Perinatal psychiatric symptoms and the continuum of breastfeeding in an urban university hospital population.

BACKGROUND: Breastfeeding has well-established public health benefits. We investigated the impact of perinatal psychiatric symptoms on reduced breastfeeding rates in an urban university community. OBJECTIVE: This study investigates the relationship between perinatal psychiatric screening of symptoms on plans, initiation, and continuation of breastfeeding. STUDY DESIGN: Pregnant women ≥18 years recruited from our urban academic clinic completed "My Mood Monitor (M-3)", a validated psychiatric screening tool, and a breastfeeding questionnaire in 3 phases: second trimester (I- plans), postdelivery (II- initiation), and postpartum (III-continuation). Data were analyzed to establish the relationship between breastfeeding, maternal demographics, and the M-3 screening at these corresponding time points. RESULTS: Although 86.3% (N=82) of our cohort planned to breastfeed, 76.1 % (N=54) initiated, and 43.4 % (N=23) continued breastfeeding. Early entry into prenatal care (≤12 weeks) was significantly associated with plans to breastfeed (*P=.02). At phase II, there was some association ( + P=.065) between mothers with positive anxiety screening and breastfeeding, which became significant at continuation (* P=.014). Positive anxiety screening was significantly associated with postpartum discontinuation of breastfeeding (P=.019). CONCLUSION: Early screening for identification and referral for diagnoses with treatment plans for psychiatric symptoms of perinatal anxiety, especially following delivery, may improve breastfeeding rates in urban minorities.