Breastfeeding can 'protect' mum's psyche for years to come

Breastfeeding may be associated with lower risks of depression and anxiety in mothers for many years after childbirth, the authors of a small observational study published in the journal BMJ Open have concluded.

The researchers suggest that women who breastfed (including briefly or partially) may be less likely to experience depression and/or anxiety disorders up to 10 years after pregnancy. However, the authors emphasise: the work does not prove causation, but rather captures a statistical association.

What exactly was studied

The analysis included 168 women who became mums for the second time and participated in the Irish ROLO project (long-term cohort). Follow-up lasted for 10 years, with controls at 3 and 6 months, then at 2, 5 and 10 years postpartum. By the end of the period, the mean age of the female participants was about 42 years.

At each stage, women completed health questionnaires - including whether they had been diagnosed with depression/anxiety and whether they had received treatment. In parallel, data were collected on factors that might influence the results (level of physical activity, diet and other habits).

Main results

• 73% of participants reported breastfeeding for at least some time.

• The mean duration of exclusive breastfeeding was 5.5 weeks and of any breastfeeding was 30.5 weeks.

• In 37.5%, the cumulative lifetime duration of breastfeeding reached 12 months or more.

• At the 10-year visit, 13% of women reported depression/anxiety, and if all follow-up points are considered - 21% had symptoms/diagnosis at least once.

According to the statistical analysis, women who had depression/anxiety recorded after 10 years were less likely to be breastfeeding and on average had a shorter duration of both any and exclusive breastfeeding.

Separately, an estimate of a 'dose' effect is noted: each week of cumulative exclusive breastfeeding was associated with about 2% lower likelihood of reporting depression/anxiety in the long term (after accounting for a number of factors including alcohol use).

Why it matters

The authors suggest that the potential 'protective' effect may be multifactorial: breastfeeding and mental health are simultaneously influenced by socioeconomic conditions, family support, cultural attitudes and previous experience of mental health problems.

Limitations of the study are also emphasised:

• small sample size and limited diversity of female participants;

• depression/anxiety data are based on self-report;

• the design is observational - it cannot be claimed that breastfeeding "reduces risk" (there may be an inverse relationship: for example, breastfeeding may be more likely to be interrupted for anxiety and depression).

Despite the limitations, the authors conclude that increased support for breastfeeding(counselling, work environment, access to specialist support) could potentially have an additional societal effect - if the association is confirmed in larger and more diverse studies.