Perinatal depression – depression during the prenatal and/or postpartum period – is a serious condition that affects both the mother and the child. Women with perinatal depression are at high risk for unhealthy eating habits and suboptimal child feeding, which can lead to issues like eating disorders in the mother and childhood obesity in the child.
Recently published in Nutrition and Health, researchers from Drexel University aimed to understand the challenges and needs of these women, as well as the role feeding plays in their interactions with infants.
Through interviews with 18 mothers who had experienced perinatal depressions and 10 health care providers who specialize in treating perinatal depression, the research team found six main themes that influence the ability of women with perinatal depression to adopt healthy eating behaviors:
- The feeling of being pressed for time: Time constraints were a significant barrier – particularly for mothers with depression who perceived household demands as overwhelming.
- The importance of social support: The absence or presence of social support also played a crucial role in mothers' experiences. Health care providers emphasized the importance of teaching mothers to seek support from community networks (as the saying goes, "it takes a village").
- Unrealistic expectations about motherhood: Unmet expectations of motherhood, from societal ideals to breastfeeding pressures, were also identified as contributing factors to perinatal depression.
- Putting themselves or their needs last: Health care providers expressed concern about the lack of focus on mothers during the postpartum period – emphasizing a gap in the healthcare system that leads to insufficient attention and care for mothers.
- Coping with changes in their bodies after childbirth: Mothers also connected worsening depression with postpartum weight gain, mingling the challenges of body image and high expectations.
- Finding contentment in feeding their infants and young children: Feeding was recognized as a critical aspect of mother-child interaction, bringing a sense of bonding and pride for many mothers, regardless of the feeding method.
"Despite the recognized importance of good nutrition during and after pregnancy, there are currently very few targeted strategies or interventions to support women with perinatal depression in meeting dietary recommendations," said Brandy-Joe Milliron, PhD, an associate professor in Drexel's College of Nursing and Health Professions and senior author of the study.
Milliron and her colleagues have provided insights that can guide the development of interventions that would target the six themes they found through the in-depth interviews. The interviews with mothers explored their experiences, as well as the facilitators and challenges related to healthful eating, self-care and child feeding, while the interviews with health care providers focused on the barriers mothers face related to healthful eating practices and the strategies they recommend for overcoming those challenges.
"Health care providers have a vital role in assisting families to marshal supports," said Lisa A. Chiarello, PhD, co-author and professor in the College of Nursing and Health Professions. "We offered six considerations and recommendations for addressing barriers to healthy dietary intake in women with perinatal depression."
- Community initiatives providing practical and emotional support, including nourishing meals, can benefit mothers in the perinatal period and should be integrated into patient care.
- Expand medically tailored meal delivery programs to include pregnant and postpartum women.
- Strengthen family and peer support and planning for the postpartum period before giving birth can help avoid the need to explicitly ask for support and should be part of birth preparedness planning.
- There is a two-way relationship between breastfeeding and maternal mental health. Breastfeeding can be either positive or negative, depending on factors such as social support, breastfeeding self-confidence, and maternal attitude.
- Interventions that enhance the joy of eating and food sharing can contribute to improvements in personal and household nutrition.
- Interventions that integrate the concept of distress tolerance with evidence-based, behavioral dietary change strategies may be particularly effective in improving dietary practices among women with perinatal depression.
Chiarello emphasized the value of interprofessional and community collaborations to provide meaningful supports for the mothers and their children, as well as building on the strengths of the mothers in nurturing and caring for their children.
"In addition to these recommendations, there is an opportunity to include the perspectives and experiences of women with a wider range of socio-economic backgrounds, health care providers with a wider range of disciplines, as well as spouses/partners and other family members," said Milliron.
A related study by the same researchers also highlighted the importance of resilience, especially during the COVID-19 pandemic.
In addition to Milliron and Chiarello, the study was co-authored by Cynthia Klobodu, PhD, Dahlia Stott, Mona Elgohail, PhD, and Pamela A. Geller, PhD, of Drexel; and Bobbie Posmontier, PhD, of Thomas Jefferson University; and June Andrews Horowitz, PhD, of the University of Massachusetts Dartmouth. It was funded the Drexel University College of Nursing and Health Professions Dean's Rapid Response Relevant (R3) Grant.
Media interested in speaking with Milliron or Chiarello should contact Annie Korp, assistant director, News & Media Relations, at amk522@drexel.edu or 215-571-4244.
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