Thesis Title: EXAMINING THE ASSOCIATION BETWEEN SELF-REPORTED POSTPARTUM DEPRESSION AND BREASTFEEDING HABITS OF WOMEN IN GEORGIA 

Thesis Chair: Dr. Ashli A. Owen-Smith

INTRODUCTION: Breastfeeding provides several health benefits for both mother and child. Breastfed infants have lowered risk of sudden infant death syndrome (SIDS), asthma, type 2 diabetes mellitus. respiratory tract infections and obesity. Mothers who have also breastfed also have lower risk of breast and ovarian cancer, cardiovascular diseases, hypertension and have faster pregnancy weight loss after delivery. For decades, researchers have hypothesized a link between breastfeeding and postpartum depression. However, the association remains unclear due to inconsistent findings in prior studies.  

AIM: The purpose of this study is to determine whether breastfeeding initiation and breastfeeding continuation up to 8 weeks are associated with decreased risk of self-reported postpartum depression among Georgia mothers.  

METHODS: A cross-sectional data from the 2017 Georgia Pregnancy Risk Assessment Monitoring System (PRAMS) was used where 955 mothers were sampled for this study. All data analysis was conducted in in SAS 9.4 and SAS-callable SUDAAN version 11.0.1 with sampling weights to account for sampling methodology and bias. A bivariate and multivariate logistic regression models were used to examine the association between breastfeeding initiation, continuation and postpartum depression.

RESULTS:  Among the 955 women who participated in the 2017 GA-PRAMS, only 129 (12%) of mothers reported experiencing PPD. A total of 749 (82 %) of mothers successfully initiated breastfeeding while Two fifths 314 (38%) of Georgia mothers reported breastfed their baby for at least eight weeks while 435(43%) of mothers discontinued breastfeeding before eight weeks. Two multivariate logistic regression were performed. In Model 1 included breastfeeding initiation measure and Model 2 included measure of breastfeeding continuation as the exposure variable. In Mode-1, the only significant relationship found was between history of depression during pregnancy and PPD (OR=1.23; 95% CI 0.36-4.21). In model 2, history of depression during pregnancy (OR=0.15; 95% CI 0.05-0.44) and maternal race NH-Asian (OR=0.19; 95% CI 0.04-0.87) were significantly associated with the odds of having PPD after adjusting for potential confounders. 

DISCUSSION: The evidence suggests that breastfeeding initiation and continuation are not associated with postpartum depression in this sample — however, the high prevalence rate of PPD is a cause for concern. Future studies should consider data sources from multiple years, and participating PRAMS states for a better understanding of the relationship between breastfeeding and PPD.