Postpartum Depression Epidemic Affects More than

Just Mom
February 2008 Scientific American Mind

By Katja Gaschler

The psychologist smiles at Manuela, a new mother in her late thirties. “Please
play with your baby for two minutes,” the therapist instructs her and then leaves the
room. Two video cameras film Manuela (which is not her real name) and her three-
month-old daughter. In the next room, a split-screen monitor shows the mother’s profile
on the left and her infant in a baby chair on the right.

At first, Manuela appears to be at a loss for what to do. Then, her face noticeably stiff,
she begins to talk softly to her baby. Her baby fidgets, briefly makes eye contact and then
turns away. Manuela eventually stops talking and stares into the distance, unsure again
how to act. She absentmindedly strokes her baby’s foot with one hand. The psychologist
knocks on the door; the videotaping is over. The new mother is now on the verge of tears.

Manuela is undergoing therapy at the Clinic for General Psychiatry in Heidelberg,

Germany, for postpartum depression, an ailment that has strained her relationship with
her baby. Although the vast majority of mothers experience periods of crying and
irritability along with concentration lapses and exhaustion, these so-called baby blues
disappear within a few hours or days of delivery. But 10 to 20 percent of women in the
U.S. develop, in the first year after childbirth, the more disabling despair that afflicts
Manuela. These mothers succumb to a deep sadness that, if untreated, may persist for
months to years.

Manuela frequently feels exhausted and emotionally empty. When her baby cries, she
sometimes wants to flee or hide. She is wracked with guilt because she cannot show love
to her daughter. Mothers with symptoms of postpartum depression [see box on page 70]
are often overwhelmed by the feeling that they might harm their babies. Although they
rarely cause any outright harm, depressed mothers may have difficulty caring for their
infants—and that fact can heighten their distress.

These emotional problems plague women worldwide. A 2006 review of 143 studies in 40
countries documents that postpartum depression is especially common in Brazil,
Guyana, Costa Rica, Italy, Chile, South Africa, Taiwan and Korea, with prevalence rates
as high as 60 percent in some countries.

The causes of the disorder are not fully known, but the dramatic hormonal fluctuations
that occur after delivery may contribute to it in susceptible women. A bout of previous
depression is a huge risk factor for the postpartum variety, new research shows.
Whatever its cause, depression can weaken the nascent bond between a mother and her
child, studies suggest, and thereby make a toddler more passive, insecure and socially
inhibited—although a child’s intellectual development usually remains unimpaired.

Thus, in addition to treating the mother’s depression, psychologists and psychiatrists

increasingly focus on strengthening the relationship between the mother and her child—
for example, by using a video camera to record and analyze their interactions. “We need
to change the unfavorable behavioral patterns that develop between mother and child
during depression,” says University of Heidelberg psychologist Corinna Reck.
 Sleep Deprivation Worsens Postpartum Depression
December 12, 2008
Posted by Katherine Stone/Postpartum Progress

I don't know. I think I'd put this in the category of "Did they really need to spend money on research to
figure this out??" I suppose I shouldn't be a pain in the butt about it, but it feels obvious. Anyway,
ignore me and read on:

"A study published in the current issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing
shows that depression symptoms worsen in PPD patients when their quality of sleep declines.

Sleep deprivation can hamper a mother's ability to care for her infant, as judgment and concentration
decline. Sleep-deprived mothers also may inadvertently compromise their infants' sleep quality because
infants often adopt their mothers' circadian sleep rhythms.

All new mothers experience some sleep loss following childbirth, as their estrogen and progesterone
hormone levels plunge. They typically spend 20 percent more of the day awake than average during the
first six weeks postpartum. Postpartum women wake more frequently and have less dream sleep than
non-postpartum women, with women in their first month postpartum spending only 81 percent of their
time in bed actually sleeping. Neurotransmitters that influence sleep quality also affect mood, raising
sleep-deprived mothers' risk for depression ...

Study author Bobbie Posmontier of Drexel University compared sleep patterns of 46 postpartum
women, half with symptoms of PPD and half without. Sleep patterns were monitored for seven
consecutive days. Results showed that mothers suffering from PPD took longer to fall asleep and slept
for shorter periods. The worse their sleep quality, the worse their depression.

Posmontier recommends clinicians treating women for PPD to address the importance of adequate
sleep. 'Mothers can develop a plan to have other family members help care for the baby at night,' she
said. 'They also should practice good sleep hygiene. That includes going to bed at the same time every
night, avoiding naps and steering clear of caffeine, exercise, nicotine and alcohol within four hours of
bedtime.'"

I completely agree with the issue of sleep management for any new mom, but especially those moms
who have a perinatal mood or anxiety disorder. My husband and I had a plan: I stayed up with the
baby two nights in a row, and he stayed up with the baby the next two nights while I slept in a room
without the monitor. And yes, he had a job to go to in the morning. But he sacrificed so that our whole
family could be healthy as soon as possible. Let me tell you, a full night's sleep does a lot for your ability
to cope. Husbands out there: You can balk now if you want to, and not stay up to help with the baby.
But if you do, you may pay for it later with a completely incapacitated wife. Remember, the vow
reads "in sickness and in health."
BABY BATH
Preparing Your Baby's Bath

• Plan for your baby's bath. Get everything ready before you start the bath. This
makes bathing your baby easier and safer.
• If you can, turn down your water heater to 120 degrees. Babies can get scalded
easily. Fill the sink or tub you're going to bathe your baby in with warm water.
Always test the water with your wrist or elbow. The water should be comfortably
warm, not hot.
• Make sure you have everything you need for the bath. You can keep mild soap,
cotton balls and a clean diaper in a shoebox or other container. Then you can
bring the box in with the towel and washcloth to the room where you bathe your
baby. When everything is ready, get your baby.
• If you forget an item, you will have to carry your baby with you. This is hard to do
when the baby is wet and slippery.
• Never leave your baby alone in water. It's best not to answer the phone or the
doorbell during your baby's bath. If you do, pick up your baby and carry her with
you. If your spouse, relatives or friends call you often, let them know when your
baby's bath time is. Tell them you won't take phone calls at that time.

Bathing Your Baby

Your baby needs sponge baths at first. Give your baby a sponge bath until her
umbilical cord or his circumcision, if any, is healed. After that, your baby can have a tub
bath.

Fill a bowl or basin with warm water: Use your wrist or elbow to check the water to make
sure it is just the right temperature. Be sure the water is not too cold or too hot. Very hot
water can be dangerous.

Take the bowl of warm water and a soft washcloth to the place where you are going to
bathe your baby.

Pick a place for bathing that is warm and not drafty. You don't want your baby to get
chilled. You can put your baby on a bath towel in her crib or any other flat surface. If you
put your baby on a table, make sure she cannot roll off. Do not leave your baby alone, not
even for a few seconds.

Take your baby's clothes off. Put the washcloth in the warm water and squeeze it out
until it is just damp. Use the washcloth to gently wipe your baby all over. Wipe her head
and neck, behind her ears, and between her fingers and toes. Your newborn does not
need to have a bath every day. Just clean her face, neck and diaper area whenever they
are dirty.

Be Gentle When Bathing Your Baby

• You can use your bathtub, kitchen sink or a plastic baby tub. Use something to line the
tub to keep your baby from slipping. If you use a foam liner for a tub, it needs to be dried
out after each use. This prevents the growth of germs. Or you can line the tub with a bath
towel. Be sure to wash and dry it after each use.
• Use a clean, damp washcloth, without soap, to wash her face. Gently wash the outside and
back of each ear and wash and dry under her neck.
• Don't use bubble bath or detergents in the bathwater since these may cause rashes.
• Use damp cotton balls or cotton pads to gently wipe your baby's eyes before you put her
in the tub. Be sure to support your baby's head when she is in the tub.
• Wash your baby's hair and scalp very gently, using soap or a baby shampoo. Do this only
once or twice a week. Rinse with a damp cloth. Make sure that soapsuds don't get into her
eyes. Wash her body, starting with the chest. After washing with a soapy washcloth, rinse
the washcloth and rinse her off. Pat your baby dry with a bath towel. Always keep her
covered and warm when she is wet.
Health Teaching
About
Baby Bath

Submitted by:
GARCIA, Kimberly A.

Course/yr/Sec:
BSN III-A

Submitted to:
Ms. Aimee Agorilla