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Women in what income level are most affected by major depression?
What is postpartum blues?
- Common:50%-80% of new mothers
- Relatively brief, few hours to several days
- Onset usually in first week to 10 days portpartum
- typically remit spontaneously
- May represent the intitial stages of PPD/PPP
What are the symtoms for postpartum blues?
- low mood
- mood lability
What is portpartum psychosis?
- Rare: 1/1000
- Hallucinations and/or Delusions
- Aggressive intervention absulutely necessary
What are the risk factors for portpartum psychosis?
- History bipolar affective disorder/pyschosis
- Family history of psychosis
- Having first child
What are the chances of having Postpartum Psychosis?
- Usually begins within 90 days postpartum
- Lenght is quite variable
- Prevalence: 1/500 to 1/1000
- Family history of bipolar disorder 33/100
- Family history of postpartum psychosis 22/1000
- Personal history bipolar disorder: 1/2
- Sequelae: Future Postpartum Psychosis
How is Postpartum Depression different?
- Not as mild or transient as the blues
- Not as severely disorienting as psychosis
- Range of severity
- Often undetected
Major Depression: Diagnostic Criteria
- Depressed Mood
- Decreased or increased appetite with or without weight changes
- Insomnia or Hypersomnia
- Low energy/fatigue
- Loss of interest or pleasure
- Psychomotor agitation or retardation
- Feelings of worthlessness or guilt
- concentration or problems making decisions
- Suicidal thoughts
How can major depression be diagnose?
- 5 or more symptoms must be present for at least 2 weeks
- Must include depressed mood or loss of interest
What are the risk factors for postpartum depression?
- Poor marital relationship
- Inadequate social support
- Past depression or anxiety disorder
- Lower SES/employment
- Past history of alcohol abuse
- Stressful life-events
- Child-care related stressors
- African American ethnicity
What are the negative effects of maternal depression and pregnancy?
- Increased risk for high blood pressure.
- Increased risk for maternal health complications after childbirth
- Poorer maternal health practices
- Higher levels of fetal stress hormones
What are the negative effects of depression on mothering?
- Perceive their infants as more bothersome.
- Make harsher judgements of their infants.
- Are more irritable with their infants
- Are more likely to neglect/abuse their children.
What is signifant of mother-infant interactions?
- Sensitive mothering means being aware of an infant's signals
- Even infants who cannot speak with language, can communicate clearly with their mothers
What are the negative effects of depression on mother-infant interactions, of the mother?
- Spend less time looking at their infants.
- Spend less time touching and talking to their infants.
- show fewer positive and more negative faces
What are the negative effects of depression on mother-infant interactions, of the infant?
- Lower activity levels, vocalize less, show fewer positive faces and more negative faces, look away more frequently, and protest more often.
- Are less content, more drowsy and fussy, and display more frequent squirming and arching of the back.
- Have high levels of withdrawal behavior in face to face interactions and a lack of positive affect.
Why is quality of mother-infant interaction so important?
- Sensitive interactions are associated with the development of secure attachments
- Secure attachments are associated with the ability to form healthy relationships
What are the negative effects of maternal depression on physical development?
- Low birth weight: espcially in lower SES women
- Preterm delivery: Anxiety/stress, depression related to preterm delivery and lower gestational age
- Reduced neuromotor activity as measure by babies' performance on the Brazelton Neonatal Behavioral Assessment.
Who did the longitudinal studies on maternal depression?
True or False, children with PPD mothers tends to use weapons in fight.
True or False, Clinical depression should be fairly obvious to most professionals.
What is use to screen new mothers for depression?
The Edinburgh Postnatal Depression Scale (EPDS)
What are the physical characteristics of newborns?
- Average: 20",7.5 lbs. 95%: 18-22" and 5.5-10 lbs.
- Large head, receding chin
- Hairy (Lanugo)
- Vernix Caseosa
Transition from fetus to newborn
- Before birth, oxygen is supplied to the fetus via the umbilical cord
- Umbilical cord immediately cut at birth
- Baby takes first breath
- Bloodstream is redirected through the lungs and all parts of the body
What is use to assess newborn?
- Apgar scale
- Brazelton Neonatal Behavioral Assessment Scale (NBAS)
- 1st quiz in life
- 1-5 mins after birth
- can get 10 points, twice
- 7-10 in good condition
- 5 - ok
- below 3 = emergency
Brazelton Neonatal Behavioral Assessment Scale (NBAS)
- High risk situations
- Performed within 24-36 hours after birth (suitable for infants up to two months)
- Evaluates neurological development, reflexes and reactions to people
- Not routinely done
Low birth weight categories
- low birth weight < 5.5 lbs.
- very low birth weight < 3.5 lbs
- extremely low birth weight < 2 lbs
What are the risk factors for low birth weight?
- Demographic: African American ethnicity, young or old age, poverty, marital status and lack of education
- Medical: First child or having more than four, being short or think, previous low birth weight or miscarriages, low birth wieght oneself, genital abnormalities, hypertension
- Behavioral and Environment: Poor nutrition, inadequate prenatal care, smoking, use of alcohol or drug use, exposure to high altitude or toxic substances
What are the immediate danger of low birth weight? What are the treatments?
- Immature immune system
- Immature nervous system
- Inability to regulate body temperature
- Isolette and Massage
How does massage help low birth weight infants?
- Infants are more active
- Better cognitive development
What are the outcomes for low birth weight infants at school age?
- Learning disabilities
- Enrollment in special education programs
What are the outcomes for low birth weight infants at teens age?
- Lower cognitive skills
- Weaker academic records
- More behavioral problems
How do infants grow and develop? Which two direction?
- Cephalocaudal - top down
- Proximodistal - inside out
Weight and Height growth
- lose weight 1st several days
- gains 5-6 oz 1st month
- double in 4 months
- weight triple by 1st birthday
- height 1.5x by 1st birthday
What is the process of neurotransmission?
- 1. synthesis of neurotransmitter and formation of vesicles
- 2. transpoort of neurotransmitter down axon
- 3. Action potential travels down the axon
- 4. Action potential causes calcium to enter, evoking release of neutransmitter
- 5. Neutransmitter attaches to receptor exciting or inhibiting postsynaptic neuron
- 6. Separation of neutransmitter molecules from receptors
- 7. Reuptake of neurotransmitters to be recycled
How does neurons change physically?
- Increase in dendrites and synapses
- Visual - rapidly after birth - 6 months
- Hearing - 4-5 years
- Frontal - teens
Brain development: Critical role of experience
Enriched environments positively affected brain development in both young and old
Infants' Sensory and Perceptual devopment
- Smell and Taste
Can the fetus hear?
- More active when born compare to those who weren't read to
Hearing in fnfancy
- Newborns recognize their mother's voice
- Gradually increase ability to hear soft sounds
- Keen ability to distinguish subtle phonetic differencesImproved in 2 years
- Borned with capacity to learn any language
- Last 2nd half of 1st year
Do infants feel touch and pain?
- connect info from touch with visual
Infant's Smell and Taste
- Smell and taste develop in the womb
- Infants prefer mother's scent
- Infants prefer sweet taste
- Differentiate odor
- Understand in 6 days
- 4 months prefer salty to sweet
- Newborns 20/400
- 6 months: 20/100
- 1 year: 20/20
- Birth: Red-green
- 2 months: all colors
- Depth perception dependent on experience
Infant's gross motor development
- Just need pratice
- When physically ready, will develop
Denver Developmental Screening Test
- Screening test
- 1 month to 6 years
- Asssesses gross and fine motor skills, language, and social development
Does the Denver Devlopmental Screening Test work in other cultures?
No, does not apply to other cultures
Does a 2 y/o have depth perception?
Cultural influences in motor devlopment
- depends on the pace of the culture
- African and West Indian cultures actively encourage early motor strenght
- Other cultures discourage...
Summary Physical Development: First Three Years
- Fetus to Newborn
- The Newborn (assessment, low birth-wight) - 10 pts
- Physical growth
- Brain and Reflexes - brain not fully develop after birth
- Sensory development
- Motor Development