The impact of post-partum depression on mother-baby interactions

Your newborn is crying. If it's a cry of pain, you're going to respond more strongly than you would to a cry of hunger - that's the normal pattern. But if you suffer from post-partum depression, the difference between your response to the pain cry and the hunger cry is going to be even greater. And this, says psychologist Alison Fleming, isn't necessarily a good thing.

As part of a study funded by the Canadian Institutes of Health Research (CIHR), Dr Fleming, together with her student, Andrea Gonzalez, and collaborator, Meir Steiner, played recordings of newborns' cries. Depressed women, she says, showed more anxiety in response to the pain cry than new mothers who aren't depressed.

"We know that, compared to non-depressed mothers, depressed moms respond less sensitively and more negatively to their infants," says Fleming, a researcher from the University of Toronto (Mississauga). "In this case, their anxiety and their negative feelings could affect their ability to soothe their babies and cope with their distress."

Fleming describes the mother-baby relationship as a dance: baby smiles, mom smiles back; baby vocalizes, mom vocalizes back. Depressed mothers, she has found, have more difficulty interacting with their babies - they don't take part in the dance, as it were.

"They may show little positive affect," she says. "Or they may become agitated and overly - but inappropriately - responsive."

Fleming wants to know more about why women with post-partum depression respond so differently to their babies. So for her next research study (also funded by CIHR), she and her colleagues will use functional magnetic resonance imaging, or fMRI, to see what is happening in the brains of depressed and non-depressed mothers while they look at pictures or hear cries of their babies. A better understanding of how the brain functions in women with post-partum depression could lead to possible interventions, as well as programs to prevent the depression and assist in child development.

But the best prescription for post-partum depression, Fleming says, at least in less severe cases, could be as simple as getting out of the house, spending more time with other people and soliciting support from family and friends.

While anywhere from 15-20% of women in Canada and other western countries experience this depression during the first postpartum weeks, Fleming says, it is not universal across all cultures. In Canada, a lack of extended family networks is coupled with long winters when people stay indoors. Women may feel isolated, particularly when their partners return to work and they are alone for most of the day.

Fortunately, Fleming adds, post-partum depression tends to pass by the time babies are four-to-six months old. When it is more severe, however, it can have negative impacts on both mothers and their babies.

"If mothers stay depressed, babies can have problems with their own social and emotional development later on," Fleming says. "For both moms and their babies, it is really important that mothers experiencing extreme postpartum anxiety or depression talk to their physicians or other health-care providers."

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Giardino J, Gonzalez A, Steiner M, Fleming AS. Effects of motherhood on physiological and subjective responses to infant cries in teenage mothers: a comparison with non-mothers and adult mothers. Horm Behav. 2008 Jan;53(1):149-58.   [Full text]