1. CHAPTER 17: Breastfeeding and Maternal Mental and Physical Health

2. Introduction The World Health Organization recommends exclusive breastfeeding for the first 6 months postpartum. While 70% of mothers initiate breastfeeding after the birth of their child, only 13.5% of infants in the United States are exclusively breastfed for 6 months.

3. Introduction Top five reasons women report for deciding to breastfeed: 1. Its benefits for infant health 2. That it is “natural” 3. To strengthen bonding with their infant 4. Convenience 5. Benefits for their own health

4. The Biology of Breastfeeding Most important hormones associated with lactation are oxytocin and prolactin. Estrogen and progesterone are suppressed during lactation, resulting in lactational amenorrhea. Animal research has assocated oxytocin and prolactin with critical maternal behaviors such as grooming, protection, and sensitivity to infant cues.

5. Physical Health Benefits of Breastfeeding Weight Loss and Metabolic Syndrome – Breastfeeding is associated with weight loss after pregnancy and a reduced risk of metabolic syndrome. Breast and Ovarian Cancer – Breastfeeding may protect against breast and ovarian cancers by suppressing ovulation, and thus limiting lifetime estrogen exposure.

6. Mental Health Benefits of Breastfeeding Stress Regulation Postpartum Depression – Breastfeeding women have lower rates of postpartum depression in comparison to formula- feeding women. Maternal Bonding – Breastfeeding is often assumed to aid in maternal- infant attachment.

7. Potential Maternal Costs of Lactation Physical Costs – Nipple discomfort – Mastitis – Candidiasis – Yeast infection transferred from baby’s mouth

8. Potential Maternal Costs of Lactation Labor and Economic Costs – Time commitment associated with breastfeeding can place a burden on women in the workplace. – Breastfeeding can affect women’s freedom.

9. Potential Maternal Costs of Lactation Social Costs – Social stigma related to breastfeeding in public – Reduced sex drive – Making partners feel left out of childcare experience

10. Conclusions More research is needed on the association of breastfeeding and postpartum depression. Additional studies should evaluate the trade- offs in the benefits and costs of breastfeeding. – Consider both individual and population level.