This is a population -based study here in Victoria (by some of my
colleagues) which found that postnatal depression was associated with not
breastfeeding. There have been two follow-up surveys in 1994 and 2000, which
have found similar results I believe.
Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia

Birth events, birth experiences and social differences in postnatal
depression.
Astbury J, Brown S, Lumley J, Small R.
Key Centre for Women's Health in Society, University of Melbourne,
Parkville, Vic.

A postal survey of all women who gave birth in Victoria in one week in 1989
was used to assess the contribution of birth events, satisfaction with care
and social differences to depression after birth. The questionnaire was
mailed to women eight to nine months after birth. The survey response was
71.4 per cent (790/1107) with underrepresentation of young women, single
women and women of non-English-speaking background. Assessment of depression
was made using the Edinburgh Postnatal Depression Scale, with a score of 13
or more indicating probable clinical depression. The point prevalence of
depression was 15.4 per cent (95 per cent confidence interval 12.8 to 18.0).
In the final logistic model two factors were associated with lower odds of
depression: nonmetropolitan residence and maternal age over 34. Factors
associated with increased odds of depression in the model were having a
first child over the age of 34, assisted delivery (caesarean, forceps,
vacuum extraction), bottle feeding, dissatisfaction with antenatal care,
having unwanted people present at the birth and lacking confidence to look
after the baby at the time of leaving hospital. When those factors were
taken into account, being unmarried, being born overseas of
non-English-speaking background, being dissatisfied with care in labour and
after birth, and not having an active say in decision making, all of which
were significantly associated with depression in univariate analyses, did
not make any additional contribution to the model.

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