Maternal/perinatal/postpartum depression can have a major impact on the child’s development, the mother’s mental health, and the family environment. It is important be aware of the prevention and intervention measures that can be put in place to support mothers, children, and families.Synthesis PDF Complete topic PDF
How important is it?
A mother’s responsive and sensitive care is crucial for children’s optimal development. Yet, 13% of women in developed countries (and a higher prevalence in developing countries) experience depressive symptoms either during and/or after pregnancy. Maternal depression, also known as perinatal depression, encompasses various mood disorders that occur during pregnancy or postpartum. Depressed mothers are more likely to be inconsistent, lax and disengaged with their child. This dysfunctional parenting is of particular concern during children’s early years when they are the most dependent on their mother’s stimulation. As a result, these parenting practices may contribute or predispose children to multiple early developmental problems. Maternal depression is now recognized as a great societal concern, and intervention approaches are needed to prevent or diminish its negative impact on infant’s development.
What do we know?
There is an overall consensus suggesting that maternal depression is associated with children’s developmental problems including impaired socio-emotional, cognitive and behavioural functioning.
Children of depressed mother are more likely to 1) express negative affect, 2) have difficulty controlling their anger, 3) have an insecure attachment, 4) have poorer interpersonal skills, and 5) experience an elevated stress level.
As well, children of depressed mothers usually 1) show less advanced language development, 2) have lower academic skills, 3) have a lower self-esteem, and 4) show other cognitive vulnerabilities to depression or other disorders.
At the behavioural level, children of depressed mothers are characterized as 1) having increased sleep problems, 2) being less cooperative, 3) having difficulty controlling their aggression, and 4) being inactive. They are also at heighten risk of developing internalizing (e.g., depression) and externalizing (e.g., aggressive behaviour) problem behaviours in comparison to children of non depressed mothers.
Children express these developmental problems in varying degrees. Family context and bi-directional influences, such as children’s temperamental characteristics and health status, may lessen or worsen the impact of maternal depression on children’s development. As an example, paternal involvement can reduce the negative impact of maternal depression on children’s internalizing behaviours. In contrast, interparental conflicts predict maladjustment in children with a depressed mother.
What can be done?
To improve children’s developmental outcomes, prevention and intervention approaches should focus on improving the quality of mother-infant interactions.
As a preventive measure, education about the beneficial effect of a healthy pregnancy should be available to parents (especially new parents). Effective skills, best child-rearing practices, and discipline should be emphasized to better prepare them for their parenting role. Women with histories of depression might especially benefit from these preventive interventions when they are considering pregnancy, in order to help reduce the likelihood of maternal depression.
Currently, the research evidence for improving mother-child interaction quality favours interventions that improve parenting skills. Evidence suggests that home visits by community workers/nurses enhance maternal sensitivity and attachment security in children. As well, considering that paternal involvement can reduce the impact of maternal depression in children’s functioning, support and encouragement by other family members should be offered to the mother.
Although intervention approaches have indicated improvements in children’s development, it is important to keep in mind that there are wide variations in outcomes in children exposed to maternal depression. None of the interventions (e.g., home visiting or family therapy) have the same effect on all children. Policy makers should therefore value the importance of flexibility in treatment and policy.
How can we help children whose mothers suffer from depression?
One of the most effective ways to mitigate problems due to maternal depression is prevention.
Education sessions about the benefits of healthy pregnancy, best child-rearing practices and positive discipline can help new parents prepare for the challenges of raising children.
Many types of psychotherapy are available to treat mothers who suffer from maternal depression, however the approaches that benefit children the most focus on building a stronger mother-child bond. These include interventions that improve parenting skills, maternal sensitivity and home visiting by workers and nurses.