Preventing Postpartum Depression Before It Starts
Prevention & Treatment The symptoms of postpartum may be affecting someone like you, which is why Adele, Kirsten Gillibrand and Chrissy Tiegen are speaking up.
The birth of a child brings high expectations of happiness. Movies and social media offer glorious images of moms and dads cooing with delight over their tiny babies. But for many, the exhaustion and struggles to feed and settle their baby’s crying drain away much of the joy, replacing it with depression, anxiety and self-doubt.
Yet, this very common problem often blindsides new mothers and fathers. Through thirty years as a practicing pediatrician, I have heard thousands of exasperated new parents ask the same question, “Why didn’t anyone tell me it would be this hard?”
In certain ways, parenting today is much harder than it was in past generations. We don’t have to wash clothes in the river or catch our dinner, but two big challenges make modern baby-rearing much more stressful: most have little experience (many never held a baby before), and most have little family support. Today, it’s a luxury to have a nanny, but 100 years ago most parents had the help of multiple nannies (your aunt, mother, older sister, cousin, etc.).
Sleep deprivation is not a trivial problem. It is used to train our special forces to endure torture.
Recently, Baby Center and I surveyed over 1000 new mothers. They rated sleep deprivation as their biggest angst, well ahead of lack of time or money. Almost 80 percent said they routinely felt tired or exhausted.
Other studies confirm that 50 percent of new parents get less than 6 and a half hours of fractured sleep each night. That level of sleep loss has been shown to cause the same mental impairment as being drunk and can double the risk of getting into a serious car accident.
Further, exhaustion can lead to: marital stress, infant death from unsafe sleeping and failed breastfeeding. And topping the list of the effects of extreme fatigue is postpartum depression (PPD). PPD affects 10 to 15 percent of all new mothers — and at least 25 percent of their partners. It is associated with deep anxiety, emotional crumbling, lifelong depression and even suicidal tendencies. This list is not meant to stoke fear, but rather to provoke us to tackle the root cause of this serious problem.
“By preventing crying and boosting a baby’s sleep, we may be able to significantly reduce new parent fatigue and the risk of PPD.”
Talk about PPD
Chrissy Teigen recently penned a moving, insightful piece in Glamour to share her battle with postpartum among other moms and parents-to-be. Other stars have come out about this issue — Brooke Shields, Hayden Panettiere and Adele, just to name a few. Centers to help depressed new mothers have popped up all across the US, from San Diego to Providence to Chapel Hill. And just last month, The Motherhood Center of New York opened in New York.
Recently, medical groups like the American Academy of Pediatrics to the American College of Obstetricians and Gynecologists have strongly supported efforts to screen all new mothers for depression. And thanks in large part to the leadership of Senator Kirsten Gillibrand, the U.S. Congress passed a bill to provide resources to support screening and treatment services.
But, these important steps fall far short of what needs to be done to stem this serious national affliction. We cannot be satisfied waiting for 0.5 to 1 million women to get depressed and then hope we catch them through screening. We need to establish robust programs to prevent PPD before it occurs.
And, to do that, there is good news on the horizon. Two top PPD triggers are fatigue and infant fussing. Infant crying is associated with a four-fold increase of PPD, and exhaustion can raise a woman’s risk 7- to 27-fold. So, by preventing crying and boosting a baby’s sleep, we may be able to significantly reduce new parent fatigue and the risk of PPD.
Over the past 15 years, my co-workers and I have trained thousands of educators to teach techniques to calm infant crying and improve sleep. These classes are taught in hospitals, clinics, military bases and teen parent programs across the United States and in over 20 other nations.
Two of the key baby calming techniques we teach are safe swaddling and the use of specific types of white noise to soothe crying and enhance sleep. These have been demonstrated to reduce infant night waking by 50 percent or more. And an increase in sleep has been shown to reduce PPD.
Screening for PPD is important. But, we must also vigorously explore various therapies to prevent this terrible depression from stealing joy from so many young families and from burdening our health care system and employers with billions of dollars of cost each year.