The Bernard L. Pacella, MD Parent Child Center

Resources: Information for Professionals

Postpartum depressive states

Post partum sadness and maternal depression are not uncommon problems (as reported in the literature). In observing children with developmental issues, one had to take into consideration the impact of a mother's possible withdrawal. In thinking about a child's development one had to consider how the child looked at faces, whether the child avoids faces, and the degree of sensitivity and over-sensitivity.

The impact of maternal depression on an infant's development is a subject that has been studied by many other researchers. A recent study in JAMA reported that the incidence of post-partum depressive states (severe or mild) has been greatly under-emphasized. At the Parent Child Groups as child psychoanalysts, we are in a unique position of trying to understand the subtleties that occur in the mother child dyad, which perhaps can be useful in helping mothers with their babies.

In the groups we try to understand the mechanism by which the specific maternal affect state (in this case depression) has on the development of child's ego (cognitive) functions as well as on the child's affective development.

When a mother has a significant post partum depression she may have trouble connecting to her child. As a result of this difficulty in the mother the child may have difficulties mastering new stimuli or has decreased eye contact or a blank stare.

In the Parent Child Groups, depressed mothers can use the group in a productive way. A mother may be quiet and not interact much but would still be involved (listening to what is going on, and observing other parents and the staff).

Markers for improvement in a child?

Is the child more related?
Can the child stay with adults as well as with the other children?
Does it look like the child is having fun?
Does the child express evidence of excitement, glee, and joy?
Are the expressions of unmodulated affects (e.g., excessive fear) diminished?
In what way has language developed? (Does an older child talk directly to people; does he or she say things like, "I like that " or "I'm afraid" [rather than screech]).

As the child uses language more and starts to enjoy people, one can evaluate more subtle aspects of development:

Does the child still call him or herself as "you" or "baby (By l8-l9 many children say "me do it")
How much symbolism is there in the play in contrast to stereotyped rote play such as lining things up over and over?
How much narration is there of the play?
How much modulation of affect is there?

In trying to ascertain the mutative factors one also has to be aware of the role of fathers in supporting depressed mothers. For example, some mothers are frightened of what might happen to an infant.

Do children at some point seem less vulnerable?

Is the father's more active presence beneficial to the mother? How?

BACK to Information for Professionals main page