Impact of postnatal depression on neonatal outcomes: an exploratory study in Kisumu County, western Kenya

Background Previous Kenyan studies suggest postnatal depression (PND) may negatively impact infant growth. However these studies are limited to Nairobi and no research has explored the effects of PND in the neonatal period. Aim To explore the impact of PND on neonatal feeding practices, weight gain, illness episodes and identify key maternal caregiving challenges. Methods A mixed methods study of mothers and newborns <72 hours post-delivery from postnatal wards and clinics across 5 facilities in Kisumu County. At baseline, the Edinburgh Postnatal Depression Scale (EPDS) identified mothers with depressive features (EPDS ≥12) and infant feeding practices were assessed by questionnaire. 24 mothers were followed up 2 weeks later with a questionnaire and interview to further explore caregiving practices. Quantitative data was analysed using descriptive statistics. A thematic framework was used to identify and analyse emerging themes from the interviews. Results 56 (37%) out of 150 mother-infant pairs screened at baseline had an EPDS score ≥12. These mothers practiced exclusive breastfeeding less frequently (76.9% vs 90.9% p = 0.6) and a smaller proportion of their infants gained weight at 2 weeks (23.1% vs 36.4% p = 0.75). Key stressors were financial insecurity and lack of social support. Mothers described the benefits of social support on their mood and caregiving abilities. Conclusion Adverse growth and feeding outcomes are already apparent in the first 2 weeks of life among infants of mothers with features of PND. Early screening and intervention through community support structures could mitigate against the impact of PND on maternal mood and caregiving ability.