Effects of postpartum depression on infant feeding practices in an urban low income settlement Nairobi-kenya

Abstract

Childbirth represents for women a time of great vulnerability to become mentally unwell, with postpartum mood disorders affecting approximately 10-15% women from diverse cultures; and such represents a considerable public health problem affecting women and their families. Women are particularly prone in the postpartum period because of hormonal changes associated with childbirth and stressors associated with parenting. There are evidences that postpartum depression can lead to child malnutrition, because care giving activities and parenting roles can be compromised by postpartum depression effects. The objective of this study was to determine the effects of postpartum depression on Infant feeding practices among women in an urban low income settlement in NairobiKenya. This was a descriptive cross- section study, based in Nairobi County –Kariobangi North- Health centre Maternal and Child Health Clinic (MCH). Kariobangi clinic captures women from Korogocho slums and other surrounding areas. The study targeted 216 mothers visiting the MCH clinics for their infant’s immunization at 6week to 14weeks. The study determined postpartum depression using Edinburg postpartum depression scale; Infant feeding practices based on (WHO, 2009) infant and young child feeding guidelines; Nutrition status (weight for age) using infants growth monitoring card (percentiles and z- score). A total sample of 216 mothers and their infants were recruited in the study but 200 were eligible for analysis. Out of 200 mothers studied 27 (13.5%) were found to have postpartum depressive illness as measured by an EPDS score of ≥ 13. Marital status was significant associated with postpartum depression (p<0.05) the single women were more likely affected. Income level of less than 10,000 per month (p<0.05) was significant associated with postpartum depression. Feeding practices specifically (exclusive breastfeeding) was assessed and results were 27% of mothers had supplemented their infants particularly with water, cow milk, and soft porridge. Out of 27 depressed mothers 62.9% of them did not exclusively breastfeed their infants. There was significant association between PPD and Out of 27 depressed mothers 66.7% of them had underweight infants. There was significant association between postpartum depression and infants underweight (OR=4.401; 95%CI [1.756-11.028]; (p<0.05). These finding reveals the prevalence postpartum depression and its effects on infant feeding practices and child under nutrition among women in low income settlement. The study recommends policy makers to allocate resources to reduce prevalence of PPD among women of reproductive age (15-45). Screening women for depression should be one among services given every day in the maternal and child clinic. It is important to sensitize women and create awareness about the symptoms and characteristics of post partum depression. There is a need for more research on PPD to be done using different study design such as longitudinal community based study to assess factors and prevalence of PPD and its effect on various health conditions.