Bidirectional Relationship Between Breastfeeding and Postpartum Depression: Current Evidence and Clinical Implications

Abstract

Purpose: Postpartum depression (PPD) is a common maternal mental health condition affecting 10–20% of women globally. Concurrently, breastfeeding though widely endorsed for its maternal and infant health benefits often falls short of optimal initiation and continuation rates. This review examines the bidirectional relationship between PPD and breastfeeding, emphasizing the mutual influences and mediating factors.

Methods: A comprehensive literature search was conducted in PubMed, Scopus, EMBASE, Google Scholar, and the Cochrane Library for studies published between 2000 and 2024. Eligible publications included quantitative, qualitative, and review articles addressing associations between PPD and breastfeeding outcomes. Thematic synthesis was employed to identify patterns and moderators.

Findings: Evidence consistently indicates that PPD impairs breastfeeding initiation, duration, and exclusivity by reducing motivation, confidence, and physiological lactation response. Conversely, breastfeeding difficulties such as pain, perceived insufficiency, or premature weaning can trigger or exacerbate depressive symptoms. Maternal self-efficacy, social support, socioeconomic conditions, and cultural expectations were identified as key moderating factors.

Conclusions: The reciprocal nature of PPD and breastfeeding underscores the need for integrated perinatal care models. Early PPD screening, individualized lactation support, and psychosocial interventions are essential to improve maternal well-being and breastfeeding outcomes, promoting long-term health for both mother and child.