Pharmacological lactation inhibition upon maternal request: a risk factor for depressive disorder

Objective. Failed lactation and perinatal depression are two common disorders with major public health consequences, but the magnitude and the direction are still unclear. We aimed to define the pharmacological lactation inhibition rate by Cabergoline upon maternal request in low-risk gestations and to determine the association with concurrent depressive symptoms, scored by the Edinburg Postnatal Depression Scale (EPDS), distinguishing Anhedonia, Anxiety, and Depression subscales. Methods. In a three-year period (January 2019 to September 2022), the self-reported EPDS questionnaire was distributed to 2,560 eligible women on the second day postpartum, prior to discharge from the maternity ward of the Abano Policlinic (Abano Terme, Italy). Concurrently, we examined the lactation inhibition rate by Cabergoline, upon maternal request. Results. In this low-risk population of women, maternal lactation suppression by Cabergoline was used upon maternal request by 95/2560 (3,71%) women, whereas perinatal mood disorders risk, defined as EPDS score >12, was found in 364/2560 (15%). Women with EPDS score >12 more frequently required Cabergoline from birth [75 (3.3% vs 20 (7.25, p<0.003)]. Conversely, data analysis revealed that women requiring Cabergoline presented with significantly higher EPDS [8.0 (5.0, 12.0) vs 6.0 (4.0, 10.0), p 0.006], supported by significantly higher Anhedonia, Anxiety and Depression Subscale scores. In addition, Anxiety was the major component of psychological distress perceived by women adopting formula feeding. Conclusion. Perinatal affective disorders may underlie pharmacological lactation inhibition request. Future research may identify treatment strategies both to relieve perinatal depression symptoms and to enable women to achieve their infant feeding goals.