title: Postpartum depression and infant feeding practices in a low income urban settlement in Nairobi-Kenya.
abstract: BACKGROUND
  Postpartum depression can compromise caregiving activities, including infant feeding practices, resulting in child malnutrition. The purpose of this study was to examine the effects of postpartum depression on infant feeding practices and malnutrition among women in an urban low income settlement in Nairobi-Kenya. We conducted a cross-sectional study based in Kariobangi North Health Centre in Nairobi County. The study sample included 200 mother-infant pairs visiting the Maternal and Child Health clinics for infant immunization at 6-14 weeks postpartum. We assessed postpartum depression using the Edinburgh Postpartum Depression Scale. Infant feeding practices were assessed based on World Health Organization infant and young child feeding guidelines. Nutritional status (weight for age) was ascertained using infants' growth monitoring card (percentiles and z-score). We conducted logistic regression analyses to determine the relative odds of non-exclusive breast feeding and infant underweight among mothers with postpartum depression.
  
  
  RESULTS
  The prevalence of PPD was 13.0% (95% CI 8.3-17.7%). Taking into account differences in socioeconomic status of depressed and non-depressed mothers, non-depressed mothers had a 6.14 (95% CI 2.45-13.36) times higher odds of practicing exclusive breastfeeding than mothers who were depressed. Mothers with PPD had a 4.40 (95% CI 1.91-11.93) time higher odds of having an underweight infant than mothers without depression.
  
  
  CONCLUSIONS
  This study contributes towards filling the knowledge gap regarding the adverse effects of postpartum depression on infant health in sub-Saharan Africa. We recommend more research on PPD using longitudinal designs to establish temporal ordering of these important public health problems and development of community-based interventions to address post-partum depression.
authors.affiliation: School of Public Health, College of Health Sciences, University of Nairobi, Nairobi, 00100, Kenya.
authors.forename: Beatrice A
authors.initials: BA
authors.lastname: Madeghe
authors.affiliation: Public Health, School of Public Health, College of Health Sciences, University of Nairobi, Nairobi, 00100, Kenya.
authors.forename: Violet N
authors.initials: VN
authors.lastname: Kimani
authors.affiliation: Psychiatry & Behavioral Sciences and Epidemiology, University of Washington, Child Health Institute, 6200 NE 74th Street, Suite 210, Seattle, WA, 88115-1538, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Vander Stoep
authors.affiliation: Clinical Research Associate, University of Washington, Child Health Institute, 6200 NE 74th Street, Suite 210, Seattle, WA, 88115-1538, USA.
authors.forename: Semret
authors.initials: S
authors.lastname: Nicodimos
authors.affiliation: Department of Psychiatry, College of Health Sciences, University of Nairobi, Nairobi, 00100 (47074), Kenya. manni_3in@hotmail.com.
authors.forename: Manasi
authors.initials: M
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D003625:Data Collection; D019052:Depression, Postpartum / Q000453:epidemiology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007228:Infant Nutrition Disorders / Q000453:epidemiology*; D007231:Infant, Newborn; D007630:Kenya; D009035:Mothers; D009752:Nutritional Status; D016017:Odds Ratio; D011203:Poverty; D015995:Prevalence; D012044:Regression Analysis; D012923:Social Class; D013851:Thinness; D014505:Urban Population; D055815:Young Adult
keywords: Breastfeeding practices; Kenya; Nutritional status; Postpartum depression