Posts Tagged ‘post natal depression’

Research on Post Natal Depression and crying babies

Sunday, January 24th, 2010

mumandbaby2 

It’s certainly been my experience as a Pediatrician that maternal depression highly correlates with infant irritability. A recent study published in Acta Paediatrica, “Infantile colic, prolonged crying and maternal postnatal depression” provides evidence supporting that association. To read this abstract, you can click here now.

I often wonder which comes first?

Does prolonged infant crying result in maternal postnatal depression? Could a mother’s low mood affect the temperament her baby? My view is that there is an interplay between the two. This research does conclude that “Both infantile colic and prolonged crying were associated with high maternal depression scores.” It is also true that depressed parents perceive their baby’s irritability more sensitively and intensively.

 

Correlation certainly does not mean causation, but in clinical practice I find that the best outcome is achieved by managing both the depression and the infant crying. Postnatal depression can be managed with:

  • early recognition and diagnosis (even in the 21st century, postnatal depression may remain undiagnosed)
  • practical and emotional support
  • good nutrition, sleep, exercise and fresh air
  • psychotherapy
  • group meetings with other parents and a health professional expert
  • antidepressant medication

 

Excessive infant irritability (crying for at least 3 hours a day, for at least 3 days a week and for at least 3 weeks) requires:

  • a thorough health assessment by an infant nurse or doctor
  • checking for an possible underlying physical disorder such as a urinary tract infection, inadequate nutritional intake and protein allergy
  • using a variety of simple settling strategies such as SMS your baby (Sounds, Movement, Swaddling)

 

The good news is that both prolonged infant crying and postnatal depression are manageable. Both will improve with treatment, simple settling strategies and time.

PND and infant irritability are both common issues and remember:

  • they are not your fault…you’ve done nothing wrong, and
  • you are not alone.

Dads and Depression

Tuesday, October 6th, 2009

dadbaby1Wonderful again this morning to have the opportunity to speak out about Dad’s and Post Natal Depression thanks to Today.

 

As I’ve previously blogged, it seems we have understated the effect of birth on fathers. Click here for the recent blog on new fathers and fussy babies.

 

So far just about all of us have heard of maternal postnatal depression (PND). However, we have little awareness and recognition of paternal stress and depression. My survey results highlighted the anguish and pain for fathers (as well as the delight, joy and love).

  • The incidence of maternal PND is around 14%    Men may suffer from psychological distress after childbirth and birth-related PND is not a rare condition. Research findings here.
  • The incidence of paternal PND is around 8%   
  • We also know that in families in which mum has PND; fathers have about a 1/3rd likelihood of being depressed as well. Not a good combination!  
  • PND can be serious. Even life threatening.   
  • Dads generally don’t understand maternal PND (nor do mothers if it remains undiagnosed). As a result it can be difficult for dads to be appropriately supportive. Even the best fathers/husbands can become critical and judgmental of their depressed partners
  • Dads like fixing things. They don’t get that PND can’t be fixed immediately. Dads feel powerless and helpless
  • Crying, colicky, irritable babies feed in to this  cycle, causing frustration, loss of self confidence, and sleep deprivation   
  • Dads don’t know how to deal with the unsettled, crying baby. If the baby is breast fed, what can the dad do to help?  

There are a number of tools out there and solutions are available:

  • for us all to be aware of the problem. Research supports including fathers in strategies related to infant settling. An intervention/prevention approach to infant behaviour problems should include fathers
  • the Australian Government has shown awareness of maternal PND with a $55 million 5 year program, including routine and universal screening.
  • Information and awareness – October is Beyond Blue’s Anxiety and Depression Awareness Month
  • better family and community supports with higher recognition of the issue of PND  
  • less stigma associated with negative  parental-baby experience/depression  
  • even better training of, and awareness by  Obstetricians, Midwives, Paediatricians, GP’s, Child Health Nurses   
  • strategies and tools (dads love tools!) to settle a crying baby.   Research supports including fathers in strategies related to infant settling. A simple tool, Sounds for Silence can help mothers and fathers settle their baby. Demonstrated here and here.
  • good non-judgmental individual or group counseling   
  • medication

Dads’ distress and powerlessness has always concerned me. I’m pleased to  continue to highlight PND and fathers. The task of making life easier for parents should never be abandoned!