Postpartum Depression

Dr. Greene's Answer

Postpartum major depression occurs in as many as one of 10 childbearing women. This depression often goes undiagnosed.

Postpartum depression can result in difficulties with breast-feeding and mother-infant bonding. Solid evidence is mounting that maternal depression is not good for babies’ development. A recent study looked at 225 four-month-old infants, and their responses to the voices of depressed and non-depressed women. Babies do not learn as well when they are listening to the flatter, less melodic voices of depressed women. Adults’ perky, high-pitched baby talk sets the stage for intellectual development (Child Development 1999;70:560-570).

Depressed mothers deserve treatment, both for their babies’ sakes, and so that the mothers do not miss out on enjoying one of life’s unrepeatable joys — the all-too-brief babyhood of each child.

When possible, it’s best to treat the depression with sleep, exercise, bright light, upbeat music, and healthy food. Exercise is particularly difficult in the postpartum period — both time and energy are often lacking. But exercise has been proven to help specifically with postpartum depression (J Sports Med Phys Fitness 1997 Dec;37(4):287-91). Cooperation and commitment will be needed from family and friends to guard Mom’s sleep and to free her up for daily aerobic exercise — outside if possible (Prev Med 1999 Jan;28(1):75-85). An hour of aerobic exercise daily can be as powerful as even the strongest antidepressant medications. Even 10 minutes a day can make a noticeable difference.

Aerobic exercise, while effective at treating depression, creates lactic acid that causes sore muscles. This lactic acid gets into the breast milk. It doesn’t taste good and leads to fussier babies — which in turn increases the risk of depressed moms (Pediatrics 1992 Jun;89(6 Pt 2):1245-7). I also wonder whether depression itself may alter breast milk, giving another good reason to treat.

In addition to exercise, new mothers need time to rest. Plan to use some of your baby’s naptimes to sit quietly in a well-lit environment. Even an hour of quiet rest with no responsibilities can significantly improve symptoms of depression. (J Sports Med Phys Fitness 1997 Dec;37(4):287-91).

It’s also important to avoid emotional and social isolation. Support groups and professional counseling can help mothers express their feelings and find connection with others.

If treating the depression without medicines isn’t satisfactory, I am in favor of using antidepressant medicines.
References:
^{Perinatal Depression. Dossett EC – Obstet Gynecol Clin North Am – 2008 Sep; 35(3); 419-434}