Association between exclusive breastfeeding and postpartum post-traumatic stress disorder

Abstract

Background Research on the association between breastfeeding and postpartum post-traumatic stress disorder (PTSD) is sparse. This study aimed to examine the association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD. Methods An epidemiologic study was conducted in a tertiary hospital in China between October 2019 and October 2020. Eligible mothers were recruited at 3 days after childbirth and assessed using the Post-Traumatic Stress Disorder Checklist – Civilian version (PCL-C) for PTSD at 42 days postpartum. The independent association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD was estimated using log-binomial regression models, after adjusting for potential confounders. Results Ninety-two of 759 (12.1%) mothers developed postpartum PTSD within 42 days after childbirth. Compared with partially breastfeeding mothers, exclusively breastfeeding mothers had lower risks of postpartum PTSD (relative risk [RR] 0.28; 95% confidence interval [CI] 0.13, 0.59), re-experience (RR 0.48; 95% CI 0.30, 0.76), avoidance (RR 0.55; 95% CI 0.32, 0.97), and hyperarousal (RR 0.52; 95% CI 0.34, 0.78). After adjustment for family support, parity, mode of delivery, perceived birth trauma, early contact / suckling, and rooming-in, associations between exclusive breastfeeding and postpartum PTSD remained significant: the overall PTSD adjusted relative risk [aRR] was 0.31; (95% CI 0.15, 0.66), with a re-experience aRR of 0.48; (95% CI 0.30, 0.77) and hyperarousal aRR of 0.56; (95% CI 0.37, 0.85). Conclusion Exclusive breastfeeding up to 42 days after childbirth was associated with reduced risk of postpartum PTSD. While the potential for reverse causation cannot be ruled out, strategies to improve rates of exclusive breastfeeding through teaching, counselling, and support may benefit mothers and their infants by reducing the risk of postpartum PTSD.

The relationship between earthquake-induced post-traumatic stress disorder and breastfeeding attitude and behavior

“…Additionally, a significant negative correlation was observed between PTSD score and BAES. Consistent with our study, İsbir et al reported that antenatal education was associated with a reduced incidence of postpartum PTSD [23]. These results emphasize the importance of prenatal education about breastfeeding for all pregnant women.…”

Traumatic Birth Experience and Breastfeeding Ineffectiveness - a Literature Review

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Exploring Tandem Breastfeeding Motivations Via Self-Determination Theory: An Interpretative Phenomenological Study

“…The importance of intrinsic motivation for prolonged breastfeeding, based on life experiences related to the prenatal and postpartum period, has been described (Martínez-Poblete & Ossa, 2020). According to Chen et al (2022), the post-traumatic stress from-and negative experiences with-childbirth negatively influence the establishment and maintenance of breastfeeding practices. However, an innovative finding in the present study is that the participants alleviated the pain and frustration they associated with their traumatic childbirth with the establishment of a bond with their child(ren).…”