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Physical health, breastfeeding problems and maternal mood in the early postpartum: a prospective cohort study

journal contribution
posted on 2021-02-16, 05:42 authored by Amanda CooklinAmanda Cooklin, Lisa AmirLisa Amir, CD Nguyen, Miranda BuckMiranda Buck, Meabh CullinaneMeabh Cullinane, JRW Fisher, SM Donath
© 2017, Springer-Verlag GmbH Austria, part of Springer Nature. This study aimed to investigate prospectively the contribution of maternal physical health and/or breastfeeding problems to maternal mood (depression, anxiety, fatigue, irritability, confusion, vigor) at 8-weeks postpartum. A prospective study was conducted. Participants were recruited antenatally from a public and a private maternity hospital in Melbourne, Australia. Nulliparous pregnant women (N = 229), ≥ 18 years of age, ≥ 36-week gestation, singleton pregnancy and with sufficient English were eligible. Data were collected by self-report questionnaire (pregnancy, weeks 1–4 postpartum) and telephone interview (week 8 postpartum). A high burden of physical problems was classified as ≥ 3 problems (caesarean/perineal pain; back pain; constipation; haemorrhoids; urinary and bowel incontinence) for ≥ 2 time points. A high burden of breastfeeding problems was having ≥ 2 problems (mastitis; nipple pain; frequent expressing; over- or under-supply of milk) for ≥ 2 time points. Multivariate linear regression was used to investigate the relationship between maternal mood, assessed using Profile of Mood States (8-week postpartum), and a high burden of breastfeeding and/or physical health problems. Forty-six women (20.1%) had a high burden of physical symptoms, 44 (19.2%) a high burden of breastfeeding problems only and 25 women (11.0%) had both. A high burden of breastfeeding problems alone (β = 10.6, p = 0.01) or with co-morbid physical problems (β = 15.35, p = 0.002) was significantly associated with poorer maternal mood at 8 weeks. Early, effective postnatal treatment of maternal health and breastfeeding problems could reduce women’s risk for poor mental health.


MoAT was a sub-study nested within the CASTLE study. CASTLE was funded by a National Health and Medical Research Council Project Grant (2009-2011, Grant Number 541907). Amanda Cooklin and Cattram Nguyen were supported though the Australian Communities Foundation, Transition to Contemporary Parenthood Program, La Trobe University.


Publication Date



Archives of Women's Mental Health






10p. (p. 365-374)


Springer Nature



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