Postpartum depression in mothers is common and can have insidious effects on mothers and their children, particularly if the depression persists beyond the early postpartum period. Infants of depressed mothers are at significantly elevated risk for irritability and withdrawal, insecure attachment, attentional deficits, and developmental delay in the achievement of basic cognitive milestones such as object permanence.? Rates of psychiatric disturbance among older children of depressed mothers are as much as four to five times those among children of nondepressed mothers, and children whose mothers are depressed are also at risk for poor academic performance, difficulties in interpersonal relationships, substance abuse, and delinquency. Depression can seriously compromise parenting quality. Depressed mothers are likely to hold negative, unfavorably views of their children and of themselves as parents, and mothers' negative affective biases may promote tendencies to attribute negative intentions and motives to their children's behavior. In turn, depressed parenting is less warm, attuned, and responsive than nondepressed parenting. Individual differences in depressed parenting are evident, however, and appear to be associated with differences in child temperament and, more broadly, with the quality of 'fit' between a mother's condition, child characteristics, and the family environment. Fortunately, depression is a highly treatable condition, and depressed mothers can make use of both pharmacological and support-based 'talking' therapies.? Pediatricians, who may be among the first health professionals to identify postpartum depression, can play an important role in referring affected mothers to appropriate mental health facilities.
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