title: The association between breastfeeding, the stress response, inflammation, and postpartum depression during the postpartum period: Prospective cohort study.
abstract: BACKGROUND
  Research suggests that exclusive breastfeeding may have a stress-protective role in postpartum depression; however, less is known about the underlying mechanisms by which this protection may occur or whether the protective relationship holds for women who mix breast and bottle feeding.
  
  
  OBJECTIVE
  To examine patterns of the stress response, inflammation, and depressive symptoms among women predominantly breastfeeding or bottle feeding their infants at 6 months postpartum.
  
  
  METHODS
  A part of a larger longitudinal study across 6 months postpartum investigating the psychoneuroimmunology (PNI) of postpartum depression.
  
  
  METHODS
  Prenatal clinics and community.
  
  
  METHODS
  One hundred nineteen postpartum women who met inclusion/exclusion criteria and followed up from the prenatal period to postpartum 6 months.
  
  
  METHODS
  Data were collected during seven home visits occurring during the 3rd trimester (weeks 32-36) and on postpartum days 7 and 14, months 1, 2, 3, and 6. Women completed stress and depression surveys and provided blood for pro- (IL-1β, IL-6, IL-8, TNF-a, IFN-γ) and anti-inflammatory (IL-10) cytokines, and collected saliva for diurnal cortisol.
  
  
  RESULTS
  Self-report of predominant breastfeeding during 6 months postpartum ranged from 91.9% at day 7 to 70.6% at month 6 postpartum. There were no associations between the pattern of feeding and depressive symptoms. Biological differences, however, existed between the groups, with levels of salivary cortisol at 8 AM and 8:30 AM at month 6 higher and levels of IL-6 at month 6 lower in women who primarily breastfed compared to those who primarily bottle fed their infants after controlling for confounding variables.
  
  
  CONCLUSIONS
  Breastfeeding was not related to postpartum depression however differences in stress and inflammatory markers are apparent at month 6 postpartum.
authors.affiliation: College of Nursing, Chungnam National University, Daejeon, Republic of Korea. Electronic address: sukheeahn@cnu.ac.kr.
authors.forename: Sukhee
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Room 244, Atlanta, GA 30322, United States. Electronic address: ejcorwi@emory.edu.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Corwin
mesh_terms: D000328:Adult; D001942:Breast Feeding; D019052:Depression, Postpartum / Q000150:complications*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications*; D049590:Postpartum Period; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications*
keywords: Breastfeeding; Depression; Inflammation; Postpartum; Psychoneuroimmunology; Stress