Date of Completion

2025

Document Type

Thesis

Degree Name

Master in Public Health

Keywords

Breastfeeding concern, postpartum depression, women’s health

Abstract

BACKGROUND Recent literature finds the association between breastfeeding and postpartum depression (PPD) complex and bidirectional. This thesis investigated the relationship between PPD symptoms and breastfeeding concerns.

METHODS This study utilized data from the COCOON Philippines study, with 500 postpartum Filipino women who gave birth in the Philippines, aged 18 years or older, from 30 January 2020 until 30 April 2024. Mothers were recruited through multiple channels using convenient sampling from October 1, 2023 to April 30, 2024. The current study solely extracted and analyzed their response on breastfeeding concerns and looked for the association of depressive symptoms, obstetrics, and demographic characteristics. The analysis determined how these concerns correlate with the individual manifestation of depressive symptoms, assessed using the Edinburgh Postnatal Depression Scale (EPDS) with 14 cut-off score.

RESULTS The majority of the respondents (78.7%, n=362) had breastfeeding concerns, with 16.3% were moderately concerned while 34.8% were extremely concerned. Three out of five mother who were at least moderately concerned demonstrated clinically significant PPD symptoms. Multivariable logistic regression revealed higher levels of breastfeeding concern were significantly associated with PPD (adjusted odds ratio=1.16, 95% Confidence Interval = 1.01- 1.33). Sociodemographic variables such as maternal age, educational attainment, employment status, fetal age at delivery, previous living child, and manner of delivery had a minimal confounding effect on the established association with PPD.

CONCLUSIONS There is a statistically significant association between breastfeeding concerns and PPD. Mental health support during breastfeeding is crucial, as well as integrating mental health screening at the primary care level, is essential to ensure appropriate care for breastfeeding mothers at risk.

First Advisor

Joemer C. Maravilla, PhD, RN, FRSPH

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