More than Milk: The Educational Power of Social Support in Shaping Maternal Mental Health

Background: The postpartum period involves significant physical, emotional, and psychological changes, including the responsibility of infant care and decisions about feeding. A central question in maternal health is whether breastfeeding protects against postpartum depression (PPD) or vice versa. While this association is commonly assumed, existing studies offer inconclusive findings. Few have examined the breastfeeding experience, mothers’ attitudes toward breastfeeding, and their relationship with PPD, particularly across cultural groups. This study addresses that gap by exploring how breastfeeding attitudes, self-efficacy, and social support relate to maternal mental health in diverse populations. Aims: To examine associations between social support, breastfeeding self-efficacy, attitudes toward breastfeeding, and PPD among Jewish and Arab mothers in Israel. Design: A cross-sectional survey examined postpartum depression, self- efficacy, and social support among Jewish and Arab mothers in Israel. Methods: A total of 348 postpartum women (252 Jewish, 96 Arab) completed validated questionnaires assessing PPD (EPDS), perceived social support, breastfeeding self-efficacy, and attitudes toward breastfeeding. Data were analyzed using t-tests, Pearson correlations, and multiple regressions. Results: Arab mothers reported significantly higher PPD and lower social support than Jewish mothers. Familial pressure to breastfeed, especially from maternal figures, often conflicted with modern roles, contributing to stress. Jewish mothers reported greater autonomy in feeding decisions, shaped by personal and professional priorities. In both groups, higher social support and breastfeeding self-efficacy were associated with lower PPD symptoms. Conclusions: Cultural norms and support systems shape maternal mental health and feeding decisions. Culturally sensitive, autonomy-supportive education and care can enhance maternal well-being.