Mind–Milk Connection: Association Between Postpartum Depression Screening (EPDS) and Lactational Success (LATCH Score) in Postnatal Women — A Prospective Observational Study

Abstract

Roughly one in five to six new mothers experience postpartum depression, a mood disturbance capable of disrupting both the physical and behavioural sides of breastfeeding. The Edinburgh Postnatal Depression Scale (EPDS) is a commonly used screening tool for this condition. And yet how EPDS scores, line up objectively with observed feeding performance—captured here through the LATCH score in Indian tertiary hospital settings is given little attention.

Objectives

To examine how EPDS scores relate to LATCH scores, and to determine whether screening for depressive symptoms soon after delivery can forecast how well a mother goes on to breastfeed exclusively until one week postpartum.

Methods

Over a 3-month window, this prospective observational study enrolled postnatal women admitted to the Postnatal Ward of the Department of Obstetrics and Gynaecology, Saveetha Medical College and Hospital. Women were included if they had a term, singleton delivery by the normal vaginal route who were breastfeeding adequately, and had no NICU admission for the baby; 120 such women were recruited consecutively. The EPDS questionnaire was completed on postpartum Day 3, while LATCH scoring took place on both Day 3 and Day 7. Whether a mother was exclusively breastfeeding was recorded on Day 7. Women scoring below 10 on the EPDS were grouped as 'Low EPDS' and those at 10 or above as 'High EPDS'. Group comparisons used the independent t-test, Pearson's correlation, the chi-square test, and multivariate logistic regression in SPSS v26, taking p<0.05 as the significance threshold.

Results

Among the 120 women studied, 42 (35.0%) crossed the EPDS ≥10 threshold. Day-3 LATCH scores were markedly lower in this High EPDS group than in the Low EPDS group (6.4 ± 1.3 vs 8.2 ± 1.0; p<0.001), and the gap persisted at Day 7 (7.1 ± 1.2 vs 9.0 ± 0.8; p<0.001). A negative correlation linked EPDS to LATCH scores at both Day 3 (r = –0.55, p<0.001) and Day 7 (r = –0.49, p<0.001). By Day 7, 80.8% of the Low EPDS group were exclusively breastfeeding compared with only 35.7% of the High EPDS group (χ²=25.4, p<0.001). After controlling for parity and maternal education in a multivariate model, an EPDS score of 10 or above still independently predicted non-exclusive breastfeeding (adjusted OR 4.8, 95% CI 2.1–10.9, p<0.001).

Conclusion

Women with higher EPDS scores went on to show weaker breastfeeding performance and were less likely to sustain exclusive breastfeeding. Building depression screening into early postnatal care could help clinicians flag mothers who stand to benefit from extra lactation support and counselling.