Postpartum Maternal Depression and its Influence on Postnatal Infant Attachment
During the early periods of life, infants are particularly dependent on their mothers. The attachment of a vulnerable newborn to the protective caregiver is manifested through physical, physiological, and emotional contact that is required for a baby to survive (Carlson et al., 2014). Postpartum maternal depression has been proved to be a significant cause of insufficient and disorganized attachment at the early stages of life, which ultimately has adverse impacts on children’s cognitive development, health, emotion regulation, and socialization (Cohn & Tronick, 1983; Thomas et al., 2017). According to Edwards and Hans (2015), maternal depression and anxiety constitute a considerable behavioral risk factor. In particular, mothers with postpartum depressive symptoms “may become intrusive or disengage during interactions; they display negative emotions more frequently; and are less responsive to infants’ positive affect” (Edwards & Hans, 2015, p. 490). Thus, the lack of positive interaction and response between mother and child due to depression leads to an array of developmental problems at later stages of a child’s life.
The study conducted by Cohn and Tronick (1983) investigated the behavioral changes in three-month-old infants in response to the simulation of depression in their mothers. The results indicated that infants could “modify their effect in response to their partners’ effective change; they markedly alter the organization of their behavior; and these changes carry over into their subsequent interactions” (Cohn & Tronick, 1983, p. 192). Moreover, in infancy, “maternal sensitivity refers to the synchronous timing of a mother’s responsiveness to her baby, her effect, flexibility, and ability to read her infants’ cues” (Weaver et al., 2018, p. 221). However, since maternal sensitivity is low due to depression, the lack of connection leads to the lack of attachment as a critical survival mechanism.
As an outcome of poor attachment under the influence of maternal depression, infants are likely to experience negative social and emotional development later in life, demonstrate helplessness, and inability to adapt to new life situations (Cohn & Tronick, 1983). Therefore, it is essential to explore the research and theories addressing the underlying principles of the influence of postpartum maternal depression and its influence on postnatal infant attachment to identify effective interventions capable of mitigating maternal depression as a risk factor for infants’ development.
Major Theories on Postpartum Maternal Depression’s Effects on Postnatal Infant Attachment
The theories and research on attachment provide a solid theoretical background for the validation of the connection between maternal depressive disorders and infant’s adverse developmental outcomes. Attachment theory developed by Bowlby and further expanded by Bretherton (1985) views attachment not as a mere social bond but as a complex system of interactions and survival dependencies between a parent and an infant. An abundance of research studies has been conducted to investigate the essence and the role of attachment in the life of a child.
The findings of several studies signify those children develop secure attachment when they perceive the primary caregiver as always available and comforting (Ainsworth & Bowlby, 1991; Palombo et al., 2010; Lionetti et al., 2015; Barone et al., 2016). In comparison, insecure attachment occurs when the child perceives the primary caregiver as distant, rejecting, or inconsistent (Ainsworth & Bowlby, 1991; Palombo et al., 2010; Lionetti et al., 2015; Barone et al., 2016). Subsequently, a disorganized attachment style develops when the child is frightened by the primary caregiver and perceives them as threatening (Ainsworth & Bowlby, 1991; Palombo et al., 2010; Lionetti et al., 2015; Barone et al., 2016). In infancy, attachment types predetermine the future attachment style influencing the child’s emotional regulation and socialization at the later stages of life. Research suggests that over time, children with insecure and disorganized attachment styles tend to exhibit greater rates of behavior disorders, social issues, emotional deregulations, school problems, and mental health concerns (The St. Petersburg-USA Orphanage Research Team, 2008). Thus, attachment theory explains the dependence of an infant’s development on the environment, socialization, and psychological health of parents.
The outcomes of disorganized attachment due to depression, infants are at risk of poor adaptation in family, society, and school. Indeed, according to Zeanah (1996), infants with insecure attachment to their mothers within the first year of life exhibit tendencies to “subsequent psychosocial maladaptation in preschool and middle childhood years,” demonstrate interaction disturbance with parents, “less social competence with peers, and more problematic relationship with their teachers” (p. 42). Thus, it is imperative to identify ways that might help new parents overcome the risks of depression and facilitate infants’ attachment in the first year of life through specific interventions to eliminate the risk of children’s maladaptation and impaired social and emotional development.
Application of Child Development Theory for Responsive Interventions
Since the core of infant insecure attachment is related to the emergence of postpartum maternal depression, the interventions should be aimed at the prevention and treatment of this condition in mothers. In particular, mothers with depressive disorders should be subject to counseling, support, and education to encourage caring, sensitive, responsive, and warm interaction with their newborns. One of the effective interventions that should be promoted in pregnant women and new mothers is the benefits of long-term engagement in breastfeeding, which has shown to lower the risks for developing postpartum depression and ensure positive attachment with a child (Weaver et al., 2018). Consequently, breastfeeding will minimize the risk for maltreatment and ensure a positive child development. Moreover, the most effective preventative measure capable of mitigating the risks of insecure attachment as the outcome of postpartum maternal depression is the identification of the factors predetermining the likelihood of mothers experiencing the disorder.
In particular, such social, psychological, and economic conditions as poverty, stress, domestic violence, and others are significant triggers of depression. Moreover, the family environment shapes infant development at the early stages of life. According to Goyal et al. (2010), mothers living in poverty are at an increased risk of developing postpartum depression. Therefore, it is imperative to implement educational and counseling interventions for families exposed to poverty, health disparities, insufficient education, employment, and other insecurities. (Goyal et al., 2010). Given the pivotal role of attachment in child development within social, emotional, educational, and health realms and the identification of vulnerable populations exposed to greater risks of depression, specific intervention approaches might be suggested. According to Hall et al. (2020), such interventions should include both educational sessions and trauma-based cognitive therapy. While educational sessions are aimed at providing necessary knowledge and skills aimed at parents’ informed interactions with the aim of positive facilitation of child development in infancy, cognitive therapies might help in restructuring thoughts and behaviors to eliminate depressive symptoms.
References
Bretherton, I. (1985). Attachment theory: Retrospect and prospect. Monographs of the Society for Research in Child Development, 3-35.
Carlson, E. A., Hostinar, C. E., Mliner, S. B., & Gunnar, M. R. (2014). The emergence of attachment following early social deprivation. Development and Psychopathology, 26(2), 479-489.
Cohn, J. F., & Tronick, E. Z. (1983). Three-month-old infants’ reaction to simulated maternal depression. Child Development, 54(1), 185-193.
Edwards, R. C., & Hans, S. L. (2015). Infant risk factors associated with internalizing, externalizing, and co-occurring behavior problems in young children. Developmental Psychology, 51(4), 489-499.
Goyal, D., Gay, C., & Lee, K. A. (2010). How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers? Women’s Health Issues, 20(2), 96-104.
Hall, E. M., Shahidullah, J. D., & Lassen, S. R. (2020). Development of postpartum depression interventions for mothers of premature infants: A call to target low-SES NICU families. Journal of Perinatology, 40(1), 1-9
Thomas, J. C., Letourneau, N., Campbell, T. S., Tomfohr-Madsen, L., & Giesbrecht, G. F. (2017). Developmental origins of infant emotion regulation: Mediation by temperamental negativity and moderation by maternal sensitivity. Developmental Psychology, 53(4), 611-628.
Weaver, J. M., Schofield, T. J., & Papp, L. M. (2018). Breastfeeding duration predicts greater maternal sensitivity over the next decade. Developmental Psychology, 54(2), 220-227.
Zeanah, C. H. (1996). Beyond insecurity: A reconceptualization of attachment disorders of infancy. Journal of Consulting and Clinical Psychology, 64(1), 42-52.