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The process of bonding with a new baby is natural for most mothers. Left alone, new mothers will hold their baby next to their bodies, rock them gently, strive for eye contact, sing or talk to the baby and begin to nurse. Often within just hours of birth, mothers report feelings of overwhelming love and attachment for their new baby.

A normal, full-term baby is also programmed to initiate and enter into a bonding relationship. Crying and making other noises, smiling, searching for the breast, and seeking eye contact give cues for a caring adult to respond.

When a caregiver consistently responds to an infant's needs, a trusting relationship and lifelong attachment develops. This sets the stage for the growing child to enter healthy relationships with other people throughout life and to appropriately experience and express a full range of emotions.

An optimum opportunity

Dr. Steinfeld is a developmental and behavioral pediatrician at UC Davis Medical Center and UC Davis Children's Hospital in Sacramento.

But what happens when things don't work out so well? What if babies and their mothers are separated at birth, as when babies are premature or ill and need special care? Or babies who are placed for adoption and may not meet their adoptive mother for quite some time after birth? Sometimes a new mother feels depressed or incapacitated after delivery and doesn't feel like interacting with her newborn.

Fortunately, humans are not completely dependent on those early moments and have many opportunities to bond appropriately throughout the first year of life. We know that mothers who adopt babies and even older children are able to form normal attachment relationships.

Still, the first few days of life are believed to offer an optimum opportunity for bonding to take place. Standard practice in most U.S. hospitals allows mothers and babies as much time as possible together after birth. Even when babies are born ill or premature, the importance of bonding is recognized. Whenever possible, health care providers in intensive care units try to create opportunities for parents to spend time holding and caring for their babies.

Dads and siblings, too

Babies who are held and comforted when they need it during the first six months of life tend to be more secure and confident as toddlers and older children.

Is it important for fathers to bond with their babies? Absolutely. New fathers often feel less confident than new mothers around a baby, and may feel excluded in the close relationship that develops between the mother and baby. If a baby is breastfed, fathers may be uncertain about what activities they can engage in with the new baby.

Like mothers, fathers need quiet time to spend holding their new babies close, gazing into their eyes, talking to them and comforting them when distressed. Fathers may wish to take walks with their babies tucked into a Snugli-type carrier or simply hold a quiet baby while reading or watching TV.

Brothers and sisters also need time and opportunities to establish a relationship with a new baby. You might offer young children who are too unreliable to hold a baby safely to have brief, supervised periods playing next to a brother or sister in a large crib or playpen. Such times often elicit unique responses of excitement and joy from the baby and allow loving relationships to develop successfully.

The 'spoiling' myth

While bonding does not occur instantly for everyone, it should be well established within the first few months after you bring your baby home.

The importance of bonding with the primary caregiver cannot be overestimated. Failure to do so profoundly affects future development and the ability to form healthy relationships as an adult.

I urge parents to give themselves plenty of time with their baby and to follow their instincts. Respond to the baby's cues, and offer love and comfort when distressed.

Contrary to the "wisdom" in past generations, responding quickly to crying with holding and nursing will not "spoil" a baby. Instead, babies who are held and comforted when they need it during the first six months of life tend to be more secure and confident as toddlers and older children.

Seek help if you feel that bonding is not progressing as it should. While bonding does not occur instantly for everyone, it should be well established within the first few months after you bring your baby home. For any problem with your baby, ask your physician for help if you feel there is something wrong.

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UC Davis Health, Public Affairs and Marketing

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The Importance of Infant Bonding | UC Davis Medical Center

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The first few days of a baby's life are believed to offer an optimum opportunity for bonding to take place between infant and mother.

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Download our English and Spanish health action sheets on postpartum depression.
Download more information on postpartum depression. What is postpartum depression?
Postpartum depression (also called PPD) is a medical condition that many women get after having a baby. It's strong feelings of sadness, anxiety (worry) and tiredness that last for a long time after giving birth. These feelings can make it hard for you to take care of yourself and your baby. PPD can happen any time after childbirth. It often starts within 1 to 3 weeks of having a baby. It needs treatment to get better.

PPD is a kind of perinatal depression. This is depression that happens during pregnancy or in the first year after giving birth. PPD is the most common complication for women who have just had a baby. It affects up to 1 in 7 women (about 15 percent).

For half of women diagnosed with PPD, it's their first time to have depression. And they may have had signs and symptoms of depression during pregnancy. If you have PPD in one pregnancy, you're likely to have it again in another pregnancy.

PPD is not your fault. It doesn't make you a bad person or a bad mother. If you think you have PPD, tell your health care provider.
Is PPD the same as the baby blues?
No. PPD lasts longer and is more serious than baby blues. Baby blues are feelings of sadness you may have after having a baby. Baby blues can happen 2 to 35 days after you give birth and can last up to 2 weeks. You may have trouble sleeping, be moody or cranky, and cry a lot. If you have sad feelings that last longer than 2 weeks, tell your provider. She can check to see if you may have PPD.
What are the signs and symptoms of PPD?
You may have PPD if you have five or more signs or symptoms that last longer than 2 weeks. Signs of a condition are things someone else can see or know about you, like you have a rash or you're coughing. Symptoms are things you feel yourself that others can't see, like having a sore throat or feeling dizzy. Signs and symptoms of PPD include:
Changes in your feelings:

Feeling depressed most of the day every day

Feeling shame, guilt or like a failure

Feeling panicked or scared a lot of the time

Having severe mood swings

Changes in your everyday life:

Having little interest in things you normally like to do

Feeling tired all the time

Eating a lot more or a lot less than is normal for you

Gaining or losing weight

Having trouble sleeping or sleeping too much

Having trouble concentrating or making decisions

Changes in how you think about yourself or your baby:

Having trouble bonding with your baby

Thinking about hurting yourself or your baby

Thinking about suicide (killing yourself)

If you think you have signs or symptoms of PPD, call your health care provider right away. There are things you and your provider can do to help you feel better. If you're worried about hurting yourself or your baby, call emergency services at 911.
Can PPD affect your baby?
Yes. PPD can make it hard for you to care for yourself and your baby. This is why it's important to treat PPD as soon as possible. If PPD is untreated:

You may skip your postpartum checkups and not follow instructions from your health care provider.

You may find it hard to bond with your baby.

Your baby may not breastfeed long. PPD may make it hard for you and your baby to get used to breastfeeding. Breast milk is the best food for your baby through the first year of life.

Your baby may not get medical care he needs. PPD may make it hard for you to take care of your baby if she's sick. You may not see health problems in your baby that need quick attention and care. It may be hard for you to get your baby regular well-baby care, like vaccinations. Vaccinations help protect your baby from harmful infections.

Your baby may have learning, behavior and development problems and mental health conditions later in life.

Getting treatment for PPD can help you feel better and be able to care for your baby. If you think you have PPD, tell your provider.
What causes PPD?
We're not exactly sure what causes PPD. It can happen to any woman after having a baby. Possible causes include:

Genes. Genes are parts of your body's cells that store instructions for the way your body grows and works. Genes are passed from parents to children. Depression is more common is people whose family members have depression. This is called a family history of depression.

Changing hormone levels after pregnancy. Hormones are chemicals in your body. Some help control your emotions and mood. During pregnancy, your body has higher levels of the hormones estrogen and progesterone. But in the first 24 hours after giving birth, these hormones quickly go back to their normal levels. This rapid drop in hormone levels may lead to PPD.

Low levels of thyroid hormones. The thyroid is a gland in your neck that helps your body use and store energy from food.

Are you at risk for PPD?
Some things make you more likely than others to have PPD. These are called risk factors. Having a risk factor doesn't mean for sure that you'll have depression. But it may increase your chances. Talk to your health care provider to see if you're at risk for PPD.

Your health care provider screens (checks) you for PPD at your postpartum care checkups. Screening means that your provider asks you questions about your risks, feelings and mood. If the screening shows that you may have PPD or that you're at risk for PPD, your provider can help you get treatment.

Risk factors for PPD include:

You had depression during pregnancy, or you've had major depression or another mental health condition in the past. Or you have a family history of depression or mental health conditions.

You've been physically or sexually abused. Or you have problems with your partner, including domestic violence (also called intimate partner violence or IPV).

You have stress in your life, like being separated from your partner, the death of a loved one or an illness that affects you or a loved one. Or you're unemployed or have low income, little education or little support from family or friends. Or your pregnancy is unplanned or unwanted, or you're younger than 19.

You have diabetes. Diabetes can be pre-existing diabetes (also called pregestational). This is diabetes you have before pregnancy. Or it can be gestational diabetes. This is a kind of diabetes that some women get during pregnancy.

You have complications during pregnancy, like premature birth, being pregnant with multiples, birth defects and pregnancy loss. Premature birth is when your baby is born too early, before 37 weeks of pregnancy. Multiples is when you're pregnant with more than one baby. Birth defects are health conditions that can change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works. Pregnancy loss is when your baby dies before birth.

You smoke, drink alcohol or use harmful drugs.

You have trouble breastfeeding or caring for your baby. Or your baby is sick or has health conditions. Or you have negative thoughts about being a mom and are having trouble adjusting to being a mom.

Negative thoughts and feelings about being a mom can include:

Having doubts that you can be a good mom

Putting pressure on yourself to be a perfect mom

Feeling that you're no longer the person you were before you had your baby

Feeling that you're less attractive after having your baby

Having no free time for yourself

Feeling tired and moody because you aren't sleeping well or getting enough sleep

Don't be afraid to talk to your provider. She's there to help you and your baby be healthy.
Can PPD be prevented?
The U.S. Preventive Services Task Force says that certain kinds of counseling (also called therapy) can prevent perinatal depression (including PPD) for women at increased risk of depression. Counseling is when you talk about your feelings and concerns with a counselor or therapist. This person helps you understand your feelings, solve problems and cope with things in your everyday life.

The Task Force recommends counseling for women with one or more of these risk factors:

Current signs and symptoms of depression

A history of depression or other mental health condition

Being pregnant as a teenager or being a single mom

Having stressful life circumstances, like low income

Being a victim of IPV

The Task Force recommends two kinds of counseling to prevent PPD for women at increased risk:

1. Cognitive behaviorial therapy (also called CBT). CBT helps you manage negative thoughts by changing the way you think and act. Common kinds of CBT include working with a therapist to help you set goals and identify negative thoughts and behaviors so you can begin to think and act differently.

2. Interpersonal therapy (also called IPT). IPT helps you identify and deal with conditions and problems in your personal life, like relationships with your partner and family, situations at work or in your neighborhood, having a medical condition or losing a loved one. Common kinds of IPT include working with a therapist in role-playing, answering open-ended questions (not yes or no questions) and looking closely at how you make decisions and communicate with others.

If you're at increased risk for PPD, your provider can help you get treatment with CBT and IPT. Be honest with your provider about your life, your pregnancy and your feelings so your provider can help you find counselors for treatment.
How is PPD treated?
If you think you may have PPD, see your health care provider right away. Your provider can be:

Your prenatal care provider. This is the provider who gave you medical care during pregnancy.

Your primary care provider. This is your main health care provider who gives you general medical care.

A mental health provider. This may be a psychiatrist, psychologist, social worker, counselor or a therapist.

Your baby's health care provider

To find out if you have PPD, your provider asks you questions about how you're feeling. He wants to know if your feelings are causing problems in how you care for yourself and your baby. He may ask you to fill out a form called a depression screening questionnaire. Your answers on the form can help him find out if you have PPD.

Your provider may do tests to see if you have other health problems that may lead to PPD. For example, he may check your thyroid hormones. Low levels of thyroid hormones may lead to PPD.

The sooner you see your provider about PPD, the better. You can get started on treatment so you can take good care of yourself and your baby. Treatment can include:

Counseling, like CBT and IPT

Support groups. These are groups of people who meet together or go online to share their feelings and experiences about certain topics. Ask your provider or counselor to help you find a PPD support group.

Medicine. PPD often is treated with medicine.

Medicines to treat PPD include:

Antidepressants. These are medicines used to treat many kinds of depression, including PPD. Some have side effects, like having a dry mouth or gaining weight. And some are not safe to take if you're breastfeeding. Talk to your provider to find out about these medicines to decide if one is right for you.

Estrogen. This hormone plays an important role in your menstrual cycle and pregnancy. During childbirth, the amount of estrogen in your body drops quickly. To help with PPD, your provider may suggest you wear an estrogen patch on your skin to replace the estrogen your body lost. If you are breastfeeding, check with your provider to see if the patch is safe for you to use. You can pass estrogen to your baby through breast milk.

If you're taking medicine for PPD:

Don't start or stop taking any medicines for PPD without your provider's OK. It's important that you take all your medicine for as long as your provider prescribes it. Some medicines used to treat depression have side effects if you stop taking them too soon. Follow your provider's instructions about how to take your medicine.

If you're breastfeeding, some medicines used to treat PPD aren't safe for your baby. Talk to your provider to make sure what you're taking is best for both you and your baby.

Some people use an herb called St. John's wort to treat depression. We don't know how safe this herb is for women with PPD. More research is needed. Until we know more about it, don't take St. John's wort for PPD.

If you have PPD, what can you do to help you feel better?
Here's what you can do to help the treatment from your provider work better:
Stay healthy and fit.

Do something active every day. Go for a walk or get back to the gym.

Eat healthy foods. These include fruits, vegetables, whole-grain breads and lean meats. Try to eat fewer sweets and salty snacks.

Get as much rest as you can. Try to sleep when your baby sleeps.

Don't drink alcohol. This includes beer, wine, wine coolers and liquor. Alcohol is a depressant, which means it can slow your body down and make you feel more depressed. It also can interact with the medicine you're taking for PPD. It's never a good idea to drink alcohol if you're breastfeeding. This is because you can pass alcohol to your baby through your breast milk.

Don't take street drugs. These affect the way your body works and can cause problems with the medicine you're taking for PPD. You also can pass street drugs to your baby through breast milk.

Ask for and accept help.

Keep in touch with people you care about and who care about you. Tell your partner, family and friends how you're feeling.

Take time for yourself. Ask someone you trust to watch the baby so you can get out of the house. Visit a friend, get outside or do something you enjoy. Plan for some time alone with your partner.

Let others help around the house. Ask your friends and family to watch the baby, help with housekeeping or go grocery shopping. Don't be afraid to tell them what you need.

Reduce your stress.

Do the things you liked to do before you had your baby. Listen to music, read a good book or take a class. Do the things that used to make you feel good about yourself before you got pregnant.

Try not to make any major changes in your life right after having your baby. These include moving or changing jobs. Major changes can add stress to your life that you don't need right now.

Talk to your boss about going back to work. Maybe you can work at home or part-time when you first go back to work.

What is postpartum psychosis?
Postpartum psychosis is a rare, severe form of depression. It's not the same as PPD. About 1 or 2 in 1,000 women has postpartum psychosis after giving birth. It usually begins in the first 2 weeks after giving birth. Women who have certain mental health conditions (bipolar disorder or schizoaffective disorder) are more likely to have postpartum psychosis than other women.

If you have postpartum psychosis, you need treatment to get better. Call your health care provider right away if you have any of these signs or symptoms:

Seeing or hearing things that aren't there

Feeling very confused

Feeling hopeless, upset or restless

Feeling paranoid, like you can't trust other people or you think other people want to harm you

Having rapid mood swings

Having trouble sleeping, even when you're really tired

Thinking about or trying to hurt yourself, your baby or other people

If you're thinking of hurting yourself or your baby, call emergency services (911) right away.

Additional versions of this article are available in: Arabic, Chinese Simplified, Hindi, and Urdu
Translated documents are courtesy of the employees of CooperSurgical Inc. More information Last reviewed: March, 2019

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Postpartum depression (also called PPD) is a kind of depression some women have after having a baby. What are signs and symptoms of postpartum depression like?

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Download our English and Spanish health action sheets on postpartum depression.
Download more information on postpartum depression. What is postpartum depression?
Postpartum depression (also called PPD) is a medical condition that many women get after having a baby. It's strong feelings of sadness, anxiety (worry) and tiredness that last for a long time after giving birth. These feelings can make it hard for you to take care of yourself and your baby. PPD can happen any time after childbirth. It often starts within 1 to 3 weeks of having a baby. It needs treatment to get better.

PPD is a kind of perinatal depression. This is depression that happens during pregnancy or in the first year after giving birth. PPD is the most common complication for women who have just had a baby. It affects up to 1 in 7 women (about 15 percent).

For half of women diagnosed with PPD, it's their first time to have depression. And they may have had signs and symptoms of depression during pregnancy. If you have PPD in one pregnancy, you're likely to have it again in another pregnancy.

PPD is not your fault. It doesn't make you a bad person or a bad mother. If you think you have PPD, tell your health care provider.
Is PPD the same as the baby blues?
No. PPD lasts longer and is more serious than baby blues. Baby blues are feelings of sadness you may have after having a baby. Baby blues can happen 2 to 35 days after you give birth and can last up to 2 weeks. You may have trouble sleeping, be moody or cranky, and cry a lot. If you have sad feelings that last longer than 2 weeks, tell your provider. She can check to see if you may have PPD.
What are the signs and symptoms of PPD?
You may have PPD if you have five or more signs or symptoms that last longer than 2 weeks. Signs of a condition are things someone else can see or know about you, like you have a rash or you're coughing. Symptoms are things you feel yourself that others can't see, like having a sore throat or feeling dizzy. Signs and symptoms of PPD include:
Changes in your feelings:

Feeling depressed most of the day every day

Feeling shame, guilt or like a failure

Feeling panicked or scared a lot of the time

Having severe mood swings

Changes in your everyday life:

Having little interest in things you normally like to do

Feeling tired all the time

Eating a lot more or a lot less than is normal for you

Gaining or losing weight

Having trouble sleeping or sleeping too much

Having trouble concentrating or making decisions

Changes in how you think about yourself or your baby:

Having trouble bonding with your baby

Thinking about hurting yourself or your baby

Thinking about suicide (killing yourself)

If you think you have signs or symptoms of PPD, call your health care provider right away. There are things you and your provider can do to help you feel better. If you're worried about hurting yourself or your baby, call emergency services at 911.
Can PPD affect your baby?
Yes. PPD can make it hard for you to care for yourself and your baby. This is why it's important to treat PPD as soon as possible. If PPD is untreated:

You may skip your postpartum checkups and not follow instructions from your health care provider.

You may find it hard to bond with your baby.

Your baby may not breastfeed long. PPD may make it hard for you and your baby to get used to breastfeeding. Breast milk is the best food for your baby through the first year of life.

Your baby may not get medical care he needs. PPD may make it hard for you to take care of your baby if she's sick. You may not see health problems in your baby that need quick attention and care. It may be hard for you to get your baby regular well-baby care, like vaccinations. Vaccinations help protect your baby from harmful infections.

Your baby may have learning, behavior and development problems and mental health conditions later in life.

Getting treatment for PPD can help you feel better and be able to care for your baby. If you think you have PPD, tell your provider.
What causes PPD?
We're not exactly sure what causes PPD. It can happen to any woman after having a baby. Possible causes include:

Genes. Genes are parts of your body's cells that store instructions for the way your body grows and works. Genes are passed from parents to children. Depression is more common is people whose family members have depression. This is called a family history of depression.

Changing hormone levels after pregnancy. Hormones are chemicals in your body. Some help control your emotions and mood. During pregnancy, your body has higher levels of the hormones estrogen and progesterone. But in the first 24 hours after giving birth, these hormones quickly go back to their normal levels. This rapid drop in hormone levels may lead to PPD.

Low levels of thyroid hormones. The thyroid is a gland in your neck that helps your body use and store energy from food.

Are you at risk for PPD?
Some things make you more likely than others to have PPD. These are called risk factors. Having a risk factor doesn't mean for sure that you'll have depression. But it may increase your chances. Talk to your health care provider to see if you're at risk for PPD.

Your health care provider screens (checks) you for PPD at your postpartum care checkups. Screening means that your provider asks you questions about your risks, feelings and mood. If the screening shows that you may have PPD or that you're at risk for PPD, your provider can help you get treatment.

Risk factors for PPD include:

You had depression during pregnancy, or you've had major depression or another mental health condition in the past. Or you have a family history of depression or mental health conditions.

You've been physically or sexually abused. Or you have problems with your partner, including domestic violence (also called intimate partner violence or IPV).

You have stress in your life, like being separated from your partner, the death of a loved one or an illness that affects you or a loved one. Or you're unemployed or have low income, little education or little support from family or friends. Or your pregnancy is unplanned or unwanted, or you're younger than 19.

You have diabetes. Diabetes can be pre-existing diabetes (also called pregestational). This is diabetes you have before pregnancy. Or it can be gestational diabetes. This is a kind of diabetes that some women get during pregnancy.

You have complications during pregnancy, like premature birth, being pregnant with multiples, birth defects and pregnancy loss. Premature birth is when your baby is born too early, before 37 weeks of pregnancy. Multiples is when you're pregnant with more than one baby. Birth defects are health conditions that can change the shape or function of one or more parts of the body. Birth defects can cause problems in overall health, how the body develops or how the body works. Pregnancy loss is when your baby dies before birth.

You smoke, drink alcohol or use harmful drugs.

You have trouble breastfeeding or caring for your baby. Or your baby is sick or has health conditions. Or you have negative thoughts about being a mom and are having trouble adjusting to being a mom.

Negative thoughts and feelings about being a mom can include:

Having doubts that you can be a good mom

Putting pressure on yourself to be a perfect mom

Feeling that you're no longer the person you were before you had your baby

Feeling that you're less attractive after having your baby

Having no free time for yourself

Feeling tired and moody because you aren't sleeping well or getting enough sleep

Don't be afraid to talk to your provider. She's there to help you and your baby be healthy.
Can PPD be prevented?
The U.S. Preventive Services Task Force says that certain kinds of counseling (also called therapy) can prevent perinatal depression (including PPD) for women at increased risk of depression. Counseling is when you talk about your feelings and concerns with a counselor or therapist. This person helps you understand your feelings, solve problems and cope with things in your everyday life.

The Task Force recommends counseling for women with one or more of these risk factors:

Current signs and symptoms of depression

A history of depression or other mental health condition

Being pregnant as a teenager or being a single mom

Having stressful life circumstances, like low income

Being a victim of IPV

The Task Force recommends two kinds of counseling to prevent PPD for women at increased risk:

1. Cognitive behaviorial therapy (also called CBT). CBT helps you manage negative thoughts by changing the way you think and act. Common kinds of CBT include working with a therapist to help you set goals and identify negative thoughts and behaviors so you can begin to think and act differently.

2. Interpersonal therapy (also called IPT). IPT helps you identify and deal with conditions and problems in your personal life, like relationships with your partner and family, situations at work or in your neighborhood, having a medical condition or losing a loved one. Common kinds of IPT include working with a therapist in role-playing, answering open-ended questions (not yes or no questions) and looking closely at how you make decisions and communicate with others.

If you're at increased risk for PPD, your provider can help you get treatment with CBT and IPT. Be honest with your provider about your life, your pregnancy and your feelings so your provider can help you find counselors for treatment.
How is PPD treated?
If you think you may have PPD, see your health care provider right away. Your provider can be:

Your prenatal care provider. This is the provider who gave you medical care during pregnancy.

Your primary care provider. This is your main health care provider who gives you general medical care.

A mental health provider. This may be a psychiatrist, psychologist, social worker, counselor or a therapist.

Your baby's health care provider

To find out if you have PPD, your provider asks you questions about how you're feeling. He wants to know if your feelings are causing problems in how you care for yourself and your baby. He may ask you to fill out a form called a depression screening questionnaire. Your answers on the form can help him find out if you have PPD.

Your provider may do tests to see if you have other health problems that may lead to PPD. For example, he may check your thyroid hormones. Low levels of thyroid hormones may lead to PPD.

The sooner you see your provider about PPD, the better. You can get started on treatment so you can take good care of yourself and your baby. Treatment can include:

Counseling, like CBT and IPT

Support groups. These are groups of people who meet together or go online to share their feelings and experiences about certain topics. Ask your provider or counselor to help you find a PPD support group.

Medicine. PPD often is treated with medicine.

Medicines to treat PPD include:

Antidepressants. These are medicines used to treat many kinds of depression, including PPD. Some have side effects, like having a dry mouth or gaining weight. And some are not safe to take if you're breastfeeding. Talk to your provider to find out about these medicines to decide if one is right for you.

Estrogen. This hormone plays an important role in your menstrual cycle and pregnancy. During childbirth, the amount of estrogen in your body drops quickly. To help with PPD, your provider may suggest you wear an estrogen patch on your skin to replace the estrogen your body lost. If you are breastfeeding, check with your provider to see if the patch is safe for you to use. You can pass estrogen to your baby through breast milk.

If you're taking medicine for PPD:

Don't start or stop taking any medicines for PPD without your provider's OK. It's important that you take all your medicine for as long as your provider prescribes it. Some medicines used to treat depression have side effects if you stop taking them too soon. Follow your provider's instructions about how to take your medicine.

If you're breastfeeding, some medicines used to treat PPD aren't safe for your baby. Talk to your provider to make sure what you're taking is best for both you and your baby.

Some people use an herb called St. John's wort to treat depression. We don't know how safe this herb is for women with PPD. More research is needed. Until we know more about it, don't take St. John's wort for PPD.

If you have PPD, what can you do to help you feel better?
Here's what you can do to help the treatment from your provider work better:
Stay healthy and fit.

Do something active every day. Go for a walk or get back to the gym.

Eat healthy foods. These include fruits, vegetables, whole-grain breads and lean meats. Try to eat fewer sweets and salty snacks.

Get as much rest as you can. Try to sleep when your baby sleeps.

Don't drink alcohol. This includes beer, wine, wine coolers and liquor. Alcohol is a depressant, which means it can slow your body down and make you feel more depressed. It also can interact with the medicine you're taking for PPD. It's never a good idea to drink alcohol if you're breastfeeding. This is because you can pass alcohol to your baby through your breast milk.

Don't take street drugs. These affect the way your body works and can cause problems with the medicine you're taking for PPD. You also can pass street drugs to your baby through breast milk.

Ask for and accept help.

Keep in touch with people you care about and who care about you. Tell your partner, family and friends how you're feeling.

Take time for yourself. Ask someone you trust to watch the baby so you can get out of the house. Visit a friend, get outside or do something you enjoy. Plan for some time alone with your partner.

Let others help around the house. Ask your friends and family to watch the baby, help with housekeeping or go grocery shopping. Don't be afraid to tell them what you need.

Reduce your stress.

Do the things you liked to do before you had your baby. Listen to music, read a good book or take a class. Do the things that used to make you feel good about yourself before you got pregnant.

Try not to make any major changes in your life right after having your baby. These include moving or changing jobs. Major changes can add stress to your life that you don't need right now.

Talk to your boss about going back to work. Maybe you can work at home or part-time when you first go back to work.

What is postpartum psychosis?
Postpartum psychosis is a rare, severe form of depression. It's not the same as PPD. About 1 or 2 in 1,000 women has postpartum psychosis after giving birth. It usually begins in the first 2 weeks after giving birth. Women who have certain mental health conditions (bipolar disorder or schizoaffective disorder) are more likely to have postpartum psychosis than other women.

If you have postpartum psychosis, you need treatment to get better. Call your health care provider right away if you have any of these signs or symptoms:

Seeing or hearing things that aren't there

Feeling very confused

Feeling hopeless, upset or restless

Feeling paranoid, like you can't trust other people or you think other people want to harm you

Having rapid mood swings

Having trouble sleeping, even when you're really tired

Thinking about or trying to hurt yourself, your baby or other people

If you're thinking of hurting yourself or your baby, call emergency services (911) right away.

Additional versions of this article are available in: Arabic, Chinese Simplified, Hindi, and Urdu
Translated documents are courtesy of the employees of CooperSurgical Inc. More information Last reviewed: March, 2019

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Postpartum depression (also called PPD) is a kind of depression some women have after having a baby. What are signs and symptoms of postpartum depression like?

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"I don't have any feelings for this baby"

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"I don't have any feelings for this baby"

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"I don't like listening to music and reading books anymore"

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"I don't like listening to music and reading books anymore"

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In order for IPT to genuinley work, there are 3 main steps that must be followed for the full effect. "the threefold targets of treatment are biopsychosocial: psychiatric symptoms, Interpersonal Problem Areas (i.e., the conflicts, transitions and loss experiences in the patient's relationships) and social support". 

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In order for IPT to genuinley work, there are 3 main steps that must be followed for the full effect. "the threefold targets of treatment are biopsychosocial: psychiatric symptoms, Interpersonal Problem Areas (i.e., the conflicts, transitions and loss experiences in the patient's relationships) and social support". 

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Stuart, Scott. “Interpersonal psychotherapy for postpartum depression.” Clinical psychology & psychotherapy vol. 19,2 (2012): 134-40. doi:10.1002/cpp.1778

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IPT is a useful technique that treats postpartum depression. "IPT studies showed overall clinical improvement in the most commonly used depression measures in postpartum depressed women". In theses cases, most women who struggled with PPD gained full recovery after their trial. 

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IPT is a useful technique that treats postpartum depression. "IPT studies showed overall clinical improvement in the most commonly used depression measures in postpartum depressed women". In theses cases, most women who struggled with PPD gained full recovery after their trial. 

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Miniati, M., Callari, A., Calugi, S. et al. Interpersonal psychotherapy for postpartum depression: a systematic review. Arch Womens Ment Health 17, 257–268 (2014). https://doi.org/10.1007/s00737-014-0442-7

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ABCT - Association for Behavioral and Cognitive Therapies

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Postpartum depression and anxiety are very common disorders, affecting as many as 1 in 6 new mothers. Very severe forms of postpartum depression and anxiety can make the experience of motherhood nearly intolerable, and a small percentage of women may even experience delusions or hallucinations (known as postpartum psychosis). Postpartum depression and anxiety disorders can be effectively treated with cognitive behavioral therapy (CBT) and/or medication.
Characteristics

Postpartum depression can occur any time within 12 months of giving birth. Typical symptoms might include feeling overwhelmed, feeling guilty, not feeling bonded with your baby, poor appetite, sleep problems, irritability, lack of interest in your baby, sadness and crying, feelings of numbness or emptiness, and/or possible thoughts of harming yourself or escaping. Not all women with postpartum depression experience all of these symptoms.

Symptoms of postpartum anxiety can include racing thoughts and distractibility, worry that is difficult to stop, obsessions (intrusive thoughts, especially thoughts that you might harm your baby), trouble sleeping, feeling pressured to be doing something all the time, a sense of dread, and/or worrying that you have "gone crazy." You may experience these symptoms almost all the time, or only during some parts of the day or night.

Many women experience both postpartum depression and postpartum anxiety. It is not yet clear why some women have these symptoms and others do not, but risk factors include:

A history of depression or anxiety (particularly a past episode of postpartum depression and/or anxiety)

Childhood trauma

Treatment for infertility

Young age at motherhood

History of physical or sexual abuse

Poverty/Low income

Unplanned pregnancy

Generally, if the symptoms have lasted for more than two weeks and they start to interfere in any aspect of your life, you may be suffering from postpartum depression or anxiety.

Treatment

Cognitive behavioral therapy (CBT) is a very effective treatment for postpartum depression and anxiety. Treatment is often short-term (12-16 sessions) and is focused on identifying unhelpful thoughts, feelings, and behaviors. You can learn to avoid "triggers" for depression or anxiety and identify "automatic" negative thoughts. You will also learn different ways of thinking and reacting to situations that trigger depression and/or anxiety.

Therapists teach behavioral activation, which involves scheduling activities, such as exercise, social activities, or even just "getting out of the house," that make you happy, as well as looking for ways to help you get additional support to help with your baby or household duties. CBT might also involve sessions with your partner or spouse and finding ways of improving communication so that you can ask for help when you need it.

One particular kind of postpartum anxiety is called postpartum obsessive- compulsive disorder (OCD). Women with postpartum OCD have intrusive, unwanted, and disturbing thoughts or images. They may be thoughts or disturbing images about something bad happening to you, your baby, or your loved ones; some mothers even have thoughts about harming their baby if left alone with their baby. Because of the fear created by these thoughts, you may feel driven to constantly check on your baby to make sure he or she is breathing or safe, or you may feel anxious and avoid being alone with your baby. If you are having any of these symptoms, a CBT therapist can help you overcome them. Research has shown that women with perinatal depression are significantly more likely to see a reduction in depressive symptoms if they are in CBT versus a control condition and they are also significantly less likely to have another depressive episode relative to women in a control condition.

There are other treatments for postpartum depression and anxiety, as well. Support groups (either online or in person), or treatment with antidepressant medication may also be a helpful option for some new mothers. There are a number of medications that are safe for women who are breastfeeding. About one-third of mothers using CBT overcome postpartum anxiety and depression.

Additional Resources

www.postpartumprogress.com: includes a list of support groups and helpful information about screening and treatment

www.postpartum.net: includes various tools for mothers, as well as a link to an online support group and offers training and certification for clinicians

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Postpartum Depression and Anxiety | Fact Sheet - ABCT - Association for Behavioral and Cognitive Therapies

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Postpartum depression and anxiety are very common disorders, affecting as many as 1 in 6 new mothers.

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MGH Center for Women's Mental Health - Perinatal & Reproductive Psychiatry at Mass General Hospital

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Postpartum Depression and Bonding Difficulties: Different but Interrelated Problems - MGH Center for Women’s Mental Health

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A mother’s emotional relationship with her baby begins during her pregnancy. The mother’s feelings about her baby, described as bonding, typically grow and intensify after the baby’s birth and become the foundation of the mother’s relationship with her child.

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PPD causes mothers to stuglle with emotional and physical feelings they mave have after childbirth. Finding different ways for women strugglkng to bond with their child can severly help. 

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PPD causes mothers to stuglle with emotional and physical feelings they mave have after childbirth. Finding different ways for women strugglkng to bond with their child can severly help. 

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CBT is is one of the most effective forms of treatment for women with postpartum depression. It mainly focuses on "is focused on identifying unhelpful thoughts, feelings, and behaviors". 

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CBT is is one of the most effective forms of treatment for women with postpartum depression. It mainly focuses on "is focused on identifying unhelpful thoughts, feelings, and behaviors". 

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(www.abct.org)