Associations between pressure to breastfeed and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum women

• Published in: Psychiatry research 2023-10, Vol.328, p.115432-115432, Article 115432
• Main Authors: Thompson, Katherine A., White, Jennifer P., Bardone-Cone, Anna M.
• Format: Article
• Language: English
• Subjects: Breastfeed; Eating disorder; Healthcare providers; Obsessive-compulsive; Postpartum women
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2023.115432

•Participants reported pressure to breastfeed from healthcare providers (HCP).•Pressure from HCP linked to depressive, OCD, and eating disorder (ED) symptoms.•Pressure from media to breastfeed linked to depressive and ED symptoms.•Pressure from HCP linked to ED symptoms above and beyond other sources of pressure. Data from qualitative interviews indicate postpartum individuals feel pressure from their healthcare providers, the media, and their partners to breastfeed their infant(s). However, the link between pressure to breastfeed and maternal mental health symptoms has not been evaluated quantitatively. The goal of the current study was to evaluate the associations between perceived pressure to breastfeed from various sources and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum individuals. Participants were 306 women, ages 18–39, who gave birth in the past 12 months in the United States (primarily in North Carolina). They completed an online survey about their health history (including mental health symptoms) and breastfeeding experiences. Results found postpartum women perceived more pressure to breastfeed from healthcare providers and from the media compared to pressure to breastfeed from their partners. Pressure from healthcare providers was associated with depressive, obsessive-compulsive, and eating disorder symptoms, but not with anxiety symptoms. Pressure from the media was associated with only depressive and eating disorder symptoms. Pressure from partners was not significantly associated with mental health symptoms. Above and beyond the other sources of pressure, pressure from healthcare providers explained a unique proportion of variance of obsessive-compulsive and eating disorder symptoms. Limitations include the cross-sectional design (which limits causal interpretations), and the homogenous sample (87% identified as White). Messaging and information about breastfeeding (particularly from healthcare providers) should be reviewed to determine if there is language which could be perceived as “pressure.” It is important to screen for a variety of mental health symptoms, including eating disorders, in perinatal populations when discussing breastfeeding.