Possible scores range from 0 to 30, with higher scores signifying greater severity. The original authors of the EDPS recommended a cut-off score of ≥ 10 to screen for minor depression in primary care

Statistical Analysis

Descriptive statistics were computed and reported for all variables. Chi-square analysis and t-tests were conducted to determine any significant associations among PPD, infant feeding practices, weight gain by 6 months, and our other selected maternal and infant characteristics. Logistic regression models estimated the effect of PPD and other maternal and infant characteristics on breastfeeding intensity, adding cereal to baby bottles, and age of introduction to solid foods. Multivariate linear

Results

Table 1 presents the overall descriptive statistics for maternal and infant characteristics of our sample and frequencies by PPD designation. In this sample, 349 (24.1%) of the mothers were categorized with depressive symptoms (EPDS score ≥ 10) at 2 months infant age. The sample consisted primarily of White women (90.8%) between the ages of 25 and 34 years of age (64.5%). A large proportion (44.6%) had completed college; 18.7% had a high school education or less. The household income

Discussion

…mothers with depressive symptoms were at greater risk for both low breastfeeding intensity and adding cereal to infant formula at 2 months of age than were those without PPD.

In this study of the effects of PPD on infant feeding practices and subsequent infant weight gain, approximately one quarter of the mothers in the sample had EPDS scores indicative of at least mild depression when their babies were 2 months old. This rate falls within the range of PPD prevalence found in other recent

Kathleen F. Gaffney, Professor, School of Nursing, George Mason University, Fairfax, VA.

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  • Cited by (0)

    Kathleen F. Gaffney, Professor, School of Nursing, George Mason University, Fairfax, VA.

    Panagiota Kitsantas, Associate Professor, Department of Health Administration and Policy, George Mason University, Fairfax, VA.

    Albert Brito, Medical Director, InovaCares Clinic for Children, Falls Church, VA, and Assistant Professor, School of Medicine, Virginia Commonwealth University, Richmond, VA.

    Carol S.S. Swamidoss, Doctoral Candidate, School of Nursing, George Mason University, Fairfax, VA.

    Conflicts of interest: None to report.

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