Dietary Intake and supplement use in mothers with depression in the first year postpartum

Background: The dietary intake of women in the weeks before and after pregnancy has important implications for health of both the mother and baby. Clinical experience suggests that during this period dietary intakes in women with mood disorders may not meet national nutrition guidelines. Furthermore, frequency and type of dietary supplement use in this population is unknown. Objective: The purpose of this project was to assess BMI, dietary intakes and dietary supplement use in patients with significant depressive symptoms in the context of a mood disorder attending the Canterbury District Health Board, Mothers and Babies Outpatient Service. The information obtained will be used to improve nutrition services for patients in this service. Design: The present study was a cross sectional observational exploratory study. Sixteen women with Major Depressive Disorder (MDD) aged 18- 35 years and within 13 months postpartum completed the study. Participants attended a one hour assessment with the research candidate. Information was collected on participant demographics and dietary supplement use during pregnancy and the postpartum period. Following this, participants completed a multiple pass 24-hour diet recall, and weight and height were measured. Results: Thirty-four different types of supplements (vitamin, mineral, oil, food and herbal) were used by the study population during pregnancy and postpartum. Fourteen participants (87.5%) took folic acid or folic acid containing supplements during pregnancy. Thirteen participants (81%) took iodine or an iodine containing multivitamin and mineral supplement in pregnancy and seven (43.75%) during the postpartum period. Iodine and folic acid supplements were most commonly recommended by either a doctor or midwife. Iron was taken by 10/16 participants and multivitamins marketed to pregnant and breastfeeding women were taken by 8/16 participants. Four participants (25%) were taking supplements containing herbal ingredients with unknown or potentially adverse effects in pregnant and lactating women. Dietary selenium and iodine intake was inadequate in breastfeeding women. Energy, fibre, iodine, selenium, calcium, copper, manganese, potassium, folate and Vitamin D intake was inadequate in non-breast feeding women. All women were above the upper level for sodium intake. Conclusion: This pilot study found high rates of supplement use in pregnant and postpartum women with depression. The majority was taking iodine and folic acid during pregnancy, but potentially toxic supplements were being taken by 25% of study participants. The dietary intake of postpartum women with depression may be influenced by breastfeeding status, with breastfeeding women meeting more nutrient requirements than non-breastfeeding women. As nutrient inadequacies may be implicated in depression this warrants further research. The results from this study and future research may guide and improve dietetic care in depressed postpartum women