Perinatal depression (PND) is the most common obstetric complication in the United
States. Even when screening results are positive, mothers often do not receive further
evaluation, and even when PND is diagnosed, mothers do not receive evidence-based
treatments. Studies reveal that postpartum depression (PPD), a subset of PND, leads
to increased costs of medical care, inappropriate medical treatment of the infant,
discontinuation of breastfeeding, family dysfunction, and an increased risk of abuse
and neglect. PPD, specifically, adversely affects this critical early period of infant
brain development. PND is an example of an adverse childhood experience that has potential
long-term adverse health complications for the mother, her partner, the infant, and
the mother-infant dyad. However, PND can be treated effectively, and the stress on
the infant can be buffered. Pediatric medical homes should coordinate care more effectively
with prenatal providers for women with prenatally diagnosed maternal depression; establish
a system to implement PPD screening at the 1-, 2-, 4-, and 6-month well-child visits;
use community resources for the treatment and referral of the mother with depression;
and provide support for the maternal-child (dyad) relationship, including breastfeeding
support. State chapters of the American Academy of Pediatrics, working with state
departments of public health, public and private payers, and maternal and child health
programs, should advocate for payment and for increased training for PND screening
and treatment. American Academy of Pediatrics recommends advocacy for workforce development
for mental health professionals who care for young children and mother-infant dyads,
and for promotion of evidence-based interventions focused on healthy attachment and
parent-child relationships.