The pediatrician's role in recognizing and intervening in postpartum depression

Postpartum depression has an estimated prevalence of 5% to 25% of new mothers, which makes it common and a significant public health issue [1-5]. Although many pediatricians may not feel responsible for recognizing postpartum depression (PPD) [6], there is growing evidence of the potential negative consequences for the mother and child [7-10]. In particular, effects on personal, social, and cognitive development of the infant seem to be long-term rather than transitory [10]. Most women see their obstetricians only once during the first postpartum year, usually at 6 weeks after delivery. Some women who are depressed during pregnancy can show improvement in their symptoms (but not full remission) in the immediate postpartum period [11]. Consequently, the symptoms could be missed at this single 6-week postpartum visit. They may see their child's pediatrician at least five to seven times in the first year after giving birth, however. Despite multiple contacts with the medical profession during the postpartum period, many women with puerperal mood disorders are not diagnosed or treated [1,12-14]. With so many encounters with the mother and child in the first postpartum year, and with the mother having so few encounters with her own physician, pediatricians play a critical role in the detection, evaluation, referral, and follow-up of mothers with PPD.