Has anyone considered level of thyroid as a cause for PPD. My
endocrinologist thinks that all mothers should be tested PP before rx for
antidepressents medications. Kate Pierce
Kate Y. Pierce RN, BSN, IBCLC
Lactation Station, Inc.
Maternity and more
527 Southland Dr.
Lexington KY 40503
859-277-2988
859-278-0880
----- Original Message -----
From: "Karen Kerkhoff Gromada, MSN, RN, IBCLC" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, June 20, 2003 10:50 PM
Subject: Re: postpartum depression - ABM vs breastfeeding
> In a message dated 6/20/03 5:01:56 PM Eastern Daylight Time,
> [log in to unmask] writes:
>
> > Buring the mindnight oil tonight looking for some info on the incidence
of
> > postpartum depression in breastfeeding and bottle feeding mothers. Found
> > plenty of info about the general incidence PPD, but would really like
some
> > good data which specifically adresses a difference between the two modes
of
> > feeding
>
>
> I don't think you're going to find "good data" one way or the other. In my
> searches on this topic I've not come across any data that supports a
difference
> either way re: PPD between lactating women and those that have involuted
> postpartum. In studies a decade or so ago, some researchers theorized PPD
incidence
> would be higher among lactating women due to lower estrogen levels, as
> estrogen was thought to play some sort of positive role in avoiding PPD.
Although
> one study found a slight increase in PPD among lactating women, the
difference
> was not significant and other research results did not support the
hypothesis.
> At this point it all still appears to be ambiguous re: the difference
you're
> looking for. I did find one Cochrane meta-analysis re: possible hormonal
> influence via treatment modalities. I doubt it's helpful but I've included
it
> below...
>
> Karen
>
> << From The Cochrane Library, Issue 2, 2003. Oxford: Update Software Ltd.
All
> rights reserved.
>
> Available: <A
HREF="http://www.update-software.com/abstracts/ab001690.htm">http://www.upda
te-software.com/abstracts/ab001690.htm</A>
>
> Oestrogens and progestogens for preventing and treating postnatal
depression
> (Cochrane Review)
>
> Lawrie TA, Herxheimer A, Dalton K
>
> ABSTRACT
>
> > A substantive amendment to this systematic review was last made on 13
> > January 1999. Cochrane reviews are regularly checked and updated if
necessary.
> > Background: Postnatal depression, with a prevalence of at least 10%, is
probably
> > the most common complication of the puerperium. A deficiency or
imbalance of
> > sex hormones has repeatedly been suggested as a cause.Objectives: The
> > objective of this review was to evaluate the role of oestrogens and
progestogens in
> > the prevention and treatment of postnatal depression.Search strategy:
The
> > register of clinical trials maintained and updated by the Cochrane
Pregnancy and
> > Childbirth Group.Selection criteria: All trials were considered in which
> > pregnant or postpartum women (up to 18 months) were randomised to
receive
> > postpartum oestrogen or progestogen or placebo for the treatment or
prevention of
> > postnatal depression.Data collection and analysis: Two published
randomised
> > placebo controlled trials were identified for inclusion in the analyses
for
> > this review. One study was excluded.Main results: Depot norethisterone
enanthate
> > given within 48 hours of delivery and lasting 8-12 weeks was associated
with
> > significantly higher postpartum depression scores than placebo.
Oestrogen
> > therapy in severely depressed women was associated with a greater
improvement
> > in depression scores than placebo.Reviewers' conclusions: There is no
place
> > for synthetic progestogens in the prevention of treatment of postnatal
> > depression. Long-acting norethisterone enanthate is associated with an
increased risk
> > of postnatal depression. It and other long-acting progestogen
contraceptives
> > should be used with caution in the postnatal period, especially in women
> > with a history of depression. The role of progesterone in the prevention
and
> > treatment of postnatal depression has yet to be evaluated in a
randomised
> > placebo-controlled trial.
> >
> > Oestrogen therapy may be of modest value at a late stage of severe
postnatal
> > depression. Its role in the prevention of recurrent postnatal depression
has
> > not been evaluated. Further research on its value is unlikely for
ethical
> > reasons.
> > Citation: Lawrie TA, Herxheimer A, Dalton K. Oestrogens and progestogens
for
> preventing and treating postnatal depression (Cochrane Review). In: The
> Cochrane Library, Issue 2 2003. Oxford: Update Software. >>
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