Moms’ Breastfeeding Experiences With Mental Health Conditions

TOPLINE:

Observing that breastfeeding rates are “staggeringly low” among the approximately 15%-25% of women with new or pre-existing mental health disorders in the perinatal period, a systematic review and synthesis of 17 qualitative studies on their breastfeeding experiences identified three overarching themes:

• The potential positive outcomes of breastfeeding, including for maternal-child bonding and maternal self-esteem.
• The vulnerabilities of mothers with mental disorders, including their perception that the reality of breastfeeding does not square with their expectations of being easy and natural.
• The challenges mothers face in obtaining support and consistent information from health professionals especially on whether their drug therapies are safe in breast milk.

METHODOLOGY:

• This study was a review and synthesis of 17 qualitative studies published during 2003-2021 and identified by a systematic search of five databases: MEDLINE, CINAHL, Ovid, PsycInfo, and Web of Science.
• Studies had a total of 551 participants from high-income countries (15 studies) and low-income countries (two studies).

TAKEAWAY:

• Positive breastfeeding experiences can yield beneficial outcomes for mother and child through enhanced mother/infant bonding, higher self-esteem in the mother, and potential for healing of the mental illness.
• Among the major challenges to realising these benefits are that healthcare professionals often provide inconsistent support and conflicting advice especially around the safety of medications in breast milk that they may produce maternal confusion, may lead women to stop breastfeeding, and may exacerbate their perinatal mental health symptoms.
• The authors recommend that healthcare professionals receive further training and improve their communication with one another to obtain a deeper understanding of maternal breastfeeding experiences.

IN PRACTICE:

The authors concluded that “Appropriate support, adequate breastfeeding education, and clear advice, particularly around medication safety, are required to improve breastfeeding experiences for women with varied perinatal mental health conditions.”

SOURCE:

The lead and corresponding author is Hayley Billings of Sheffield Hallam University, Sheffield, UK. The study appeared in BMC Pregnancy and Childbirth.

LIMITATIONS:

Limitations included overrepresentation of White study participants with high levels of education and different methods of diagnosing mental health conditions across studies.

DISCLOSURES:

Only one of the authors reported conflicts of interest. The study was funded by the British Academy and Leverhulme Trust.