Postnatal depression and infant feeding: A review of the evidence

The evidence supporting the widely-accepted benefits of breastfeeding regularly comes under scrutiny and parents and midwives often receive conflicting information on the subject. However, one of the likely advantages of breastfeeding seems to have been largely overlooked—breastfeeding may help protect against postnatal depression (PND). This review explores the evidence of the link between breastfeeding and postnatal depression. Although research in the early 1980s suggested that breastfeeding increases the risk of PND, more recent research is almost unanimous in suggesting that breastfeeding actually improves postnatal mood, with some evidence suggesting that it makes no difference. While the evidence for maternal psychoprotection conferred by breastfeeding is strong, many studies are confounded by inconsistent definitions of breastfeeding and the variety of clinical tools used to assess depression, many of which are not specific for PND symptoms. This review demonstrates that, not withstanding these research challenges, there is clear evidence that breastfeeding helps to protect against PND. An evidence-based understanding of the risk factors for PND will assist midwives in encouraging breastfeeding and helping women combat this devastating condition.