Postpartum Symptoms of Depression are Related to Infant Feeding Practices in a National WIC Sample

Objective: To examine the association between elevated maternal postpartum depression symptoms and select targets of nutrition education within the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), including infant feeding beliefs, feeding practices, and dietary intake choices. Design: Longitudinal analysis of secondary data from the WIC Infant and Toddler Feeding Practices Study-2. Setting: Eighty WIC sites. Participants: The WIC Infant and Toddler Feeding Practices Study-2 participants interviewed through 13 months postpartum (n = 1,851). Main Outcome Measures: Latent factor variables for infant feeding beliefs, feeding practices, and dietary intake choices. Analysis: Confirmatory factor analysis using structural equation modeling; multivariable linear regression models. Results: Biological mothers with elevated postpartum depression symptoms engaged in significantly less optimal feeding practices than biological mothers with fewer symptoms of depression, in multivariable analyses controlling for sociodemographic variables (beta = -0.26; P = 0.02). Maternal depression symptoms were not significantly associated with infant feeding beliefs or dietary intake choices. Conclusions and Implications: Maternal depression symptoms are specifically associated with infant feeding practices. The Special Supplemental Nutrition Program for Women, Infants, and Children could consider screening for depressive symptoms and referring mothers for treatment. For mothers with elevated depression symptoms, nutrition education may need greater emphasis on healthy and safe feeding practices.