Screen New Moms for Postpartum Depression, says American Academy of Pediatrics
Mood changes after giving birth is thought to affect up to 80% of new mothers not only due to hormonal changes, but also because of sleep deprivation and the sudden onset of new and critical responsibilities. However, up to a fourth of women may also experience something more serious – postpartum depression – and the American Academy of Pediatrics stresses to its member pediatricians to begin screening moms at new baby well checks to prevent a host of problems.
Recognize Signs and Symptoms of Postpartum Depression Early
Rates of depression among pregnant and postpartum women are estimated to be between 5 and 25% with the incidence of major depression in the first year after birth being between 1 and almost 7%. According to Marian F. Earls MD and colleagues from the AAP Committee on Psychosocial Aspects of Child and Family Health, this means that more than 400,000 infants are born annually to depressed mothers.
Depression in new mothers can cause problems such as delay in maternal-child bonding and an environment that can lead to cognitive and social development problems (ie: behavior problems, anxiety and mood disorders) as early as two months. “The processes for early brain development – neuronal migration, synapse formation and pruning – are responsive to and directed by environment as well as genetics,” write the authors in the November issue of the journal Pediatrics.
Maternal depression can also lead to inappropriate medical care, impaired attention to health and safety concerns, discontinuation of breastfeeding, and most seriously, child abuse and neglect says the committee.
Although pediatricians may currently lack training to identify postpartum depression, the committee feels that screenings are feasible and can be successful as it may identify at-risk mothers sooner. Infants are seen more often in the first month after birth by a healthcare professional than are postpartum women. In general, babies are seen at 1 week, 2 weeks and one month after birth by a pediatrician, while women usually wait until 6 weeks after giving birth for a follow-up by an obstetrician/gynecologist.
There are also obstacles to be overcome, such as time pressure, inadequate reimbursement, and the need for postpartum screening tools. Pediatricians would also not treat patients under the new model but would provide referrals to mental health professionals, the committee stresses.
Women and their partners should be on the lookout for the symptoms of postpartum depression, which include loss of appetite, insomnia, intense irritability and anger, feelings of shame or guilt, and withdrawal from family and friends. Women who suffer from postpartum depression should recognize that she is not alone, not at fault, and that the situation will improve. She should seek help as soon as possible from a qualified mental health professional.
Earls M, et al "Clinical report -- incorporating recognition and management of perinatal and postpartum depression into pediatric practice" Pediatrics 2010;126:1032-1039.