Family Matters

Pediatricians Should Start Screening for Postpartum Depression

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We’ve all heard about the importance of mother-baby bonding. When that doesn’t happen because a mother is battling postpartum depression, it’s not only mom who suffers; baby does too. Research has shown that babies who are neglected or cared for by depressed mothers may experience developmental delays.

That’s why the American Academy of Pediatrics (AAP) is now recommending that baby docs get in on the action and screen new moms for telltale signs of depression.

But isn’t the pediatrician the baby’s doctor? Well, yes, but mom’s well-being affects baby’s. In any case, a pediatrician has many more opportunities to interact with a new mother than other physicians since newborns have frequent well-baby check-ups. The peak time for major postpartum depression is six weeks, which coincides with the peak time of infant crying. Minor to moderate depression strikes most often in the first four months after delivery. The AAP recommends pediatricians screen mothers at babies’ one-, two- and four-month visits. (More on Diagnosing Postpartum Depression with a Brain Scan)

With some research indicating that up to a quarter of moms develop some form of depression after their baby’s birth, recognizing and treating the condition is a matter of public health.

It’s not enough for a pediatrician to simply make a gut assessment of how mom and baby are doing. “It wouldn’t necessarily always be obvious, so the evidence is that you really need to ask and it needs to be routine,” says Marian Earls, a Greensboro, N.C., pediatrician who was the lead author of the clinical report published in the November issue of Pediatrics.

As a result, pediatricians are being advised to ask mothers to complete a brief questionnaire called the Edinburgh Postnatal Depression Scale, 10 questions designed to reveal whether a mother is struggling. (More on Time.comHaving Kids, Especially Young Ones, Ramps Up Depression)

While the recommendation to screen is new, a fair number of pediatric practices — including Earls’ clinic and others in Minnesota, Illinois and New Hampshire — have already begun.

Earls’ practice has been doing it for five years; in that time, doctors have identified fewer than 10 women who needed immediate emergency services. When the questionnaire reveals cause for concern, mothers are more commonly referred on the spot to clinical social workers, who help them find support in the community. Sometimes they’re directed to early intervention services, where they learn how to interact and play with their baby. (More on The ‘Mommy Brain’ Is Bigger: How Love Grows a New Mother’s Brain)

A pediatric listserv established to share pediatricians’ experiences with the screening has fielded plenty of comments about patients who are grateful their babies’ doctors are taking an interest in their emotional health. “A lot of moms need reassurance and demystification of what’s going on,” says Earls.

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