Depressed moms have poor sleepers for children

I was aware of the association between maternal depression and infant sleep patterns and know that when I see an infant for a well child exam who isn’t sleeping well I need to ask about mom’s mental health. I had assumed that the primary reason for this association was that depressed or anxious mothers were not exuding the confidence and calm that infants need to settle and sleep and may also be misinterpreting infants’ cues and not allowing babies to learn how to self soothe appropriately. It seems there’s more to it than that.

In a recent study using video surveillance of mother-infant pairs (the mothers were aware they were being recorded), depressed mothers would wake their 1-2 year old babies during the night much more frequently than healthy mothers. I really didn’t expect to hear that depressed mothers were actually waking their children but it seems that when the infant stirs, even without crying, depressed mothers were likely to lift the baby up and often feed the baby even though he’s not fully awake.  This pattern disrupts sleep for baby and mother alike and results in more sleep deprivation for both. Sleep deprivation may worsen depression and may cause additional sleep issues for the baby including more wakings due to disrupted sleep cycles.

I have long advocated allowing babies to learn how to put themselves to sleep and to ignore older infants who are waking out of habit or minor issues such as teething so as to avoid reinforcing the waking and having a long-lasting issue. I am now going to advise some families to turn off the infant monitors so it takes more than a stirring or a short fussy period for a parent to be awakened. My rule of thumb is that if a baby really needs you, you’ll hear them. Unless you live in a mansion with a baby wing and a parent wing, there’s no need for an infant monitor and if you’re prone to depression or anxiety, it may make even more sense to turn it off.

If the thought of turning off the monitor or having your child fuss or cry briefly without your intervention feels overwhelming to you as a parent, you may indeed be struggling with postpartum depression or anxiety and should talk to your pediatrician or OB/GYN about your symptoms. A little trepidation is normal, of course, but if you lie awake all night because the monitor is off, worried about your infant, or paralyzed by the thought that some fussing may cause irrevocable harm to your infant (which it won’t) it’s really time to talk about your worries and perhaps get some help and support.