Exploring the relationship between breastfeeding grief and postpartum depressive symptoms: a convergent parallel mixed methods study

Background Women who did not meet their breastfeeding goals often experience breastfeeding grief (BG) and may be likely to have postpartum depression. Postpartum depression is nearly twice as common in African American women as in Non-Hispanic White women. No research exists on BG and its role in postpartum depression. This study examined African American women’s experiences of BG and its possible contributions to postpartum depressive symptoms. Methods Convergent parallel mixed methods design. A purposive sample of 14 African American women with children aged 6 months-2 years with BG participated in individual semi-structured interviews about their experiences of BG and completed an online survey including the Edinburgh Postnatal Depression Scale (EPDS). Qualitative and quantitative data were analyzed using reflexive thematic analysis and descriptive statistics, respectively. Both data were integrated using joint display of data and side-by-side comparison. Results Participants’ mean age was 29.6 years. Four meaning-based themes about BG were generated: Yearning to fulfill maternal responsibilities, Disconnect between idealized plans and lived realities, Navigating the disconnect , and The disconnect is preventable. From quantitative results, all participants reported history of postpartum depressive symptoms, and they all reported that experiencing BG contributed to their postpartum depressive symptoms. Half of participants also had EPDS scores ≥11. Findings suggest that BG may contribute to postpartum depressive symptoms in African American women without prior diagnosis of depression. Conclusions Qualitative and quantitative findings from this novel exploratory study revealed an overlap that African American women with BG may experience postpartum depressive symptoms.