Breastfeeding And Postpartum Depression State Of The Art-Books Pdf

Breastfeeding and postpartum depression state of the art
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Breastfeeding and postpartum depression 333, PALAVRAS CHAVE Amamentac o e depress o p s parto revis o do estado de arte. Amamentac o, Depress o na Resumo, gravidez Objetivo Revisar a literatura sobre a associac o entre a amamentac o e a depress o p s parto. Depress o p s parto Fontes Uma revis o da literatura encontrada na base de dados MEDLINE Pub Med. Horm nios Resumo dos achados A literatura mostra de forma consistente que a amamentac o fornece. uma ampla quantidade de benef cios tanto para a crianc a quanto para a m e Ainda s o. necess rias mais pesquisas sobre os benef cios psicol gicos para a m e Alguns estudos apontam. que a depress o na gravidez um dos fatores que pode contribuir para a n o amamentac o. Outros estudos sugerem tamb m uma associac o entre amamentac o e depress o p s parto. n o estando clara ainda a direc o dessa associac o A amamentac o pode promover processos. hormonais que protegem as m es contra a depress o p s parto por atenuar a resposta do cor. tisol ao estresse E isso tamb m pode reduzir o seu risco por auxiliar na regulac o dos padr es. do sono e vig lia da m e e do lho melhorando a autoe c cia e o envolvimento emocional. da m e com a crianc a reduzindo as di culdades de temperamento e promovendo uma melhor. interac o entre eles, Conclus es A pesquisa aponta que a amamentac o pode proteger as m es da depress o p s. parto e comec a a esclarecer que processos biol gicos e psicol gicos podem explicar essa. protec o Contudo ainda existem resultados amb guos na literatura que poder o ser explicados. pelas limitac es metodol gicas apresentadas por alguns estudos. 2013 Sociedade Brasileira de Pediatria Publicado por Elsevier Editora Ltda Todos os direitos. reservados, Introduction their babies by the time of hospital discharge At three. months postpartum the percentage of exclusive breast. feeding was 40 3 falling to 14 7 at ve months 22 The. Breastfeeding has been associated with the well being. European rates of breastfeeding initiation vary from 63 in. of both the child and the mother Breastfeeding ben. Belgium to 99 in Norway 23 After hospital discharge rates. e ts for children s physical and psychological status. start to fall and at six months the percentage of mothers. include decreased risk of infectious diseases and obe. who continue to breastfeed varies from 10 in Belgium to. sity decreased blood pressure lower cholesterol levels 1 2. 80 in Norway 23 Scandinavian countries present the high. and increased cognitive and motor performance 3 4 Positive. est rates of breastfeeding at six months postpartum 80 in. health outcomes for the mother s physical health include. Norway 72 in Sweden and 65 in Iceland 23 In Brazil a. decreased blood pressure and risk of breast and ovarian. national survey conducted in 2008 showed a rate of 41 of. cancer 5 7 for the mother s psychological health they include. exclusive breastfeeding in babies from 0 to 6 months 24 In. attenuated stress response8 12 and enhanced sleep 13 14. the same survey the percentage of breastfeeding in babies. However bene ts for the mother s psychological well being. from 9 to 12 months old was approximately 58 7 24, need more supportive empirical evidence 15.
Therefore identi cation of women at risk for early ces. The World Health Organization WHO 16 the European, sation of breastfeeding and implementation of effective. Commission for Public Health ECPH 17 and the Ameri. breastfeeding promotion strategies are considered health. can Academy of Pediatrics AAP 18 recommend exclusive. priorities, breastfeeding for the rst six months of life Despite the. established bene ts of breastfeeding rates are still low. and even though rates of breastfeeding initiation are high. there is a marked decline in breastfeeding during the rst Breastfeeding and depression in pregnancy. few weeks after initiation and exclusive breastfeeding is and postpartum depression. rare In Portugal despite the high rate of breastfeeding. at the time of hospital discharge 91 19 and 98 5 20 an Recent literature reviews suggest that breastfeeding is. accentuated decrease is observed in the following months less common among depressed mothers even though their. with only 54 7 19 to 55 20 of mothers breastfeeding at three infants bene t from breastfeeding 25 26 Studies from dif. months postpartum and 34 1 19 to 36 20 at six months ferent socio cultural contexts show almost unequivocally. postpartum The national health surveys provided by the that depressed mothers tend to breastfeed less or for less. Portuguese Health Ministry showed that breastfeeding ini time than non depressed mothers However the association. tiation rates increased from 81 4 in 1995 1996 to 84 9 between breastfeeding and postpartum depression remains. in 1998 1999 21 In 2010 2011 this percentage ascended equivocal 25 27. to 98 5 22 However despite the increase in breastfeeding When depressed during pregnancy women are less likely. rates these surveys also show a decrease in breastfeeding to initiate28 29 or to maintain breastfeeding 30 32 compared. over the months In 2010 2011 in baby friendly hospitals with those with no depressive symptoms In a recent study on. between 65 2 to 72 5 of mothers exclusively breastfeed the association between prenatal psychosocial risk factors. 334 Figueiredo B et al, and breastfeeding intention of Hispanic women researchers breastfeeding cessation 55 Another recent study on the asso. found that women who scored higher in depression at the ciation between breastfeeding and depression in pregnancy. middle of gestation about 25 7 weeks and women who and postpartum depression concluded that higher depres. showed persistent depressive symptoms during pregnancy sion scores at the third trimester of pregnancy predicted. presented a lower intention to breastfeed their babies 33 lower exclusive breastfeeding duration 30 This study also. Other studies have shown that 1 5 of pregnant women found a decrease in depressive symptoms in women who ini. are depressed at the third trimester of pregnancy 34 35 and tiated or maintained exclusive breastfeeding for three or. that half of these depressed pregnant women will not ini more months 30. tiate or breastfeed for three months or more 30 Depression The association between breastfeeding and depression. scores at the third trimester were the best predictors of the has also been studied taking into account both parents A. length of exclusive breastfeeding and when considering all study undertaken to trigger the association between breast. the mothers not breastfeeding at three month postpartum feeding and mental health of both the parents concluded. 37 could be easily detected because of depression during that the simultaneous presence of mental disorders in both. pregnancy 30 Results also showed a signi cant decrease in the mother and the father was not associated with the. depression scores from childbirth to three months postpar early breastfeeding cessation before four months 56 How. tum in women who maintained exclusive breastfeeding for ever mothers tended to breastfeed for a longer period of. three or more months 30 time when they felt that their partners actively supported. Exclusive breastfeeding appears to be signi cantly lower breastfeeding 56. among depressed mothers 36 39 Mothers who do not initiate. or maintain breastfeeding are more at risk for depression. during the postpartum period 30 40 43 Moreover when moth Breastfeeding and hormonal protection to. ers are depressed in the postpartum period they tend to postpartum depression. not initiate28 29 or maintain breastfeeding 27 36 44 50. Some studies have shown that postpartum depression Research has been showing that breastfeeding promotes. emerges in the sequence of and may result from breast hormonal and psychological conditions and processes that. feeding interruption 40 43 suggesting that early cessation are inversely associated with postpartum depression How. of breastfeeding may be involved in the cause of post ever the simultaneous study of these dimensions and their. partum depression For example an association between potential explanatory value in the connection between. negative early breastfeeding experiences and depressive breastfeeding and pre and postpartum depression has not. symptoms at two months postpartum was found 51 Another yet been accomplished. study that aimed to assess the association between the It is possible that the positive effects of breastfeed. infant feeding method and depressive symptoms showed ing may outweigh the positive effects of antidepressants 26. that breastfeeding initiation among multiparous mothers Even when the potential harmful effects of medication are. was associated with signi cantly decreased odds of postpar taken into account some studies suggest that women with. tum depression 43 postpartum depression who are taking antidepressant should. Other studies suggest that postpartum depression may be not discontinue breastfeeding 57 Lactogenic hormones oxy. involved in the cause of early breastfeeding cessation and tocin and prolactin are associated with anti depressant and. that depressive symptoms have been observed to precede anxiolytic effects 43 Some studies suggest that breastfeed. the cessation of breastfeeding 27 46 49 52 54 For example a ing may have a protective effect on maternal psychological. recent study screening for depression levels immediately health because it attenuates stress responses 15 58 59 Lacta. after delivery demonstrated that mothers with higher levels tion has been associated with attenuated stress responses. of depressive symptoms have a higher likelihood to bottle especially that of cortisol 8 12 Attenuated cortisol stress. feed their infants at three months postpartum 38 Results responses 8 10 as well as attenuated total cortisol and. also showed that the odds of bottle feeding increased with free cortisol stress responses 11 were observed in lactat. the severity of maternal depression 38 Another recent study ing mothers compared to the non lactating These results. indicated an association between breastfeeding cessation suggest that lactation attenuates neuro endocrine responses. at four months postpartum and higher depressive symp to stress 8 a factor that has been related with fewer post. toms at one month after delivery showing that mothers partum depressive symptoms 60 62 In a recent study on. who continued to breastfeed at four months had lower maternal adreno corticotropic hormone ACTH and cortisol. depression scores at one month than those who stopped release patterns during a breastfeeding session researchers. breastfeeding 36 found that breastfeeding was associated with a signi cant. Research has also been focusing on the association decrease in ACTH and cortisol levels 63 Skin to skin contact. between breastfeeding and depression in pregnancy and before sucking the breast was shown to play an important. postpartum depression A recent study showed that higher role in the reduction of these levels the longer the dura. levels of depression and anxiety during pregnancy were tion of skin to skin contact the lower the maternal cortisol. associated with breastfeeding cessation and that breast levels 63. feeding cessation predicted higher levels of anxiety and Additionally the usual diurnal pattern of cortisol consist. depression after birth 55 Moreover the results showed an ing of high morning levels and gradual decline throughout. interaction effect between anxiety and depression levels the day also associated with fewer postpartum depres. at pregnancy and six months postpartum and breastfeed sive symptoms 64 was found to be more common in. ing cessation so that baseline levels anxiety and depression multiparous breastfeeding women compared with the non. are increased at six months postpartum by the effect of breastfeeding 12 Despite the fact that some studies did. Breastfeeding and postpartum depression 335, not report differences in daily cortisol levels in depressed Maternal emotional involvement with the infant is. pregnant or postpartum women 8 65 67 cortisol has also been also improved by breastfeeding75 and is negatively cor. found to be lower 10 as well as higher in depressed mothers related with postpartum depression 65 76 In fact feeding. when compared with their non depressed counterparts 60 68 patterns appear to in uence mother child bonding with. A recent study suggested that depressed mothers present non breastfeeding mothers presenting more dif culties to. a down regulated HPA axis showing lower salivary cortisol establish an emotional involvement with the infant than. levels compared with non depressed mothers 62 Conversely breastfeeding mothers 77 Regarding the relationship with. another recent study found signi cantly higher levels of the partner studies relate breastfeeding initiation with. serum cortisol in the group of depressed mothers 69 A dif stronger parental bonds 78. ferent diurnal pattern of cortisol with higher cortisol levels Temperamental dif culties and sleep problems are. at waking and no increase from waking to 30 minutes com reduced when the child is breastfed 79 while the presence. pared to a signi cant increase in cortisol levels from waking of those problems has been associated with postpar. to 30 minutes found in non depressed women was reported tum depression 72 80 Depressed breastfeeding mothers. in postpartum depressed women 64 were less likely to have infants with highly reactive. breastfeeding cessation 55 Another recent study on the asso ciation between breastfeeding and depression in pregnancy and postpartum depression concluded that higher depres sion scores at the third trimester of pregnancy predicted lower exclusive breastfeeding duration 30 This study also found a decrease in depressive symptoms in women who ini

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