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AAP: More Perinatal Depression Screening, Referrals Needed
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aternal depression can affect a baby’s health before and after birth, and it is one of the most common – and costly – obstetric complications in the United States when left undiagnosed and untreated,
according to a report released by the American Academy of Pediatrics. In its updated policy statement, the AAP recently renewed its call for physicians to screen women for depression during and after pregnancy and details the health implications for children. “When we are able to help a mother deal with her mental health, we are essentially reaching the whole family,” said Marian Earls, MD, FAAP, a lead author of the report. “We hope to create a protective buffer for the baby while strength-
ening family relationships and wellbeing.” An estimated 50 percent of women who are depressed during and after pregnancy are undiagnosed and untreated, according to research cited in the report. When left untreated, perinatal depression can hinder bonding and healthy attachment, distort perception of the infant’s behavior and impair the mother’s attention to and judgment concerning safety. Perinatal depression has typically referred to a period of time when symptoms appear
Whine Down: A Cheeky Children’s Book-Style Book for Moms A new book for moms hilariously captures the realities of motherhood, and why it’s okay to prioritize your “me time.” Written by a mom of three, Ashley P. Smith, “Whine Down” is a light-hearted children’s-style book for adults that shows the realities of mom life. A former medical device sales representative, Smith has become a motivational speaker. “Whine Down” is about more than a book: Smith wants to create a global movement. “The basis for ‘Whine Down’ came from a 2 a.m. rant I typed on my phone while nursing my son,” Smith said. “I shared the rant with a few of my mom friends, and it really took off. I realized I wasn’t alone, and that other moms were having the same struggles.” From that 2 a.m. rant came the beginnings of the “Whine Down” book. Smith is using the book as a platform to spread her message. “I want to create a movement and awareness for mom self-care,” Smith said. “Motherhood can be so overwhelming. We’re hard-wired to be givers, doers, and nurturers. ‘Whine Down’ is helping women embrace the art of selfishness, and making more time for themselves.” Smith’s goal is to help mothers across the world find 20 minutes a day for positivity, self-love, and kindness. Whine Down is available at http://www.whinedowntime.com or Amazon.
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anytime during pregnancy or within four weeks of delivery. More recently, some professional organizations have expanded the time period to include the full 12 months following delivery. The report finds that an estimated 15 to 20 percent of new mothers are affected by perinatal depression, an umbrella term that includes forms of prenatal and postpartum depression. Emerging research also has begun to examine the importance and influence of a father’s emotional state on a child’s early development and well-being. “Fathers also experience a high rate of postpartum depression and need to be supported, identified and referred for treatment,” said Michael Yogman, MD, FAAP, a coauthor. AAP recommends that mothers are screened for depression once during pregnancy, and that pediatricians screen mothers during the infant’s well visits at 1, 2, 4 and 6 months of age. Pediatricians are also encouraged to work with prenatal health providers to identify systems of support for the patients and identify communi-
ty resources. “We know that postpartum depression can be a form of toxic stress that can affect an infant’s brain development and cause problems with family relationships, breastfeeding and the child’s medical treatment,” said Jason Rafferty, MD, MPH, EdM, FAAP, a coauthor. “Pediatricians are in a unique position to help identify parents in need of extra support.” Many factors play into risk of perinatal depression, including family and personal history, substance use, marital discord, family violence, isolation, poverty, difficult infant temperament, young maternal age and chronic illness. Risk is also higher for teen mothers, mothers with multiple births and preterm births, as well as those undergoing stressful transitions, such as returning to work. “We have made strides in the past 10 years in education and screening parents for depression,” Dr. Earls said. “But more work needs to be done, in tackling the stigma associated with mental illness and steering families to the right support.”