Md Jahirul Islam1,2, Lisa Broidy1,3, Kathleen Baird4, Mosiur Rahman5, Khondker Mohammad Zobair6. 1. Griffith Criminology Institute, Mt Gravatt, Brisbane, Queensland, Australia. 2. Skills for Employment Investment Program (SEIP) Project, Finance Division, Ministry of Finance, Dhaka, Bangladesh. 3. Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America. 4. Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Sydney, New South Wales, Australia. 5. Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh. 6. Department of International Business and Asian Studies, Griffith University, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: Early termination of exclusive breastfeeding (EBF) and postpartum depression (PPD) are both recognized as global health problems. Recent literature reviews demonstrate a notable link between PPD and breastfeeding outcomes, however, the underlying mechanisms linking the two remain unclear. OBJECTIVES: The aim of the study is to: 1) explore the comparative risk for PPD among new mothers who terminated EBF before the 6-month mark, compared to those who did not; and 2) test whether maternal stress and social support operate to mediate and/or moderate the relationship between EBF and PPD. METHODS: Between October 2015 and January 2016, a cross-sectional study was carried out among 426 new mothers of Bangladesh who were six months postpartum. RESULTS: Based on the multivariate logistic regression model, non-exclusively breastfeeding mothers were 7.58-fold more likely to experience PPD (95% CI [3.94, 14.59]) than exclusively breastfeeding mothers. Additionally, maternal stress and social support not only partially mediate the relationship between EBF and PPD but also substantially moderate this relationship. Specifically, the odds of PPD are significantly higher among mothers who had early EBF interruption in conjunction with increased stress levels and limited social support. CONCLUSIONS: Current evidence suggests that concurrent screening for EBF difficulties and maternal stress are important red flags that might hint at complications even before mother's screen positive for PPD. Support and care from family members can provide assistance in overcoming this issue.
BACKGROUND: Early termination of exclusive breastfeeding (EBF) and postpartum depression (PPD) are both recognized as global health problems. Recent literature reviews demonstrate a notable link between PPD and breastfeeding outcomes, however, the underlying mechanisms linking the two remain unclear. OBJECTIVES: The aim of the study is to: 1) explore the comparative risk for PPD among new mothers who terminated EBF before the 6-month mark, compared to those who did not; and 2) test whether maternal stress and social support operate to mediate and/or moderate the relationship between EBF and PPD. METHODS: Between October 2015 and January 2016, a cross-sectional study was carried out among 426 new mothers of Bangladesh who were six months postpartum. RESULTS: Based on the multivariate logistic regression model, non-exclusively breastfeeding mothers were 7.58-fold more likely to experience PPD (95% CI [3.94, 14.59]) than exclusively breastfeeding mothers. Additionally, maternal stress and social support not only partially mediate the relationship between EBF and PPD but also substantially moderate this relationship. Specifically, the odds of PPD are significantly higher among mothers who had early EBF interruption in conjunction with increased stress levels and limited social support. CONCLUSIONS: Current evidence suggests that concurrent screening for EBF difficulties and maternal stress are important red flags that might hint at complications even before mother's screen positive for PPD. Support and care from family members can provide assistance in overcoming this issue.