One in three new mothers during early COVID-19 screened positive for postpartum depression––nearly triple pre-pandemic levels––and one in five had major depressive symptoms, say University of Michigan researchers.

New research from the U-M School of Nursing found that depression in new mothers rose considerably during the pandemic. Before COVID, the Centers for Disease Control and Prevention estimated that one in eight women experienced postpartum depression, and about 5-7% experienced major depressive symptoms, said lead author Clayton Shuman, U-M assistant professor of nursing.

The study, "Postpartum depression and associated risk factors during the COVID-19 pandemic" appears in BMC Research Notes. It comes from a larger study called "COVID-19 MAMAS (Maternal Attachment, Mood, Ability, and Support)," which gave rise to several papers about pregnancy and postpartum experiences during COVID.

For this paper, researchers collected survey data between February and July 2020 from 670 U.S. postpartum patients who completed the Edinburgh Postnatal Depression Scale online and provided demographic information.

Their research found that:

• Moms who fed infants formula had 92% greater odds of screening positive for postpartum depression and were 73% more likely to screen positive for major depressive symptoms, compared to those who breastfed or bottle-fed with their own human milk.

• Moms with infants in neonatal intensive care units had 74% greater odds of screening positive, and each one-week increase in weeks postpartum increased the odds of screening positive by 4%.

• Moms worried about contracting COVID-19 had 71% greater odds of screening positive for postpartum depression.

Shuman says he was surprised by how many women screened positive for depression and major depression.

"We also found that almost one in five participants who screened positive for postpartum depression reported having thoughts of harming themselves. This is very concerning given that prior to the pandemic, Dr. Lindsay Admon and colleagues from U-M found the rate of suicidality among prenatal and postpartum patients is on the rise in the U.S."

There are several possible reasons for the breastfeeding finding, Shuman said.

Previous research found that breastfeeding support resources such as lactation consults were limited during early COVID and may have increased distress or caused people to switch to formula. Stress from supply chain problems that resulted in formula shortages could have also contributed to depression. Finally, studies suggest that breastfeeding may help to protect postpartum patients from postpartum depression, helping to minimize the severity of depressive symptoms and improving recovery time.

This increase highlights the need to identify depressive symptoms in postpartum patients, but screening is only a first step, Shuman said.

"Treatment is pivotal to recovery," he said. "Resources and education about postpartum depression must be better disseminated and implemented. These resources should be shared with the general public to reduce stigma, and shared with those who provide social and emotional support to postpartum patients, such as partners and family members.