Leading Lactation Insights - October 2022

One-third of New Mothers Screened Positive for Postpartum Depression During COVID-19

Maria Lennon, MSN, CNM, IBCLC

According to a study by the University of Michigan School of Nursing, one-third of new mothers during early COVID-19 screened positive for postpartum depression, and one in five mothers had major depressive symptoms. This is nearly triple the pre-pandemic levels.

This research study, “Postpartum depression and associated risk factors during the COVID-19 pandemic” appears in BMC Research Notes. It is associated with a larger study called “COVID-19 MAMAS (Maternal Attachment, Mood, Ability, and Support) from which several papers were written about pregnancy and postpartum experiences during COVID. 

This study used a cross-sectional and descriptive design and collected survey data from a convenience sample of 670 postpartum patients who lived in the US and delivered a live infant born after the US declared COVID-19 a public health emergency. These patients completed the Edinburgh Postnatal Depression Scale (EPDS) and answered certain demographic questions (e.g. NICU admission status, infant gestational age and infant feeding method – breastfeeding and/or pumping versus formula feeding).  This paper is an analysis of the results of the EPDS and the associations among positive screens and demographic factors.

The Edinburgh Postpartum Depression Scale is a valid and reliable screening tool that is widely used to identify depression in postpartum patients. A score of 10 or higher is considered a positive screen for postpartum depression and a score of 13 or higher is suggestive of major depressive symptoms, both of which show a need for further follow up.

Results from this study include:

• Mothers who fed infants formula had 92% greater odds of screening positive for postpartum depression and were 73% more likely to screen positive for major depressive symptoms, compared to those who breastfed or pumped and fed their infants their own human milk by bottle.
• Mothers of infants in neonatal intensive care units (NICUs) had 74% greater odds of screening positive, and each one-week increase in the number of weeks postpartum increased the odds of screening positive by 4%. 
• Mothers who reported that they were worried about contracting COVID-19 had 71% greater odds of screening positive for postpartum depression.

Formula feeding, NICU admission, weeks postpartum, and worry of COVID-19 infection was associated with EPDS scores > 10. Only formula feeding was associated with EPDS scores > 13. One in three mothers screened positive for depression and 1 in 5 screened positive for major depressive symptoms; this is much higher than those reported before the pandemic began. 

One very concerning finding was that almost 1 in 5 participants who screened positive for postpartum depression also reported having thoughts of harming themselves. A previous study by the University of Michigan found that the risk of suicide in the prenatal and postpartum periods was already on the rise in the US. Screening is very important, but treatment is paramount. Mothers who suffer from postpartum depression or anxiety need to have resources available which are easy to access. 

Restrictions and stay-at-home orders during COVID-19 may have led to COVID-related worry, decreased support for breastfeeding, and more mothers turning to formula. The authors of the study encourage clinics and healthcare systems to bolster their breastfeeding support and resources to help patients achieve their breastfeeding goals and reduce their risk for postpartum depression.

Reference:
Shuman, CJ, Peahl, AF, Pareddy, N. et.a;. (2022). Postpartum depression and associated risk factors during the COVID-19 pandemic. BMC Research Notes 15(102). https://doi.org/10.1186/s13104-022-05991-8

This month we are spotlighting Alice French, RN, IBCLC

Megan Quinn

Alice French, RN, IBCLC is a part-time lactation consultant overseeing Labor and Delivery, Postpartum, and the NICU at a community hospital near her home in Edmonton, Alberta, Canada. Originally from St. John’s, Newfoundland, Alice shares that she was interested in healthcare as a profession because she has always enjoyed helping people. After working in the NICU for many years and enjoying helping moms with their breastfeeding journeys, she became an IBCLC and continues to provide inpatient lactation support for parents of both term babies and complex pediatric patients. Alice also provides regular education and support for all pediatric staff members and notes that she works at “a lovely community hospital with staff that truly care for the patients. The staff are very much an extension of my family.”

Alice is proud of the appreciation she’s received from moms and fellow staff members throughout her career, which has taken her to healthcare centers throughout Canada as well as to Hawaii and Arizona in the U.S. She shares that current professional challenges include unnecessary formula usage at the hospital and the need for more lactation consultant support for evening, night, and weekend shifts. She would also love to see more breastfeeding tools, resources, and supplies available on-site. 

In her free time, Alice enjoys walking and gardening, noting the similarities between nurturing young plants in her spare time and new moms and babies professionally. Thank you, Alice, for dedicating your career to helping mothers through their breastfeeding experience while supporting the wonderful bond between new families! 

Thank you to this issue's contributors!

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