Change in Maternal Mental Health Trends Among Lactating Women during the COVID-19 Pandemic

Purpose: To determine if the COVID-19 pandemic was associated with changing trends in maternal depression, anxiety and stress levels among lactating women compared to pre-pandemic.Methods: Data originated from the UC San Diego Mommy’s Milk Study of breastfeeding mothers residing in the U.S or Canada (2016-2021). Participants were interviewed and completed a self-administered Edinburgh Postnatal Depression Scale (EPDS), Perceived Stress Scale (PSS-10) and State Trait Anxiety Inventory (STAI) questionnaire after childbirth during the time they were breastfeeding. Interrupted times-series analyses using regression models were used to investigate the change in different samples of women over time in EPDS, STAI and PSS-10 scores following the onset of the Covid-19 pandemic. All time points prior to March 1, 2020 were considered the “pre-COVID19” time period, and time points from March 1, 2020 and on were considered the “COVID19” time period. Models were adjusted for seasonality, and in sensitivity analyses, maternal parity and income. Results: During the 41 months prior to the onset of the COVID-19 pandemic, mean scores on all three measures remained consistent. Following the onset of the COVID-19 pandemic, mean scores on depression (b = 0.432, p = 0.003) and stress inventories (b = 0.731, p = 0.002) increased in a linear fashion in each month. Anxiety scores followed a similar pattern, but it did not reach statistical significance (p = 0.07). Results were essentially unchanged when adjusting for seasonality or maternal covariates. Conclusion: The increase in maternal depression and stress scores have public health implications and suggest that breastfeeding mothers are at high risk for mental health issues during the COVID-19 pandemic. These findings show the need for increased screening for postpartum women during the COVID-19 pandemic, and increased availability of mental health resources for postpartum women during the COVID-19 pandemic. Research has shown other catastrophic events affect maternal mental health in similar ways. (Harville, 2009) Therefore, beyond the COVID-19 pandemic, the findings of this study can be used for economic downfalls, other viral or bacteria outbreaks, and even natural disaster response strategies