A recent study investigated the effectiveness of two pediatric primary care interventions for reducing the risk for postpartum depressive symptoms. The researchers tested two interventions designed to promote parental responsiveness:
- Video Interaction Project (VIP) is a relationship-based intervention, using video- recordings of mother–child dyads which are used to reinforce positive interactions
- Building Blocks (BB) communicates with parents via parenting newsletters, learning materials, and questionnaires.
A group of low income women were randomized to receive VIP, BB, or no intervention. Maternal depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9) at a mean child age of 6.9 months. The results showed:
- Rates of mild depressive symptoms were lower for VIP (20.6%) and BB (21.1%) than controls (32.1%, P = .04).
- Rate of moderate depressive symptoms were lower for VIP (4.0%) compared to controls (9.7%, P = .031).
This study indicates that an intervention where new mothers learn about positive interactions with their baby can reduce the risk of postpartum depression. Using videotapes to convey this information (the VIP intervention) was more effective than using printed educational materials (the BB intervention).
Over the last several years, we have seen a number of studies which have shown the effectiveness of relatively simple interventions for reducing the risk of postpartum depressive symptoms. One study demonstrated that an intervention which teaches new parents about normal infant sleeping and crying patterns and provides them with techniques for infant settling improved new mothers’ depression scores. Another study demonstrated that an action-oriented behavioral educational intervention addressing modifiable risk factors for depression (such as social isolation, lack of support, low self-esteem) reduced the prevalence of postpartum depressive symptoms in a group of low-income mothers.
What all of these studies tell us is that we can make a tremendous difference by increasing support for and by providing practical childcare education to new mothers. None of the interventions described above require specially trained clinicians and can be carried out in variety of settings. In a society where new mothers are often geographically separated from their own families and may not have adequate supports or experience with childcare, we need to offer more support and guidance to new mothers.
Ruta Nonacs, MD PhD
Berkule SB, Cates CB, Dreyer BP, et al. Reducing maternal depressive symptoms through promotion of parenting in pediatric primary care. Clin Pediatr 2014; 53(5):460-9.