The demands of parenting put mothers of infants and young children at a particularly high risk of depression, according to background information in the article. As many as 24 percent of mothers with children younger than age 3 have depressive symptoms, which may in turn affect their babies. "The science of early development is clear about the importance of parenting and early caregiving relationships, especially during infancy, when there is total dependency for safety, health, protection, nurturing and stability," the authors write. "When a mother is coping with postpartum depressive symptoms, it places a burden on the caregiving relationship at a time when early patterns of parenting are established."
Kathryn Taaffe McLearn, Ph.D., of Columbia University, New York, and colleagues studied 4,874 mothers who visited one of 15 pediatric care sites around the country. The women were given a short questionnaire when they entered the study, between 1996 and 1998. Researchers then interviewed the participants by telephone when their infants were two to four months old, asking questions about child care practices and depressive symptoms.
During these interviews, 17.8 percent of mothers reported symptoms of depression. Among women who had breastfed, mothers with depressive symptoms were less likely to still be breastfeeding at the two- to four-month mark than women without symptoms of depression (43.8 vs. 56.9 percent). Mothers with symptoms of depression were also less likely to play with their infants at least once a day (87.4 vs. 91.9 percent), show a book to the infants at least once a day (22.4 vs. 28.2 percent) or regularly talk to their infants while working (59.6 vs. 64.1 percent).
The researchers found no significant differences between mothers with and without depressive symptoms in terms of safety practices, such as lowering the temperature of the water heater and using the correct sleep position, when other factors were considered, such as the mothers' age, income and level of education. This indicates that mainly parenting practices that involve active engagement with children are affected by mothers' symptoms of depression, the authors write.
"The findings from this study offer important implications for pediatric health care professionals and practice," the authors conclude. "The first is the need to screen for maternal depressive symptoms among all mothers during the postpartum period, when parenting practices are being established and when pediatric practices have frequent contact with families to provide guidance." In addition, they continue, pediatricians should take extra care to discuss ongoing interactive parenting practices with mothers who are suffering from depression.
(Arch Pediatr Adolesc Med. 2006;160:279-284. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: This study received funding from The Commonwealth Fund, New York.
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