Breast-feeding experiences in women with postnatal depression
The aim of this review is to consider the current state of evidence for the relationship between postnatal depression and breast-feeding. Postnatal depression has been conceptualised in cognitive, psychodynamic and biological terms. However, research most strongly supports the stress-vulnerability model of depression, which predicts the development of postnatal depression in those who are vulnerable, for example, because of adverse life circumstances and psychopathology. Research has also demonstrated the negative effects of postnatal depression on mother-infant interaction and infant development, and highlighted the possibility that experiences of interaction may contribute to, as well as reflect, maternal depression. Literature on breast-feeding has mainly focussed on predicting feeding duration in relation to cognitive styles and social determinants. Observational studies have shown that breast-feeding, when compared with bottle-feeding, is associated with more positive dyadic (mother-infant) interaction. Differing associations between postnatal depression and breast-feeding have been identified. Research has revealed a positive relationship between maternal depression and breast-feeding, but has also shown that depression has a negative effect on breast-feeding. This latter finding suggests that for infants of depressed mothers, the adverse effects of depression on their dyadic (mother-infant) experiences may be further compounded by their mothers' decisions not to breast-feed. In spite of these findings, some research has indicated that the beneficial effects of breast-feeding on the mother-infant relationship may hold irrespective of maternal mood. On the basis of these findings, it has been hypothesised that breast-feeding may represent a useful intervention for depressed mothers in order to buffer against the negative effects of depression on her interaction with the infant.