Postpartum Depression: What Do Pediatricians Need to Know?

Sriraman, Natasha K.; Pham, Do-Quyen; Kumar, Reeti

doi:10.1542/pir.2015-0133

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…PPD can present with anxiety, difficulty sleeping, and weight loss that last longer than 2 weeks and occur daily (1). Risk factors that can lead to the development of PPD include mothers with a history of anxiety or depression, young maternal age, low socioeconomic status, alcohol and substance abuse, or a family history of depression (1,5,6). PPD is important to recognize clinically because of the effect it can have on the mother-child bond.…”

Section: Introductionmentioning

confidence: 99%

“…PPD is important to recognize clinically because of the effect it can have on the mother-child bond. If not recognized early, it can result in developmental delays in the infant and impair maternal recognition of infant behaviors and cues (1,2). It can cause new mothers to develop a lack of interest in caring for their child, which may include developing negative feelings toward providing nutrition for their child through breastfeeding (1,7).…”

Section: Introductionmentioning

confidence: 99%

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Brexanolone, a GABAA Modulator, in the Treatment of Postpartum Depression in Adults: A Comprehensive Review

et al. 2021

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Postpartum depression (PPD) is one of the three major categories on the spectrum of postpartum psychiatric syndromes. Postpartum psychiatric syndromes are classified as either postpartum blues, postpartum depression, or postpartum psychosis. Postpartum depression is important to recognize clinically because of the effect it can have on the mother-child bond. The neurosteroid allopregnanolone, a progesterone derivative, is important for its role in positively modulating GABAA receptors. GABA-mediated signaling has been previously implicated in major depressive disorder. Allopregnanolone-mediated signaling has been identified as an important therapeutic target. Treatment with an allopregnanolone-analog, brexanolone, has been shown to improve depression scores in trials for the treatment of PPD. Brexanolone is a positive allosteric modulator of GABAA and is the first drug approved by the FDA to treat postpartum depression. Brexanolone enhances the inhibitory effects of GABAA, restores dysfunctional GABAA transmembrane channels, and mimics a naturally produced progesterone metabolite that fluctuates during pregnancy and postpartum. One open-label study and two phase two studies have some significant reduction in HAM-D scores after treatment and that the effect was still there 30 days post-treatment. Per the data reported, intravenous infusion of brexanolone could be efficacious and safe for the treatment of women suffering from postpartum depression.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Brexanolone, a GABAA Modulator, in the Treatment of Postpartum Depression in Adults: A Comprehensive Review

et al. 2021

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“…Because of the limited data we haven't analyzed the relations of FA with family support and history of psychiatric and psychological problems, that is the study limitation. Postpartum anxiety are always associated with unpleasant emotional experiences, such as worry, fear, irritability, and frustration, that can last for a few weeks or even longer [25]. Maternal anxiety during feeding may eradicate any willingness to breastfed and even affect the composition of the breast milk, ultimately affecting the growth and development of infant.…”

Section: Discussionmentioning

confidence: 99%

Maternal postpartum feeding anxiety was associated with infant feeding practices: results from the mother-infant cohort study of China

Sun

Zhu

Li³

et al. 2020

BMC Pregnancy Childbirth

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Background Maternal feeding anxiety (FA) was prevalent during puerperium and might affect infant feeding practices. This study was aimed to investigate the FA status in Chinese postpartum women and its relationship with infant feeding practices (FPs). Methods Participants were from the Mother-Infant Cohort Study of China, in which the dietary and feeding practices, physical and psychiatric health for both mothers and infants were followed up from childbirth to next 2 years. In this study the maternal feeding anxiety (FA) status at 0–3 months postpartum was assessed by Li’s Self-rating Feeding Anxiety Scale (SFAS). Infant feeding practices (FPs) at 0–3 months, including breastfeeding-related behaviors, responsive feeding and infant food refusal were investigated by self-designed questionnaire. Results In total 456 mothers the average feeding anxiety scores (FAS) was 41.02 ± 8.02 (mean ± SD), and maternal FA prevalence were 61.4% (FAS>38) with severe FA being 8.6% (FAS>52) at 0–3 months postpartum. The FAS was related with infant FPs, and lower maternal FAS was significantly related with infant colostrum feeding (40.86 ± 8.02 vs 44.74 ± 11.33, P < 0.05), but higher FAS was related with bottle feeding (41.95 ± 8.28 vs 39.69 ± 7.92, P < 0.05). The mothers with severe feeding anxiety (FAS > 53) were more likely to feed infants with bottle (ORs, 95%CI: 2.41, 1.11 ~ 5.19). There were not significant association between FAS and exclusive breastfeeding and responsive feeding practices (P > 0.05). The higher FAS was associated with infant food refusal behaviors, the maternal scores whose infant “never”, “rarely”, “sometimes” and “often” spat out food when feeding were 39.86 ± 8.02, 41.47 ± 8.18, 41.36 ± 7.44 and 42.14 ± 12.03 increasingly (P > 0.05), and the FA prevalence was significantly different among groups (P < 0.05). The infants whose mother was identified as feeding anxiety were more likely to refuse opening the mouth when feeding (P < 0.05). Multivariate analysis indicated maternal FAS was positively related to infant bottle feeding (βi = 2.487, P < 0.05) and outdoor sunshine exposure practice (βi = 1.787, P < 0.05), and negatively related to household income level (βi = − 0.118, P < 0.05). Conclusions Maternal postpartum feeding anxiety was associated with some infant feeding practices, including bottle feeding and infant food refusal behaviors.

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“…Although there is no completely risk-free approach, there are many medications to treat anxiety and depression that are widely considered safe for lactating women and their infants (McDonagh et al, 2014; Vu & Shaya, 2017). Professionals who work with lactating women should understand the risks of not treating PMADs as well as the risk of the specific medication being considered and should be able to discuss the risks and benefits with their patients so that no woman feels that she must choose between breastfeeding her infant and her own mental health (Sriraman, Melvin, Meltzer-Brody, & Academy of Breastfeeding Medicine, 2015; Sriraman, Pham, & Kumar, 2017).…”

Section: Recommendationsmentioning

confidence: 99%