In this paper studies are reviewed from the last decade on postpartum depression effects on early interactions, parenting, safety practices and on early interventions. The interaction disturbances of depressed mothers and their infants appear to be universal, across different cultures and socioeconomic status groups and, include less sensitivity of the mothers and responsivity of the infants. Several caregiving activities also appear to be compromised by postpartum depression including feeding practices, most especially breastfeeding, sleep routines and well-child visits, vaccinations and safety practices. These data highlight the need for universal screening of maternal and paternal depression during the postpartum period. Early interventions reviewed here include psychotherapy and interaction coaching for the mothers, and infant massage for their infants.The significance of continuing research on postpartum depression is highlighted by the increasing incidence of postpartum depression and some longitudinal studies that have reported long-term negative effects of postpartum depression on children's health and their social, emotional, cognitive and physical development. Statistics from large sample studies have placed postpartum depression at about 20-40% in mothers and a somewhat lower percentage in fathers (Goodman, 2004;McCoy, Beal, Shipman, Payton, Watson, 2006). In these samples, similar rates of postpartum depression were noted for the mothers and fathers in families where the mother was experiencing postpartum depression symptoms.The long-term negative outcomes, including behavioral, emotional and health problems, have been frequently attributed to disturbed mother-infant interactions, although more recent data suggest that poor parenting and safety practices are also risk factors. This paper is a review of studies from the last decade on postpartum depression effects on early interactions, parenting and safety practices and on early interventions. Early InteractionsAs already mentioned, researchers have attributed the long-term effects of maternal depression including behavior problems, cognitive delays and physical health problems to disturbed early interactions (Beardslee, Versage & Gladstone, 1998). In a meta-analysis of studies on the early

Behavior-state matching and synchrony in interactions were assessed in 48 depressed and nondepressed mother-infant dyads when the infants were 3 months old. Attentive/affective behavior states were coded for the infants and mothers on a negative to positive scale. The depressed mothers and their infants matched negative behavior states more often and positive behavior states less often than did the nondepressed dyads. The total percentage of time spent in matching behavior states was less for the depressed than for the nondepressed dyads. Cross-spectral analyses of the mothers' and infants' behavior-state time series suggested only a trend for greater coherence or synchrony in the interactions of the nondepressed dyads.Recent studies have documented disturbed interactions between mothers who appear to be depressed and their infants (

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Literature is reviewed demonstrating the impact of maternal depression on early infant interactions and development. Infants of depressed mothers (a) develop a depressed mood style as early as 3 months; (b) this mood generalizes to interactions with nondepressed women; (c) it persists over the first year if the mother's depression persists; and (d) it affects growth and Bayley developmental scores by the end of the first year. Other data are reviewed on individual differences including maternal depression styles of withdrawal and intrusion, negative behavior matching, and distorted perceptions of behavior. Finally, genetic, intrauterine, and extrauterine environment effects are discussed and interventions are suggested for altering the mother's depressed behavior and distorted perceptions. The review concludes that a developmental psychopathology perspective is needed to better understand the development of early depression.

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Eighty-four prenatally depressed women were randomly assigned to yoga, massage therapy or standard prenatal care control groups to determine the relative effects of yoga and massage therapy on prenatal depression and neonatal outcomes. Following 12 weeks of twice weekly yoga and massage sessions (20 minutes each) both therapy groups versus the control group had a greater decrease on depression, anxiety and back and leg pain scales and a greater increase on a relationship scale. In addition, the yoga and massage therapy groups did not differ on neonatal outcomes including gestational age and birthweight, and those groups, in turn, had greater gestational age and birthweight than the control group.