Introduction: Male bias in India has resulted in an altered sex ratio. It also results in maternal postpartum depression (PPD) and lower breastfeeding rates. We studied depression among fathers in this context.
Methods: Edinburgh postnatal depression scale (EPDS) questionnaire was administered to 479 parents separately. Breastfeeding on day 7 was determined.
Results: Depression was significantly higher in fathers of girls. Mean EPDS score was 5.86 ± 4.98 versus 2.5 ± 2.64 (p < 0.001). Concordance between parents was significant (r = 0.95, p < 0.001). Boys were more likely to be exclusively breastfed (64.46% versus 35.54%, p < 0.001). In second-order births, if the first born was a girl and second baby was again a girl, 23% were exclusively breastfed compared with 86% if it was boy after a girl (p < 0.001). Among parents who had EPDS scores ≥11, no babies were exclusively breastfed. Among the 25 babies who received no breast milk, 21 were girls and 4 were boys (p < 0.042). The multiple logistic regression analysis indicated that birth of girls (OR 0.269, 95% CI 0.076-0.953), high EPDS score in mothers (OR = 0.080, 95% CI 0.026-0.249), and high EPDS score in fathers (OR = 0.096, 95% CI 0.031-0.299) were associated with lower breastfeeding rates.
Conclusion: Paternal depression correlates closely with maternal PPD and low exclusive breastfeeding of girls. Breastfeeding has implications for survival of girls. Efforts are needed to support the parents of girl children with PPD and such support must extend to fathers to improve survival.
Keywords: EPDS; breastfeeding; gender bias; paternal depression.