Pregnancy and the arrival of a new baby is usually a joyous time for the new parents and their families.\u00a0 Months of planning, preparation for the new baby, and delivery can cause quite a bit of physical and emotional stress in the new mother.\u00a0 Because this is such an exciting time for new parents, new moms and their doctors focus on the immediate questions about the new baby such as feeding issues, vaccinations, developmental questions, safety, and minor infections.\u00a0 Pediatricians and Obstetricians often forget to ask the new moms about their emotional health. The incidence of major and minor depression varies between 6.5%-12.9% in the first year after the birth of a child.\u00a0 Every year there are more than 400,000 infants born to mothers who are depressed; this makes perinatal depression the most undiagnosed obstretric complication in America.<\/p>\n
The symptoms of depression during the postpartum period ranges from \u201cmaternity blues\u201d to postpartum depression and postpartum psychosis.\u00a0 Maternity blues can affect 60-80% of new mothers and occurs within a few days after delivery.\u00a0 Symptoms include crying, worrying, sadness, anxiety, and mood swings.\u00a0 These symptoms usually resolve on their own within 2 weeks and do not impair normal activities. The only treatment required is reassurance and emotional support from the family.<\/p>\n
Postpartum depression occurs in up to 20% of mothers after birth.\u00a0 The symptoms meet the DSM-IV<\/a> criteria for depression.\u00a0 In general, major depression is diagnosed when a person has at least 5 of 9\u00a0 following symptoms for at least 2 weeks, occurs most days, and is changes her level of functioning.\u00a0 Also the depessed symptoms are not related to medications, medical condition, normal grief or loss.<\/p>\n a.\u00a0Depressed mood. Postpartum psychosis affects about 1 to 3 mothers per 1000 deliveries and usually happen within the first 4 weeks after delivery.\u00a0 These mothers are severely affected and may have paranoiea, mood shifts, hallucinations, delusions, and suicidal and homicidal thoughts.\u00a0 This is a very serious problem and will require hospitalization and immediate medical treatment. Mothers with a history of bipolar disorder are at higher risk of developing post partum psychosis.<\/p>\n Postpartum depression affects the mother-baby bonding which leads to an environment that can affect the baby\u2019s development.\u00a0 Early brain development is highly sensitive to the enviroment; brain cell migration and connections are affected by environment and genetics.\u00a0 MRI scans have changes in the brain in children who lived in neglectful environments.\u00a0 Infants also show impaired social interaction and developmental delays.\u00a0 If there is no early intervention, the baby becomes less and less responsive to treatment.\u00a0 Studies have shown that maternal deperession can negatively affect intelligence, social and emotional development, and behavior of a child.\u00a0 Language development depends on the number of words spoken, playing, and cuddling with the infant; these behaviors are less likely to occur in a family of a depressed mother.\u00a0 Research has shown infants as young as 2 month of age looks at the depressed mother less often and have a lower activity.\u00a0 Parenting skills are also affected which can lead to poor attention to and judgment about supervision of safety and health issues.\u00a0 Early and continued treatment of the mother\u2019s depression has shown improved functioning in the mother and child.<\/p>\n Many experts believe that the Primary Care Physician (PCP) is key in screening and identifying depression.\u00a0 Unfortunately not all Pediatricians or Obstetricians are trained to screen for postpartum depression.\u00a0 A recent study from the University of Pittsburgh followed 731 families to see the effect of intervention for maternal depression on the behaviors for children between 3 and 4 years of age.\u00a0 The researchers concluded that reductions of maternal depression improved the children\u2019s behavioral problems.\u00a0 Many Pediatricians agreed that they should be screening for maternal depression but they were concerned about their lack of training in the screening process and treatment of maternal depression and the lack of resources to refer those mothers who were identified to have depression.\u00a0 To address this issue, The Parental Well-Being Project of Dartmouth Medical School used a simple 2- question screen.\u00a0 It was found to be effective in screening for depression but only used in 67% of well-child visits.\u00a0 Although the PCP may not be able to address the mother\u2019s depression, the PCP may have a role in supporting the mother and facilitating her access to resources.<\/p>\n The American Academy of Pediatrics endorses the Bright Futures program.\u00a0 This program has guidelines that include screening for depression.\u00a0 Useful tools for depression screening are the Edinburgh Postnatal Depression Scale and the 2-Question screen.\u00a0 It is recommended that the screening is done at the 1-, 2-, 4-, and 6-month visits.\u00a0 The Edinburgh scale is a 10 question screen and a score of > 10 indicates a risk for depression and an affirmative response for Question 10 (suicidality indicator) constitutes a postive screen. The key to treatment is to realize that(1)\u00a0 the mother is not alone in having postpartum depression, (2) she is not to blame (hormonal changes are a big part), and (3) she will get better.\u00a0 Treatment should include addressing the mother-child relationship.\u00a0 If the mother does not get adequate treatment this will affect attachment issues, growth, abuse\/neglect, and developmental delay.\u00a0 New mothers should actively discuss their feelings with their Obstetrician and Pediatricians.\u00a0 There are many resources available to new mothers such as What to Expect When You’re Expecting<\/a> and Postpartum Depression For Dummies<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":" Pregnancy and the arrival of a new baby is usually a joyous time for the new parents and their families.\u00a0 Months of planning, preparation for […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[5],"tags":[116,249],"class_list":["post-1438","post","type-post","status-publish","format-standard","hentry","category-child-health-news","tag-depression","tag-postpartum-depression"],"yoast_head":"\n
\nb.\u00a0A significantly reduced level of interest or pleasure in most or all activities.
\nc.\u00a0A considerable loss or gain of weight (e.g., 5% or more change of weight in a month when not dieting). This may also be an increase or decrease in appetite.
\nd.\u00a0Difficulty falling or staying asleep (insomnia), or sleeping more than usual (hypersomnia).
\ne.\u00a0Behavior that is agitated or slowed down. Others should be able to observe this.
\nf.\u00a0Feeling fatigued, or diminished energy.
\ng.\u00a0Thoughts of worthlessness or extreme guilt (not about being ill).
\nh.\u00a0Ability to think, concentrate, or make decisions is reduced.
\ni.\u00a0Frequent thoughts of death or suicide (with or without a specific plan), or attempt of suicide.<\/p>\n
\nThe 2-question screen is:
\nOver the past 2 weeks:
\n1.\u00a0Have you ever felt down, depressed, or hopeless?
\n2.\u00a0Have you felt little interest or pleasure in doing things?\u00a0 One yes is a positive screening result.<\/p>\n