My new baby is wonderful, so why am I so miserable?

Depression after childbirth, or postpartum depression, occurs in between 13-20% of women. Its onset is usually a few weeks after childbirth, and many risk factors for it have been identified, including a history of depression preceding childbirth, poor support networks in caring for the newborn, and what has been termed "difficult child temperament" (though it is not always clear whether the mother's mood colors her perception of the infant's temperament, or if the infant's temperament does in fact influence the mother's mood).

A study published in the August 2009 issue of the Archives of Women's Mental Health looking at the effect of sleep fragmentation on the development of postpartum depression found that new mothers who were awake for more than two hours between midnight and 6 am on a regular basis, and new mothers who napped less than one hour during the day on a regular basis, were at increased risk for depression three months after delivery. Their sleep was measured with a motion sensor (an actigraph) which can give a more accurate indication of sleep patterns than diaries, particularly if they are not filled out in "real time", as can happen when one is chronically sleep deprived and trying to deal with all the extra work accompanying a newborn.

This study's findings demonstrate the very important role sleep plays in the health and well being of a new mother, sleep which is all too often very lacking. It also points to a very simple way that partners, older children, extended family, and/or friends can help a new mother adjust to and cope with the hardships and responsibilities of caring for a newborn: taking care of the baby for portions of the day and night so that she can simply get more sleep. A less sleep deprived mother is a happier and healthier mother (and wife, partner, friend).

Many of the infants seen at the sleep center at Children's Hospital Boston are referred because of irregular sleeping patterns, and difficulties initiating and maintaining sleep. These almost never have a negative effect on the child, but do wreak havoc on the parents' (especially the mother's), ability to get a decent amount of sleep. The children are usually bright eyed, smiling and playful, often in stark contrast to the exhausted mother with dark circles under her eyes who looks like she hasn't slept in half a year (and in many cases, she indeed has not).

Postpartum depression is a serious, and unfortunately, all too common disorder. Perhaps by making sure new mothers have a chance to sleep properly, its incidence can be mitigated. In any event: helping a new mother get some sleep can have a big impact on her well being.

Best,

Dennis

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Dennis Rosen, M.D.

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The Harvard Medical School Guide to Successful Sleep Strategies for Kids: Helping Your Child Sleep Well and Wake Up With a Smile!