AAP Policy Statement: screen for perinatal depression in pediatric practice

  • Earls MF & al.
  • Pediatrics
  • 17 Dec 2018

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Pediatricians have a role in recognizing and coordinating care for perinatal maternal depression, says the American Academy of Pediatrics (AAP) in this policy statement. 

Why this matters

  • Maternal depression around the time of birth is the most common obstetric complication in the United States.
  • Postpartum depression (PPD), in particular, adversely affects newborn development.  
  • This statement says that pediatricians are “in a good position to recognize the signs of PPD” because of their frequent contact with parents. 

Key recommendations

  • Screen routinely for PPD at 1-, 2-, 4-, and 6-month well-child visits.
  • At least 1 PPD screening in first 6 months postpartum should be in the quality metrics used for payment. 
  • Advocate for improved access to treatment for mothers screening positive for PPD.
  • Promote evidence-based interventions for health attachment.
  • For a brief intervention during a visit:
    • Promote strength of mother-child relationship.
    • Encourage mother, especially regarding feeding concerns.
    • Encourage understanding and response to infant cues and reading and talking to the infant.
    • Emphasize the importance of routines (sleep, diet, exercise, stress relief) for safety and predictability.
    • Talk about realistic expectations and priority setting.
    • Encourage making/maintaining social connections.
  • Screen for infant social-emotional development as follow-up.
  • Refer to mental health professional as appropriate, warranted.

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