Postpartum depression (PPD) is common among mothers. In many cases, it occurs within the first ten days after delivery, and it affects about 15% of mothers (Pearlstein et al. 2014). PPD has both biological and psychosocial risks attributed to it. It affects bot the mother and infant and thus the need for treatment. The treatment options for PPD include prescription of antidepressants and psychotherapy. However, there are concerns when it comes to the procedures. Accessibility of the psychotherapists and risks of exposure of infants to antidepressants through breast milk are the main issues. The dilemma, in this case, is on the recommendation of antidepressant medications on mothers and the adverse effects of exposure of the medicine to breastfeeding infants.
Literature Review
In psychiatric context and vocabulary, PPD is considered as a Major Depression Disorder, and it manifests within the first month after childbirth. Depression in women may start during the pregnancy period, or it may onset beyond the postpartum period. It can only be termed as MDD if the symptoms present for at least two weeks in the mother. Such symptoms include loss of interest in activities and depicting a depressed mood. Other symptoms may include sleep and appetite disturbance, feeling quilt, having suicidal thoughts, loss of energy, and reduced concentration (Simhi et al. 2019). Early diagnosis of PPD is essential to enhance its treatment and limit the effects on the mother and infant. However, it is hard to diagnose the disorder because some of the symptoms tend to be common characteristics of women. For instance, fatigue, changes in sleep, and appetite are frequent among women, and thus making it difficult to determine. The features are often considered as routine for women, especially after childbirth.
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The best time for screening PPD is between the first two weeks and six months after delivery. Edinburgh Postnatal Depression scale is one of the self-assessment measures with a 10-item questionnaire. The size is widely validated and used. Another step is the Postpartum Depression Screening Scale that is commonly used by clinicians because it is suitable for clinical settings. However, it has high false-positive cases of PPD and thus the concern on its accuracy.
There is hormonal fluctuation attributed to PPD among women. There are healthy control subjects that can be used to mitigate PPD among women. In other cases, there may be addition and withdrawal of doses of progesterone and estrogen that may prompt sensitivity in the women and cause alteration in other hormones (Simhi et al., 2019). The treatments increase sensitivity in estrogen and progesterone. Scientific theories also have it that there tends to be fluctuation in retroactive steroid levels and other gonadal hormones among women after delivery. Cytokines, HPA axis hormones, fatty acids, oxytocin, among other hormones, are also altered (Pearlstein et al. 2014). The alteration and sensitivity of hormones in a woman increase the chances of exposure to the newborns and subsequent effects on their development. Newborns are likely to have a sleep disturbance because of PPD experienced by the mothers.
The relationship between untreated PPD and impaired child development has been established over time. Some of the risk factors found among newborns as a result of PPD include colic, sleep disturbance, and subsequent temperament issues among children (Simhi et al. 2019). The risk factors are demonstrated among all children within the first weeks after birth, but they are severe and persistent when the mother has PPD. In standard settings, PPD is attributed to limited mother-newborn interaction, maternal withdrawal, increased hostility, and even intrusion (Zeuderer, 2009). there are some of the things that may affect the newborn negatively is the disorder is not treated. Such women may even fail to introduce their children to breastfeeding, or they may fail to maintain it after the introduction. When PPD is not treated, newborns may experience development difficulties because of limited maternal attention, lack of nutrients from breast milk, and other risks. Untreated PPD may result in reduced cognitive functioning among infants, behavioral inhibitions, and subsequent emotional disorders among children.
In line with the treatment of PPD, there are many kinds of antidepressant medications that can be administered to mothers besides psychotherapy. Notably, the treatment mechanisms have to work together so that there can be an achievement of the best outcome. Administration of medicine is helpful to reduce the depression and mitigate the symptoms while counseling is useful in enhancing the mother with the knowledge to avoid stressors. While administering antidepressant medication to breastfeeding mothers, there may not be adverse effects on the infants exposed to the medicines. However, it is identifiable that the serum levels of such infants tend to be below the recommended levels. However, the serum levels reduce in infants when the mothers have prescribed antidepressants like sertraline or Nortriptyline and not paroxetine (Pearlstein et al. 2014).
Studies have been conducted over time about the effects of antidepressant medicine to infants. There are different outcomes in terms of adverse effects on infants with exposure to a different drug. Depressed mothers need to earn about the various treatment options before making a choice of which treatment to opt for. Additionally, medical practitioners must empower society, especially mothers, on the importance of treating depression correctly. PDD medications should be classified according to their risk summaries, clinical consideration, and statistical data collected over time about lactation (Zeuderer, 2009). In many cases, people tend to pay attention to things that are backed up with data. Some of the adverse effects on infants exposed to PPD medications include poor weight gain, irritation, change in feeding patterns, and sedation.
Viewpoint
Having have understood the effects of untreated PPD on infants and children, I would opt for the administration of antidepressant medications together with psychotherapy to mothers with PPD. There are effects attributed to exposure of the medicine to infants, but the slow introduction should always be considered. Medical practitioners should always recommend the drugs that have been administered before and recorded to have fewer effects on infants. While the gradual introduction of the medicine is done on the mother at the early stages of PPD, the impact on the infant should be carefully observed (Pearlstein et al. 2014). The infant should not be allowed to get adverse effects. Another way that could also enhance the treatment process is imparting knowledge on the community and family members about the condition so that they can offer adequate support to the mothers and reduce postpartum depression. Family and community play a significant role in ensuring that the mother is healthy so that they can raise healthy generations.
References
Pearlstein, T., Howard, M., Salisbury, A., Zlotnick, C (2014) postpartum depression. Am J Obstet Gynecol publication.
Simhi, M, Sarid, O., Cwikel, J (2019). Preferences for mental health treatment for postpartum depression among new mothers. Israel Journal of health policy research. Springer publishers.
Zauderer, C (2009). Postpartum depression: how child educators can help break the silence. The journal of Perinatal education. National Institutes of health.
