tag:theconversation.com,2011:/africa/topics/new-parents-41979/articlesNew parents – The Conversation2023-10-12T17:11:40Ztag:theconversation.com,2011:article/2148072023-10-12T17:11:40Z2023-10-12T17:11:40ZPlaygroups are struggling to survive – here’s why we need them<figure><img src="https://images.theconversation.com/files/553248/original/file-20231011-15-1kf0m.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4992%2C3323&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/parents-join-their-childs-learning-club-1234165120">Rawpixel.com/Shutterstock</a></span></figcaption></figure><p>Playgroups can be a lifeline for new parents. Run by volunteers, they give young children a space to explore and interact with others, and parents a chance to have a cup of tea and a chat. </p>
<p>This was certainly the case for me. Having low moments following the birth of my children, as <a href="https://theconversation.com/maternal-mental-health-problems-the-impact-in-numbers-96935">one in five women</a> may do, these playgroups helped me make connections with other parents and carers. They led to new friends for my children and provided a safe space to go on difficult days. </p>
<p>I witnessed first-hand the value of these groups, and the integral role volunteers fill in communities. But, according to charity <a href="https://earlyyearsscotland.org/everything-to-play-for/">Early Years Scotland</a>, community-based playgroups are “<a href="https://planetradio.co.uk/clyde/local/news/playgroups-struggling-with-volunteers/">struggling to survive</a>” due to a decrease in volunteers. </p>
<p>Now, I’m researching the value of playgroups for families and communities, understanding what role they play in the first years of parenthood, and how that can contribute to community wellbeing and resilience.</p>
<h2>Building community</h2>
<p>Playgroups have been a <a href="https://www.tandfonline.com/doi/abs/10.1080/0300443890430108">staple part of communities</a> in the UK since the 1970s. They create a <a href="https://onlinelibrary.wiley.com/doi/10.1002/casp.2592">sense of belonging</a> for the people who attend and help parents build their parenting skills as well as develop connections, which <a href="https://journals.sagepub.com/doi/10.1177/1476718X15597022">improve their mental wellbeing</a>. </p>
<p>Playgroups are also a place where parents can take a first step into volunteering, <a href="https://onlinelibrary.wiley.com/doi/10.1002/hpja.4">learning skills</a> that can allow them to go on to take further leadership roles in their wider community. And playgroups can have <a href="https://cur.org.au/cms/wp-content/uploads/2016/05/playgroups-report-may-2016.pdf">economic benefits</a>, if volunteers gain knowledge and confidence that they can take into paid employment. </p>
<p>However, there has been an overall <a href="https://www.theguardian.com/society/2023/may/02/volunteering-in-sharp-decline-in-england-since-covid-pandemic">reduction in volunteering across the UK</a> since the pandemic, despite the remarkable <a href="https://www.volunteerscotland.net/wp-content/uploads/2022/11/The-Road-to-Recovery-Summary-Report.pdf">grassroots efforts witnessed</a> during lockdowns. </p>
<p>Early Years Scotland has attributed the <a href="https://planetradio.co.uk/clyde/local/news/playgroups-struggling-with-volunteers/">decrease in volunteers</a> in part to an increase in working hours. Parents may have also been <a href="https://www.theparentingdaily.co.uk/article/2022/09/13/cost-living-sees-1-5-parents-returning-work-sooner-planned">returning to work earlier</a> after parental leave as a result of the <a href="https://scvo.scot/p/55743/2022/11/29/cost-of-living-crisis-scvo-and-volunteer-scotland-briefing-for-mps">cost of living crisis</a>, leaving less time to get involved with playgroups. </p>
<p>During lockdown, inside group activities like playgroups were unavailable. But I saw volunteers innovating: moving outside and creating new spaces, such as the <a href="https://www.helensburghadvertiser.co.uk/news/19038921.buggy-clubs-help-new-parents-walk-away-covid-blues-together/">Scottish Buggy Club</a>. </p>
<p>My own local playgroup moved to outdoor facilities at a local farm. Activity groups such as the charity group <a href="https://www.funfirst.org.uk/">Fun First</a> <a href="https://www.helensburghadvertiser.co.uk/news/18346595.fun-first-goes-online-keep-helensburghs-pre-schoolers-entertained/">moved online</a> for their classes. </p>
<p>Still, for many families, the pandemic was a <a href="https://publichealthscotland.scot/news/2022/june/how-has-the-covid-19-pandemic-affected-children-and-young-people-in-scotland/">very isolating experience</a>. Research shows that <a href="https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-021-00701-8">parents of young children</a> suffered – in particular <a href="https://wbg.org.uk/wp-content/uploads/2021/02/General-parents-FINAL-VERSION.pdf">women and lower-income parents</a>. </p>
<figure class="align-center ">
<img alt="Mothers with babies" src="https://images.theconversation.com/files/553254/original/file-20231011-29-z7kmds.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/553254/original/file-20231011-29-z7kmds.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/553254/original/file-20231011-29-z7kmds.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/553254/original/file-20231011-29-z7kmds.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/553254/original/file-20231011-29-z7kmds.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/553254/original/file-20231011-29-z7kmds.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/553254/original/file-20231011-29-z7kmds.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Playgroups give parents a place to connect.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/group-mothers-their-babies-584702683">Oksana Shufrych/Shutterstock</a></span>
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<p>Now, the cost of living crisis is limiting opportunities for activities with children. As winter looms, more parents will be stuck inside with small children with nowhere to go. We know that <a href="https://opfs.org.uk/wp-content/uploads/2020/02/1.-Briefing-One-180904_FINAL.pdf">single parents</a> are particularly susceptible to social isolation.</p>
<p>We are at risk of <a href="https://www.gov.scot/binaries/content/documents/govscot/publications/independent-report/2021/01/not-now-social-renewal-advisory-board-report-january-2021/documents/not-now-social-renewal-advisory-board-report/not-now-social-renewal-advisory-board-report/govscot%3Adocument/not-now-social-renewal-advisory-board-report.pdf">losing community groups</a> that create opportunities for their members to establish <a href="https://www.monbiot.com/2017/02/09/all-together-now/">“thick networks”</a>: collaborations between local people that create a welcoming and valuable local culture. </p>
<h2>To help families, help volunteers</h2>
<p>Recent policy initiatives from the <a href="https://www.gov.scot/publications/tackling-child-poverty-priority-families-overview/#:%7E:text=This%20evidence%20pack%20highlights%20key,one%2C%20and%20larger%20families%20">Scottish</a> and <a href="https://www.gov.uk/government/publications/supporting-families-programme-guidance-2022-to-2025">UK governments</a> have focused on families. There is an effort in Scotland to focus on <a href="https://www.gov.scot/binaries/content/documents/govscot/publications/independent-report/2021/01/not-now-social-renewal-advisory-board-report-january-2021/documents/not-now-social-renewal-advisory-board-report/not-now-social-renewal-advisory-board-report/govscot%3Adocument/not-now-social-renewal-advisory-board-report.pdf">community-based responses</a> to sustain community wellbeing. </p>
<p>But there have been complaints that resources are not being seen at a <a href="https://www.cosla.gov.uk/news/2021/reduction-in-local-government-funding-must-be-halted-to-prevent-communities-and-businesses-suffering">community level</a>, where funding is decreasing and there is not enough support for volunteers. </p>
<p>In the short-term, <a href="http://whatworksscotland.ac.uk/publications/hard-to-reach-or-easy-to-ignore-promoting-equality-in-community-engagement-evidence-review/">solutions</a> would include more resources to support volunteers – training, incentives and community funding, which will enhance their role and encourage volunteers to stay in their role for longer. But the decrease of volunteers is more fundamental that this.</p>
<p>Long-term strategies are needed if governments wish to rely on the services offered to local communities by the members of that community. These include encouraging businesses and industries to seriously consider the wealth of research that shows <a href="https://timewise.co.uk/article/good-news-for-the-four-day-working-week-and-wider-insights-for-flexible-working/">flexible working</a>, job shares and four-day weeks are beneficial for the economy, productivity and wellbeing. With more time, more people could be able to help out in places like playgroups.</p>
<p>Finally, introducing a universal basic income, such as the <a href="https://theconversation.com/participation-income-the-social-welfare-model-that-could-help-communities-fight-climate-change-196504">participation income model</a> – which requires that people contribute to their community in order to receive income – could help people to take on community and voluntary roles and instil a wider sense of wellbeing in the population.</p><img src="https://counter.theconversation.com/content/214807/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ruth Lightbody works for Glasgow Caledonian University. In 2023 she has been awarded funding from the British Academy/Leverhulme Small Research Grant to research playgroups and resilient and wellbeing communities.
</span></em></p>Playgroups are good for parents’ wellbeing – and are a place where they can take a first step into volunteering.Ruth Lightbody, Senior Lecturer in Politics, Glasgow Caledonian UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2119912023-08-31T16:38:29Z2023-08-31T16:38:29ZZuranolone for postpartum depression: Hope, hype or both?<figure><img src="https://images.theconversation.com/files/545577/original/file-20230830-29-opoz13.jpg?ixlib=rb-1.1.0&rect=343%2C49%2C3084%2C2103&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">While zuranolone represents an exciting advance in the treatment of postpartum depression, many questions about its potential impact remain unanswered. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/zuranolone-for-postpartum-depression-hope-hype-or-both" width="100%" height="400"></iframe>
<p>While mothers with <a href="https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/postpartum-depression">postpartum depression</a> have always faced barriers accessing the care they need, things have been particularly bad since the onset of the COVID-19 pandemic. </p>
<p>Prior to COVID-19, it was thought that up to <a href="https://www.ncbi.nlm.nih.gov/books/NBK37740/">one in five</a> women would develop depression in the first postpartum year, but the stresses and service disruptions associated with the pandemic increased this to <a href="https://doi.org/10.1016/S2215-0366(21)00074-2">one in three</a>. However, the pandemic also coincided with a period of significant innovation in treatment that may increase access to and effectiveness of care.</p>
<h2>Medications specifically for PPD</h2>
<p>One exciting development was the United States Food and Drug Administration’s approval of the medication brexanolone in <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression">early 2019</a>. It represented the first of an entirely new class of medicines for postpardum depression (PPD), which target the steep decrease in hormones after delivery. Brexanolone is a synthetic version of allopregnanolone, a naturally occurring substance made from progesterone, that helps the brain regulate stress. </p>
<p>Its approval in the U.S. was especially notable for two reasons: it was the first medicine approved specifically for the treatment of PPD, and it takes effect especially quickly — within 60 hours. </p>
<p>While it represents a significant breakthrough, it must be given intravenously in hospital over 2½ days, and <a href="https://www.cbc.ca/news/health/zulresso-postpartum-depression-1.5064086">can cost as much as USD$34,000</a> per course.</p>
<figure class="align-center ">
<img alt="Out-of-focus image of exhausted woman sitting on the floor beside a crib" src="https://images.theconversation.com/files/545573/original/file-20230830-27-ye7dqi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545573/original/file-20230830-27-ye7dqi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545573/original/file-20230830-27-ye7dqi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545573/original/file-20230830-27-ye7dqi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545573/original/file-20230830-27-ye7dqi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545573/original/file-20230830-27-ye7dqi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545573/original/file-20230830-27-ye7dqi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">During the pandemic, as many as one in three new mothers may have experience postpartum depression.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>On Aug. 4, the U.S. FDA <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-first-oral-treatment-postpartum-depression">approved zuranolone</a>, another allopregnanolone derivative. Unlike brexanolone, zuranolone can be taken in pill form over two weeks, which is much shorter than traditional antidepressants which are usually prescribed for several months. </p>
<p>Early studies of zuranolone suggest PPD symptom improvement can be observed <a href="https://doi.org/10.1001/jamapsychiatry.2021.1559">as early as three days</a> after starting the treatment. This is an unusually rapid response to an antidepressant medication, which usually <a href="https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/antidepressant-medications">take effect over several weeks</a>. </p>
<h2>Behind the hype</h2>
<p>The <a href="https://www.vogue.com/article/zuranolone-postpartum-depression-explainer">fanfare</a> that <a href="https://www.cbc.ca/radio/thecurrent/postpartum-depression-pill-zuranolone-offers-hope-1.6935868">has accompanied</a> these <a href="https://www.cnn.com/2019/03/19/health/postpartum-depression-drug-fda-bn/index.html">medications</a> also has the potential to increase awareness of PPD, suggesting a biological explanation for a condition associated with <a href="https://doi.org/10.1080/02646838.2020.1754372">so much self-blame</a>, encouraging more people to seek treatment and increasing screening and detection efforts among health-care providers. </p>
<p>If approved in Canada, it would also add to the array of effective treatments that already exist. These include evidence-based talking therapies like cognitive behavioural therapy and interpersonal psychotherapy, which are <a href="https://journals.sagepub.com/doi/epub/10.1177/0706743716659276">first-line treatments</a> for mild to moderate PPD. </p>
<p>Antidepressant medications like the <a href="https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/overview/">selective serotonin re-uptake inhibitors</a> (SSRIS, such as sertraline and escitalopram) are also widely available and usually recommended as second-line therapies for most individuals with PPD. </p>
<figure class="align-center ">
<img alt="Photo of a smartphone screen displaying a New York Times story about a new PPD medication" src="https://images.theconversation.com/files/545574/original/file-20230830-16-b7bnss.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545574/original/file-20230830-16-b7bnss.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545574/original/file-20230830-16-b7bnss.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545574/original/file-20230830-16-b7bnss.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545574/original/file-20230830-16-b7bnss.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545574/original/file-20230830-16-b7bnss.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545574/original/file-20230830-16-b7bnss.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=423&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The fanfare surrounding new medications for zuranolone also has the potential to increase awareness of PPD.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>Although psychotherapy and antidepressants can help most individuals with PPD, timely access to talking therapies is relatively rare within publicly funded health-care systems, and many <a href="https://doi.org/10.1111/j.1523-536X.2006.00130.x">prefer to avoid</a> antidepressant medications during pregnancy and lactation if they can.</p>
<p>While zuranolone represents an exciting advance, many questions about its potential impact remain unanswered. </p>
<p>To date, just <a href="https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.20220785">two clinical trials</a> <a href="https://doi.org/10.1001/jamapsychiatry.2021.1559">in humans exist</a>, and eligibility for these studies was restricted to a very small subset of those with PPD. Only individuals with more severe depression that emerged between the third trimester of pregnancy and four weeks post-delivery could be enrolled. </p>
<p>Researchers also only studied zuranolone’s effects over six weeks, and no information on its safety during pregnancy and lactation is available (participants had to agree to stop breastfeeding while taking the medication). </p>
<p>Despite the excitement surrounding its U.S. approval, the cost of zuranolone is likely to be high, and it is not known if it will be approved in Canada. Finally, it is unclear if this medication will be covered by public or private insurers, which could put it out of reach for many with PPD who could need it the most. </p>
<h2>PPD is still underdiagnosed</h2>
<p>The development of innovative new medications is exciting and can generate significant hope for those affected. However, it is important in this case that we not lose sight of the fact that PPD is a <a href="https://doi.org/10.1017/S1092852914000510">vastly underdetected and undertreated problem</a> for which safe and effective treatments already exist. </p>
<figure class="align-center ">
<img alt="Two women pushing strollers in park, seen from behind" src="https://images.theconversation.com/files/545575/original/file-20230830-24-3j5cxd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545575/original/file-20230830-24-3j5cxd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545575/original/file-20230830-24-3j5cxd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545575/original/file-20230830-24-3j5cxd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545575/original/file-20230830-24-3j5cxd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545575/original/file-20230830-24-3j5cxd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545575/original/file-20230830-24-3j5cxd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Inexpensive self-care interventions like improving social and practical supports, sleep hygiene, relaxation techniques, exercise and taking time for oneself can also be helpful.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>Free screening tools such as the <a href="http://www.perinatalservicesbc.ca/Documents/Resources/HealthPromotion/EPDS/EPDSQuestionnaireApril2013.pdf">Edinburgh Postnatal Depression Scale</a> can be used to help detect PPD, and psychotherapy along with several existing antidepressants <a href="https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/postpartum-depression">can be effective and safe</a> during pregnancy and lactation.</p>
<p>Inexpensive <a href="https://www.canada.ca/en/public-health/services/child-infant-health/postpartum-health-guide.html#a1.6">self-care interventions</a> like improving social and practical supports, sleep hygiene, relaxation techniques, exercise and taking time for oneself can also be helpful, but can be challenging to engage in with a newborn. </p>
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Read more:
<a href="https://theconversation.com/heart-rate-variability-and-self-compassion-two-tools-to-help-postpartum-mothers-make-exercise-decisions-193548">Heart rate variability and self-compassion: Two tools to help postpartum mothers make exercise decisions</a>
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<p>Although provincially funded psychotherapy can be difficult to access, research and <a href="https://www.stcatharinesstandard.ca/life/health-wellness/mothers-experiencing-postpartum-depression-aided-by-online-therapy-delivered-by-niagara-public-health-nurses/article_238ee7dd-6b7b-5165-b6e7-1b80cdcc252a.html">efforts to apply findings</a> are starting to bring together the fragmented network of community organizations and traditional and public health services to try to increase access in Canada. </p>
<p>Research into treatments for PPD and the federal government’s actions in appointing a <a href="https://www.pm.gc.ca/en/mandate-letters/2021/12/16/minister-mental-health-and-addictions-and-associate-minister-health">Minister of Mental Health and Addictions</a> and prioritizing perinatal parents are also cause for genuine optimism. </p>
<p>While zuranolone is raising awareness about PPD, it’s important to <a href="https://www.ourcommons.ca/Content/Committee/441/FEWO/Brief/BR11978299/br-external/VanLieshoutRyan-Brief-e.pdf">highlight the need</a> to develop national quality standards and Canadian-specific stepped-care models and care pathways. That would enable people to access existing treatments in a more timely manner, which would go a long way in helping Canada become the best country in the world to have a baby.</p><img src="https://counter.theconversation.com/content/211991/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ryan Van Lieshout receives funding from The Canada Research Chairs Program, The Canadian Institutes of Health Research, and The Daymark Foundation. </span></em></p>Amid the fanfare about a new medication for postpartum depression, it’s important to remember that PPD is underdiagnosed and undertreated, and that safe and effective treatments already exist.Ryan Van Lieshout, Canada Research Chair in Perinatal Mental Health, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2085532023-07-24T19:54:44Z2023-07-24T19:54:44ZWhat to expect when you’re expecting: How will your sex life change during pregnancy and postpartum?<figure><img src="https://images.theconversation.com/files/538886/original/file-20230724-23-sj2thq.jpg?ixlib=rb-1.1.0&rect=142%2C0%2C7499%2C5190&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The perinatal period can be hectic. It's understandable that sex may be on the back burner for a little while.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/what-to-expect-when-youre-expecting-how-will-your-sex-life-change-during-pregnancy-and-postpartum" width="100%" height="400"></iframe>
<p>Welcoming a new baby is often a joyous experience for couples. While many couples take time to prepare for the arrival of their bundle of joy, fewer take time to prepare for challenges that can emerge in their sexual and romantic relationships during this period. </p>
<p>At The University of British Columbia’s <a href="https://swelllab.psych.ubc.ca/">Sexuality and Well-Being Lab (SWell)</a>, we conduct research to understand the factors that lead some couples to thrive during pregnancy and the postpartum while others struggle. We then use this research to develop resources to help couples navigate these changes together.</p>
<h2>What to expect</h2>
<p>Sexual challenges during pregnancy and the postpartum are common. Up to <a href="https://doi.org/10.1007/s11930-021-00313-8">88 per cent of people who give birth and 45 per cent of their partners experience problems with their sex life during this time</a>. </p>
<p>With shifting roles and responsibilities, the perinatal period (pregnancy and up to one year postpartum) can be hectic. It’s understandable that sex may be on the back burner for a little while. </p>
<p>Studies conducted by our team and <a href="https://natalieorosen.com/">our collaborators at Dalhousie University</a> have shown that many expectant and new parents <a href="https://doi.org/10.1037/fam0000689">desire sex less often and/or at different times than their partner</a>. </p>
<p>Many couples report having <a href="https://doi.org/10.1080/00224499.2020.1836114">distressing concerns about their sex life</a>, such as body image or whether having sex during pregnancy will hurt the baby — <a href="https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/sex-during-pregnancy/art-20045318#:%7E:text=Sexual%20activity%20won't%20affect,of%20comfort%20and%20sexual%20desire.">FYI, it won’t</a>. Approximately one in five people who gave birth <a href="https://doi.org/10.1097%2FAOG.0000000000004662">report moderate pain during sex that either starts in pregnancy or after the baby is born</a>. </p>
<p><a href="https://doi.org/10.1037/fam0000689">Sexual problems usually get worse throughout pregnancy until three months postpartum</a>, when they generally start improving.</p>
<figure class="align-center ">
<img alt="A pregnant woman lying on her back and a smiling man lying beside her with his hand on her belly" src="https://images.theconversation.com/files/538887/original/file-20230724-27-lwti2r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/538887/original/file-20230724-27-lwti2r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/538887/original/file-20230724-27-lwti2r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/538887/original/file-20230724-27-lwti2r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/538887/original/file-20230724-27-lwti2r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/538887/original/file-20230724-27-lwti2r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/538887/original/file-20230724-27-lwti2r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Expectant and new parent couples often don’t know what to expect when it comes to their sex lives.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>If this seems daunting, you’ll be encouraged to hear that despite sexual challenges being common, <a href="https://doi.org/10.1007/s11930-021-00313-8">64 per cent of couples say that they are still sexually satisfied during this time</a>. </p>
<p>This is great news because <a href="https://doi.org/10.1111/j.1751-9004.2011.00408.x">having a strong sexual connection with your partner is important for your mental and physical health</a>, and <a href="https://doi.org/10.1037/0893-3200.20.2.339">contributes to the longevity of your relationship</a>. </p>
<h2>The information gap</h2>
<p>Expectant and new parent couples often don’t know what to expect when it comes to their sex lives. In <a href="https://doi.org/10.1080/00224499.2023.2193570">a recent study</a> sampling 204 couples across Canada and the United States, we found that up to 78 per cent of expectant and new parents received little to no information about changes to their sexuality. This is despite most individuals wanting to receive sex-related information! </p>
<p>Given that sexual problems are common and not inconsequential to the health of the romantic relationship, this lack of information for couples about what to expect regarding their perinatal sexuality is a problem.</p>
<p>On top of this information gap, the content of information that couples receive doesn’t match what they want to receive. </p>
<p>In our study, we found that expectant and new parents most often received information about things like safety of sexual activity in pregnancy, contraception, when to resume sex in the postpartum and information only relevant to the partner who gave birth. </p>
<p>What’s missing is reassurance that changes to sexuality are common and advice on how to manage changes. Information about the sexuality of the partner who didn’t give birth is also lacking, even though <a href="https://doi.org/10.1007/s11930-021-00313-8">both members of the couple are affected</a>. Expectant and new parents <a href="https://doi.org/10.1080/00224499.2023.2193570">want a variety of information to help them be better prepared.</a></p>
<p>Research has also revealed that psychological factors such as <a href="https://doi.org/10.1093/abm/kaaa117">postpartum depression</a>, social factors such as <a href="https://doi.org/10.1177/0192513X15604343">divisions of labour</a> and relationship factors such as <a href="https://doi.org/10.1177/02654075221107393">coping together as a couple</a> are important for couples’ sexual relationships in pregnancy and the postpartum. </p>
<p>Perhaps surprisingly, biological factors — such as whether the delivery was vaginal or caesarean, and the degree of tearing — <a href="https://doi.org/10.1097%2FAOG.0000000000004662">are not strong predictors of sexual problems during this time</a>. </p>
<h2>Translating knowledge into practice</h2>
<p><a href="https://doi.org/10.1111/jmwh.13206">Health-care professionals feel they have a lack of knowledge and training to talk about sexual health with expectant and new parents</a>, and worry that doing so would make them and/or their patients feel uncomfortable. However, our research showed that <a href="https://doi.org/10.1080/00224499.2023.2193570">most couples would welcome these conversations</a>. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/n0iLT_1jJCw?wmode=transparent&start=2" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Researchers at Dalhousie University have made a series of videos that summarize recent research on sex after having a baby.</span></figcaption>
</figure>
<p>Health-care professionals need training on how to initiate conversations about perinatal sexual health with expectant and new parents, but they also need to know the latest research in this area.</p>
<p>Researchers at Dalhousie University recently produced <a href="https://postbabyhankypanky.com/">a series of short informational videos</a> that summarize recent research on sex after having a baby. The goal of #PostBabyHankyPanky is to normalize changes to postpartum sexuality, encourage conversations about sex between partners and help health-care professionals feel more prepared to have these discussions with their patients. </p>
<p>If you’re a new or expectant parent and you’ve been noticing changes in your relationship, here’s some good news: Our research shows that when couples receive more information about what to expect regarding changes to their sex lives in pregnancy or the postpartum (like what you’ve read here) they report greater desire, engage in sex more often, feel more sexually satisfied and feel less worried about their sex lives.</p><img src="https://counter.theconversation.com/content/208553/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erin T. Fitzpatrick receives funding from the Social Sciences and Humanities Research Council of Canada and the Guiding Interdisciplinary Research on Cisgender and Transgender Women and Girl’s Health and Well-being (GROWW) program. </span></em></p><p class="fine-print"><em><span>Dr. Samantha Jane Dawson works for the University of British Columbia. She receives funding from the Natural Sciences and Engineering Research Council, the Social Sciences and Humanities Research Council, the Women's Health Research Institute, and the Michael Smith for Health Research BC foundation. </span></em></p>Sexual challenges during pregnancy and postpartum are common, but couples often don’t know what to expect when it comes to their sex lives during this time. The good news is that information helps.Erin T. Fitzpatrick, Master's Student in Clinical Psychology, University of British ColumbiaSamantha Jane Dawson, Assistant Professor, Clinical Psychology, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2038282023-06-05T12:06:11Z2023-06-05T12:06:11ZBirth of a story: How new parents find meaning after childbirth hints at how they will adjust<figure><img src="https://images.theconversation.com/files/529856/original/file-20230602-19-u8qb1f.jpg?ixlib=rb-1.1.0&rect=94%2C549%2C4418%2C2943&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Having a new baby can upend everything about your old life.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/newborn-baby-boy-being-cradled-by-new-parents-in-royalty-free-image/1307728623">Cavan Images/Cavan via Getty Images</a></span></figcaption></figure><p>Gather a group of new parents and the conversation will likely turn to their childbirth stories – ranging from the joyful to the gnarly to the positively traumatic. <a href="https://slate.com/human-interest/2022/01/birth-stories-feminist-history-internet-sharing.html">Birth story podcasts and websites</a> feature a curated range of birth experiences, and you can buy embossed leather “birth story” journals as a baby shower gift. People are fascinated by this pivotal, emotionally complex and literally life-and-death experience.</p>
<p>Birth narratives might also contain clues about how the adjustment to parenthood will go.</p>
<p><a href="https://www.penguinrandomhouse.com/books/203434/the-uses-of-enchantment-by-bruno-bettelheim/">People have long used stories</a> to understand difficult experiences. Stories may be particularly valuable as a source of “meaning-making,” the process of finding order in chaos by making sense of unexpected events, identifying silver linings and discovering the patterns and connections that thread seemingly random events together into a coherent narrative.</p>
<p>In a new study led by <a href="https://scholar.google.com/citations?user=YRIcV6YAAAAJ&hl=en&oi=ao">Geoffrey Corner</a>, a former graduate student in <a href="https://dornsife.usc.edu/nestlab/">my lab</a>, we found that the levels of meaning-making in the stories new parents told about their baby’s birth <a href="https://doi.org/10.1037/fam0001062">predicted their relationship quality and parenting stress</a> in the child’s first months.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="three moms with infants on mats facing an instructor with a doll in a baby yoga class" src="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When new moms come together, the talk often turns to their childbirth stories.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/baby-massage-class-switzerland-new-mothers-learn-how-to-news-photo/629429057">BSIP/Universal Images Group via Getty Images</a></span>
</figcaption>
</figure>
<h2>Constructing meaning in your own life</h2>
<p>Finding meaningful themes and patterns in life’s seeming randomness is a fundamentally human activity. As writer Joan Didion put it, “<a href="https://www.penguinrandomhouse.com/books/40775/we-tell-ourselves-stories-in-order-to-live-by-joan-didion-introduction-by-john-leonard/">we tell ourselves stories in order to live</a>.”</p>
<p>“Meaning-making” can buffer despair in the wake of tragedy. Holocaust survivor Victor Frankl’s memoir, “<a href="http://www.beacon.org/Mans-Search-for-Meaning-P602.aspx">Man’s Search for Meaning</a>,” argued that meaning and purpose can prevent the bitterness and disillusionment that can otherwise fester after great loss. Research on what psychologists call <a href="https://doi.org/10.1207/s15327965pli1501_01">post-traumatic growth</a> has found that the level of “meaning-making” in people’s narratives about a difficult event predicts their mental health over time.</p>
<p>For example, studies have found <a href="https://doi.org/10.1037/a0018301">links between meaning-making and resilience</a> in cancer patients, bereaved parents and caregivers. Cancer survivors might discover that their chemo ordeal brought them closer to friends and family, or helped them step back from the hustle of everyday life and embrace a slower pace.</p>
<p>Although childbirth is typically experienced as a joyful rather than a tragic event, it can still be unpredictable, frightening and even life-threatening. Indeed, psychologists have begun to recognize that particularly difficult labors <a href="https://doi.org/10.1080/02646838.2015.1031646">can trigger post-traumatic stress symptoms</a>, not just in mothers but in their partners as well. Even normal, nontraumatic births require parents to cope with hours, sometimes days, of pain and discomfort. Therefore, we hypothesized that meaning-making might be an important part of couples’ birth narratives, potentially promoting resilience in new parents.</p>
<p>To test these hypotheses, we collected birth stories from 77 couples who were participating in our lab’s <a href="https://dornsife.usc.edu/nestlab/research/">longitudinal study of the transition to parenthood</a>. We visited couples at the hospital within a day or two of their infant’s birth, and audio-recorded them sharing their stories together. We told couples, “We’d like to hear you tell the story of your birth experience. Start from the beginning and tell us as much as you remember.”</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="three masked medical workers hold newborn above mother's body during C-section operation" src="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=443&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=443&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=443&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=557&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=557&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=557&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Parents may need to process even a normal childbirth with healthy outcomes.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/caesarian-babys-first-breath-royalty-free-image/125951777">Peter Dazeley/The Image Bank via Getty Images</a></span>
</figcaption>
</figure>
<h2>Listening for meaning-making in birth stories</h2>
<p>A team of coders listened to each story and recorded examples of meaning-making, using three categories established in the research literature:</p>
<ul>
<li><p>Sense-making: Identifying reasons that an event might have unfolded the way it did or making connections that show why an event was meaningful. For example, one mother in our sample found meaning in her long labor, describing her baby as “very brave and tough” because she survived hours of pushing. </p></li>
<li><p>Benefit-finding: Pointing out silver linings or unexpected positive effects of a difficult experience. For example, after a difficult birth, one parent in our sample stated, “It was scary, but the nurses and the doctors were so nice to us.”</p></li>
<li><p>Change in identity: Describing how an event has transformed one’s sense of self. As a parent in our sample said, “I feel like my life has changed completely with the baby now here.”</p></li>
</ul>
<p>Although couples told their story together, we tracked meaning-making separately for each partner. We also rated how much each partner participated in telling their story so we could adjust for their levels of engagement in sharing their birth narrative.</p>
<p>The couples in our <a href="https://doi.org/10.1037/fam0001062">sample were avid “meaning makers”</a>: Almost all the participants made at least some meaning-making statements in their birth stories. Of the three categories of meaning-making, “change in identity” language surfaced least often, appearing in about 37% of the birth stories. Mothers tended to use more “sense-making” and “benefit-finding” language than fathers. And both members of a couple tended to use similar amounts of meaning-making language. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="infant on mother's chest in hospital bed with father smiling down at baby" src="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=487&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=487&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=487&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=612&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=612&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=612&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A new parent’s meaning-making can affect them and their partner.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mixed-race-family-admiring-their-newborn-baby-at-royalty-free-image/1248789907">SelectStock/E+ via Getty Images</a></span>
</figcaption>
</figure>
<h2>Becoming mom or dad</h2>
<p>After we had coded all of the narratives, we next looked to see whether “meaning-making” predicted relationship satisfaction and parenting stress in our couples. The transition to parenthood can be a “<a href="https://doi.org/10.2307/347802">crisis event” for the couple relationship</a> and is often linked with <a href="https://theconversation.com/have-children-heres-how-kids-ruin-your-romantic-relationship-57944">declines in relationship quality</a>.</p>
<p>But when mothers used more “sense-making” and “benefit-finding” language, they showed a smaller drop in their relationship satisfaction than moms who used less. Fathers who used more “sense-making” and “benefit-finding” language reported lower parenting stress at six months postpartum than dads who used less.</p>
<p>And partners of fathers who used more “change in identity” language also reported lower parenting stress later on, suggesting that dads who experience the transition to parenthood as transformative may be able to help mothers cope better with new parenthood. On the flip side, though, when mothers showed more meaning-making, their partners actually reported more parenting stress at six months postpartum. It may be that when mothers find the birth experience to be more personally meaningful, partners feel left out or pressured to step up their own parenting.</p>
<p>Overall, these results supported our initial hunch that meaning-making might be detectable in birth narratives and forecast parents’ psychological adjustment after birth. Greater meaning-making language seemed to benefit the couple relationship and largely buffer parenting stress.</p>
<p>This study was limited by a fairly small sample of cohabiting heterosexual parents. Nevertheless, it highlights the value of stories in shaping family transitions. For therapists working with new parents in the wake of a difficult birth, encouraging couples to seek meaning in their birth story may help ease their transition to parenthood. Journaling and storytelling exercises may help couples process their feelings about their childbirth experiences. After all, the birth of a baby is also the birth of a story – and that story is well worth telling.</p><img src="https://counter.theconversation.com/content/203828/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Darby Saxbe receives funding from the National Institutes of Health and the National Science Foundation. </span></em></p>How you tell the story of a momentous event can help you make sense of what happened. Research finds new moms’ and dads’ narratives around childbirth held clues about their transition to parenthood.Darby Saxbe, Associate Professor of Psychology, USC Dornsife College of Letters, Arts and SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1919992022-11-30T13:35:24Z2022-11-30T13:35:24ZFatherhood changes men’s brains, according to before-and-after MRI scans<figure><img src="https://images.theconversation.com/files/497703/original/file-20221128-25-czgjjr.png?ixlib=rb-1.1.0&rect=233%2C363%2C990%2C527&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fathers' brains adjust their structure and function to parenthood</span> <span class="attribution"><span class="source">María Paternina-Die</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>The time fathers devote to child care every week has <a href="https://www.pewresearch.org/fact-tank/2019/06/12/fathers-day-facts/">tripled over the past 50 years</a> in the United States. The increase in fathers’ involvement in child rearing is even steeper in countries that have expanded paid paternity leave or created incentives for fathers to take leave, such as <a href="http://dx.doi.org/10.2139/ssrn.3273712">Germany</a>, <a href="https://doi.org/10.1177/00016993211008517">Spain</a>, <a href="https://doi.org/10.1017/S0047279419000230">Sweden</a> and <a href="https://www.jstor.org/stable/26727040">Iceland</a>. And a growing body of research finds that children with engaged fathers do better on a range of outcomes, including <a href="https://doi.org/10.1016/j.acap.2018.03.011">physical health</a> and <a href="https://doi.org/10.1111/jomf.12532">cognitive performance</a>. </p>
<p>Despite dads’ rising participation in child care and their importance in the lives of their kids, there is surprisingly little research about how fatherhood affects men. Even fewer studies focus on the brain and biological changes that might support fathering. </p>
<p>It is no surprise that the transition to parenthood can be transformative for anyone with a new baby. For women who become biological mothers, pregnancy-related hormonal changes help to explain why a new mother’s brain might change. But does fatherhood reshape the brains and bodies of men – who don’t experience pregnancy directly – in ways that motivate their parenting? We set out to investigate this question in our <a href="https://doi.org/10.1093/cercor/bhac333">recent study of first-time fathers</a> in two countries.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/498065/original/file-20221129-18-6991vn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="pregnant woman looks at strollers in a store" src="https://images.theconversation.com/files/498065/original/file-20221129-18-6991vn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/498065/original/file-20221129-18-6991vn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/498065/original/file-20221129-18-6991vn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/498065/original/file-20221129-18-6991vn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/498065/original/file-20221129-18-6991vn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/498065/original/file-20221129-18-6991vn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/498065/original/file-20221129-18-6991vn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">While the baby grows inside the mother-to-be, biological changes prepare the woman for motherhood.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/pregnant-woman-looking-at-strollers-royalty-free-image/498116621">Orbon Alija/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<h2>Pregnancy’s effect on a new mom’s brain</h2>
<p>Recent research has found compelling evidence that <a href="https://doi.org/10.1038/s41467-022-33884-8">pregnancy can enhance neuroplasticity</a>, or remodeling, in the structures of a woman’s brain. Using <a href="https://www.nibib.nih.gov/science-education/science-topics/magnetic-resonance-imaging-mri">magnetic resonance imaging</a>, researchers have identified large-scale changes in the anatomy of women’s brains from before to after pregnancy.</p>
<p>In one study, researchers in Spain scanned first-time mothers before conceiving, and again at two months after they gave birth. Compared with childless women, the <a href="https://doi.org/10.1038/nn.4458">new mothers’ brain volume was smaller</a>, suggesting that key brain structures actually shrank in size across pregnancy and the early postpartum period. The brain changes were so pronounced that an algorithm could easily differentiate the brain of a woman who had gone through a pregnancy from that of a woman with no children. </p>
<p>All across the brain, these changes are visible in gray matter, the layer of tissue in the brain that is rich with neurons. Pregnancy appears to affect structures in the cortex – the most recently evolved, outer surface of the brain – including <a href="https://doi.org/10.1037/bul0000303">regions linked with thinking about others’ minds</a>, a process that researchers call “theory of mind.” Mothers also show brain changes in the <a href="https://doi.org/10.1038/nrn.2016.163">subcortex</a> – the more ancient structures nestled deeper within the brain that are linked with more primitive functions, including emotion and motivation. </p>
<p>Why do these structural brain changes happen after pregnancy?</p>
<p>Researchers believe these brain changes may facilitate mothers’ sensitive caregiving of newborns, who demand constant attention and cannot verbalize their needs. Indeed, when mothers see photos or videos of their own infants, it <a href="https://doi.org/10.1016/j.tins.2015.04.004">activates many of the same brain regions</a> that changed the most across pregnancy. It seems plausible that new mothers’ brains change in ways that help them to respond to and care for their newborns. </p>
<p>But what about fathers? They do not experience pregnancy directly, but may take care of the new baby, too.</p>
<h2>Dads’ brains change, too</h2>
<p>As with practicing any new skill, the experience of caring for an infant might leave a mark on the brains of new parents. This is what neuroscientists call experience-induced brain plasticity – like the brain changes that occur when you learn a new language or master a new musical instrument. </p>
<p>A sparse but growing body of research is observing this type of plasticity in fathers who experience the cognitive, physical and emotional demands of caring for a newborn without going through pregnancy. In terms of brain function, for instance, <a href="https://doi.org/10.1073/pnas.1402569111">gay male fathers who are primary caregivers</a> show stronger connections between parenting brain regions when viewing their infants, compared with secondary male caregivers.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/498067/original/file-20221129-14-l5ze9s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="view from above of the shaved head of a man holding a newborn" src="https://images.theconversation.com/files/498067/original/file-20221129-14-l5ze9s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/498067/original/file-20221129-14-l5ze9s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/498067/original/file-20221129-14-l5ze9s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/498067/original/file-20221129-14-l5ze9s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/498067/original/file-20221129-14-l5ze9s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/498067/original/file-20221129-14-l5ze9s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/498067/original/file-20221129-14-l5ze9s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Scientists are interested in what spending more time with a newborn means for a father’s brain.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/newborn-baby-sleeping-in-fathers-arms-royalty-free-image/1263047151">Cavan Images via Getty Images</a></span>
</figcaption>
</figure>
<p>To learn more about plasticity in new dads’ brains, our research groups <a href="https://dornsife.usc.edu/nestlab">at the University of Southern California</a> in Los Angeles and the <a href="https://neuromaternal.github.io">Instituto de Investigación Sanitaria Gregorio Marañón</a> in Madrid, associated with the <a href="https://bemother.eu/">BeMother project</a>, collaborated on a new study. We recruited 40 men – 20 in Spain and 20 in California – and put each into an MRI scanner twice: first during their partner’s pregnancy, and again after their baby was 6 months old. We also included a control group of 17 childless men.</p>
<p>We found several <a href="https://doi.org/10.1093/cercor/bhac333">significant changes in the brains of fathers</a> from prenatal to postpartum that did not emerge within the childless men we followed across the same time period. In both the Spanish and Californian samples, fathers’ brain changes appeared in regions of the cortex that contribute to visual processing, attention and empathy toward the baby. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/498070/original/file-20221129-12-qkthmt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="baby and man peeking into a cardboard box" src="https://images.theconversation.com/files/498070/original/file-20221129-12-qkthmt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/498070/original/file-20221129-12-qkthmt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/498070/original/file-20221129-12-qkthmt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/498070/original/file-20221129-12-qkthmt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/498070/original/file-20221129-12-qkthmt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=478&fit=crop&dpr=1 754w, https://images.theconversation.com/files/498070/original/file-20221129-12-qkthmt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=478&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/498070/original/file-20221129-12-qkthmt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=478&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">It’s not clear yet whether simply spending more time parenting changes fathers’ brains or the changes occur in men who are more motivated to spend time parenting.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/found-a-secret-hideout-spot-royalty-free-image/1163767427">AJ_Watt/E+ via Getty Images</a></span>
</figcaption>
</figure>
<h2>What remolds a new father’s brain?</h2>
<p>The degree of brain plasticity in fathers may be linked with how much they interact with their baby. Although fathers in many parts of the world are increasingly taking part in child care, paternal involvement varies widely across different men. This range of involvement may explain why we found more subtle brain changes in these fathers compared with those observed in first-time mothers. In fact, brain changes in fathers were almost half the magnitude of the changes observed in the mothers.</p>
<p>Social, cultural and psychological factors that determine how much fathers engage with their children may, in turn, influence changes to the fathering brain. Indeed, Spanish fathers, who, on average, have <a href="https://dialnet.unirioja.es/servlet/articulo?codigo=6635241">more generous paternity leaves</a> than fathers have in the U.S., displayed more pronounced changes in brain regions that support goal-directed attention, which may help fathers attune to their infants’ cues, compared with Californian fathers.</p>
<p>This finding raises the question of whether family policies that boost how much time dads spend on infant care during the early postpartum period may help support the development of the fathering brain. On the flip side, perhaps men who show more remodeling of the brain and <a href="https://doi.org/10.1016/j.yhbeh.2016.07.005">hormones</a> are also more motivated to participate in hands-on care.</p>
<p>Much more research is needed to tease out these questions and to figure out how best to intervene with fathers who may be at risk of having trouble adjusting to the parenting role. Despite the importance of fathers to child development, funding agencies have not tended to prioritize research on men becoming dads, but this may start to change as more findings like these emerge. Future studies with more detailed measures of postpartum caregiving can reveal more about parental brain plasticity in both men and women.</p><img src="https://counter.theconversation.com/content/191999/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Darby Saxbe receives funding from the National Institutes of Health and the National Science Foundation. </span></em></p><p class="fine-print"><em><span>Magdalena Martínez García received funding from Instituto de Salud Carlos III and the Fulbright Commission. </span></em></p>Neuroscientists know that pregnant mothers’ brains change in ways that appear to help with caring for a baby. Now researchers have identified changes in new fathers’ brains, too.Darby Saxbe, Associate Professor of Psychology, USC Dornsife College of Letters, Arts and SciencesMagdalena Martínez García, Doctoral Student of Neuroimaging, Instituto de Investigación Sanitaria Gregorio Marañón IiSGM Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1898842022-09-19T20:13:44Z2022-09-19T20:13:44Z‘Soothing to an almost unexpected degree’: new online art project Glow is rethinking mindfulness for new parents<figure><img src="https://images.theconversation.com/files/484524/original/file-20220914-12-m87akh.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4925%2C3321&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Jonathan Borba/Unsplash</span></span></figcaption></figure><p>As a new mum to a “bonny” 6-month-old boy (as several doctors have described him), being frazzled sometimes feels like just part of the job. </p>
<p>For the first three months of my baby’s life, my wife and I rarely got more than two or three hours of sleep at a time and felt like we were on a treadmill of feeding, changing, soothing and, let’s be honest, panicking. </p>
<p><a href="https://www.thethreshold.com.au/glow">Glow</a>, a new online art project, invites mums like me and other carers of new babies to slow down, connect and breathe. </p>
<p>This project, created by a group of Australian artists, includes a series of audio and video “Moments”. </p>
<p>There are “We Moments” designed for carers to listen to with their baby, and “Me Moments” designed for solo listening or watching. </p>
<p>The Moments include a combination of soothing music, meditative poems or affirmations, or guidance on activities you can do with your baby to connect and relax together. </p>
<h2>A deep lack of sleep</h2>
<p>As a sleep researcher, I was all too aware of the potential effects of the broken and disturbed sleep I could expect after our son arrived. </p>
<p>I knew to expect things like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1307172/">fatigue</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/3992104/">changes in mood</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/28757454/">poor cognitive performance</a> and maybe even times when I would be so tired I shouldn’t get behind the <a href="https://www.sciencedirect.com/science/article/pii/S1369847822001310">wheel of a car</a>. </p>
<p>For many new parents, the effects of poor sleep are compounded by feelings akin to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/cad.20388">burnout</a>, with many parents experiencing <a href="https://pubmed.ncbi.nlm.nih.gov/17397691/">depression</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/28302701/">anxiety</a> or high <a href="https://pubmed.ncbi.nlm.nih.gov/18655259/">levels of stress</a> after having a baby. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/484525/original/file-20220914-12-hb2b8e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A yawning baby" src="https://images.theconversation.com/files/484525/original/file-20220914-12-hb2b8e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484525/original/file-20220914-12-hb2b8e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484525/original/file-20220914-12-hb2b8e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484525/original/file-20220914-12-hb2b8e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484525/original/file-20220914-12-hb2b8e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484525/original/file-20220914-12-hb2b8e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484525/original/file-20220914-12-hb2b8e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Babies need their sleep – but so do parents.</span>
<span class="attribution"><span class="source">Minnie Zhou/Unsplash</span></span>
</figcaption>
</figure>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704916/">Nearly 60%</a> of new mums have poor sleep, with one in five mothers and one in ten fathers or partners <a href="https://www.perinatalwellbeingcentre.org.au/news/cost-of-perinatal-depression-and-anxiety-in-australia">reporting depression or anxiety</a> during pregnancy or after the baby arrives. </p>
<p>Being woken up every few hours for months on end is something people are not expected to do even when employed under the most extreme work schedules. </p>
<p>For shift workers or on-call workers – whose sleep is often broken, shortened or poor quality – these negative effects are typically managed head-on, with <a href="https://www.safeworkaustralia.gov.au/doc/guide-managing-risk-fatigue-work">regulated management strategies</a>, employee assistance programs and calls for <a href="https://pubmed.ncbi.nlm.nih.gov/31955278/">mental health support</a>. </p>
<p>New parents, on the other hand, are generally limited to the (online and rare) support available from local family and health services and/or our local GP – in my case, at least. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-is-normal-baby-sleep-how-evolutionary-clues-not-cultural-expectations-can-help-new-parents-187747">What is 'normal' baby sleep? How evolutionary clues, not cultural expectations, can help new parents</a>
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</em>
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<hr>
<h2>Mindful moments</h2>
<p>Glow’s online Moments present the idea that perhaps the best strategy for relieving these feelings of exhaustion and burnout is to give space for new parents to practice a little mindfulness as part of their day. </p>
<p>The term “mindfulness” <a href="https://www.annualreviews.org/doi/abs/10.1146/annurev-psych-042716-051139">generally refers</a> to being present and aware of what is going on around us in the moment.</p>
<p>Practising mindfulness typically involves a meditative component, where you can focus on your breathing or the sensations and sounds you are experiencing – to avoid your mind wandering to whether you left the oven on, or if the washing is ready to be hung out. </p>
<p>In recent decades, mindfulness has taken on a life of its own, with mindfulness retreats, smartphone apps and clinicians all espousing the potential benefits. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/484523/original/file-20220914-11-zlu3u9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Baby feet" src="https://images.theconversation.com/files/484523/original/file-20220914-11-zlu3u9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484523/original/file-20220914-11-zlu3u9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484523/original/file-20220914-11-zlu3u9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484523/original/file-20220914-11-zlu3u9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484523/original/file-20220914-11-zlu3u9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484523/original/file-20220914-11-zlu3u9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484523/original/file-20220914-11-zlu3u9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Being mindful is about being present in the current moment.</span>
<span class="attribution"><span class="source">Alex Passarelu/Unsplash</span></span>
</figcaption>
</figure>
<p>For new parents, there is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586989/">a wealth of evidence</a> suggesting mindfulness can be effective in reducing depression, anxiety and stress. </p>
<p>Practising mindfulness can improve <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/imhj.21827">parent/infant bonding</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/23512648/">increase feelings</a> of self-efficacy (belief in your own abilities) and self-compassion (feelings of kindness towards yourself).</p>
<p>When I listened to the Moments presented on the Glow platform, I found myself breathing more slowly and deliberately. </p>
<p>These recordings and their lovely, calming artwork are soothing to an almost unexpected degree. </p>
<p>The first Me Moment I listened to – comfortingly titled “Put the Kettle On” – brought a sense of calm to an otherwise hurried task (“the kettle is taking too long! Why are we always out of pre-ground coffee?”). </p>
<p>As well as mindfulness for parents to do alone, Glow offers soothing background audio for shared activities with your baby, such as having a bath or playing with a fabric wrap. To me, this is the brilliance of the Glow platform. </p>
<p>Telling new parents to do mindfulness tasks with their five minutes of free time during the crazy first days of parenthood might not be realistic – but adding mindfulness to tasks you’re already doing? That’s just a good use of time. </p>
<p><em>Glow, by Threshold, is available <a href="https://www.thethreshold.com.au/glow">online now</a>.</em></p>
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Read more:
<a href="https://theconversation.com/how-effective-is-mindfulness-for-treating-mental-ill-health-and-what-about-the-apps-182436">How effective is mindfulness for treating mental ill-health? And what about the apps?</a>
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<img src="https://counter.theconversation.com/content/189884/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Madeline Sprajcer does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Telling new parents to do mindfulness tasks with their five minutes of free time might not be realistic – but adding mindfulness to tasks you’re already doing is just a good use of time.Madeline Sprajcer, Lecturer in Psychology, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1877472022-08-05T15:25:04Z2022-08-05T15:25:04ZWhat is ‘normal’ baby sleep? How evolutionary clues, not cultural expectations, can help new parents<figure><img src="https://images.theconversation.com/files/477394/original/file-20220803-15-gdgghs.jpg?ixlib=rb-1.1.0&rect=46%2C0%2C3725%2C3453&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/father-holding-newborn-baby-son-nursery-627696287">Monkey Business Images/Shutterstock</a></span></figcaption></figure><p>The <a href="https://link.springer.com/article/10.1007/s10995-015-1798-7">sleep disruption</a> of new parenthood is both well known yet unexpected. While new parents are aware that babies need frequent night time care, the reality is often a cruel surprise. “What’s wrong with my baby?” new parents ask themselves, or “what’s wrong with me that I can’t get this baby to sleep?”</p>
<p>If you are facing this, you are not a bad parent, nor is your baby abnormal. You are simply asking <a href="https://www.bmj.com/content/346/bmj.f2344.full">the wrong questions</a>. Rather than “why won’t my baby sleep?”, parents should be asking “why do I think they should be sleeping now?” and “what am I basing my expectations on?”</p>
<p>There are <a href="https://doi.org/10.1002/ajhb.23589">three currently prevalent views</a> of infant sleep norms. These are known as the cultural norm, the biomedical norm, and the biological or evolutionary norm.</p>
<p>The cultural norm refers to the beliefs held by different cultural groups that underpin notions of what is right. Dominant cultural beliefs about babies in the UK are that “good babies” are not demanding and sleep through the night; a good baby is a sign of a good parent. </p>
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<img alt="Quarter life, a series by The Conversation" src="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><strong><a href="https://theconversation.com/uk/topics/quarter-life-117947?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">This article is part of Quarter Life</a></strong>, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/baby-names-why-we-all-choose-the-same-ones-185546?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Baby names: why we all choose the same ones</a></em></p>
<p><em><a href="https://theconversation.com/what-is-gentle-parenting-an-expert-explains-184282?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">What is gentle parenting? An expert explains</a></em></p>
<p><em><a href="https://theconversation.com/rihanna-and-radical-pregnancy-fashion-how-the-victorians-made-maternity-wear-boring-182000?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Rihanna and radical pregnancy fashion – how the Victorians made maternity wear boring</a></em></p>
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<p>This cultural norm also holds that babies must be left to cry and will be spoiled if they are picked up too often. It says that babies should learn to “self-soothe” (to fall asleep by themselves) and that rocking or cuddling a baby to sleep prevents this. </p>
<h2>The roots of beliefs about sleep</h2>
<p>These <a href="https://books.google.co.uk/books/about/Dream_Babies.html?id=NbJFvgAACAAJ&redir_esc=y">cultural beliefs about infant care</a> are recent. They emerged in the late 1800s and early 1900s and were heavily promoted by authoritative figures such as American psychologist <a href="https://dspace.gipe.ac.in/xmlui/bitstream/handle/10973/26494/GIPE-007396.pdf?sequence=3&isAllowed=y">John B Watson</a> and pediatrician <a href="https://www.gutenberg.org/files/15484/15484-h/15484-h.htm#Sleep">L Emmet Holt</a>. They reflect the practices and lifestyles of the white middle classes 100 years ago at a time when independence, self-reliance and stoicism were highly prized in western society. Child-rearing experts claimed their methods would help parents raise children that displayed these qualities. </p>
<p>On the other hand, biomedical (or clinical) expectations for what is normal tend to come from average values determined by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2012111/">classic studies</a>, which may be presented in parenting books, websites and charts in baby clinics as guidelines for normal infant sleep. For instance, they might suggest that at three months, babies need 14-16 hours of sleep a day, and should take three or four naps per day. </p>
<figure class="align-center ">
<img alt="Baby sleeping in cot" src="https://images.theconversation.com/files/477396/original/file-20220803-19-wfl02c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/477396/original/file-20220803-19-wfl02c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/477396/original/file-20220803-19-wfl02c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/477396/original/file-20220803-19-wfl02c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/477396/original/file-20220803-19-wfl02c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/477396/original/file-20220803-19-wfl02c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/477396/original/file-20220803-19-wfl02c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Asleep… but for how long?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/newborn-baby-cot-35040535">Monkey Business Images/Shutterstock</a></span>
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<p>However, these recommendations often reflect <a href="https://academic.oup.com/emph/article/2020/1/1/5651020">only the averages</a> from data gathered from smallish samples at specific times and places. Meta-analyses – studies which review numerous pieces of research – have found <a href="https://www.sciencedirect.com/science/article/pii/S1087079211000682?via%3Dihub">huge underlying variations</a> in how much babies sleep. Rather than relying on charts of average sleep patterns, we can tell a baby has slept sufficiently if they are alert and happy when they are awake.</p>
<h2>Answers from evolution</h2>
<p>The biological or evolutionary norm is less well known but arguably more realistic. It considers how the <a href="https://books.google.co.uk/books?hl=en&lr=&id=wAcfoVK23XcC&oi=fnd&pg=PA241&ots=VjX_yzDrKJ&sig=tHZsEFzMiABeGYyli1NJQKOoJSA#v=onepage&q&f=false">evolved biology of mothers and babies</a> can help us understand infant sleep over the first months of life. Remembering that human babies are mammal babies can help us grasp this. </p>
<p>Mammal babies are, by definition, fed with their mother’s milk and intensively cared for after birth. Humans, like other primates, produce milk that is low in fat and high in sugar. This means that human babies must feed often to fuel their rapidly growing brains, which at birth are only a quarter of their eventual adult size. </p>
<p>This explains why human infants are <a href="https://books.google.co.uk/books?hl=en&lr=&id=hrMzDQAAQBAJ&oi=fnd&pg=PP1&ots=vjbYU_6UzW&sig=DwnkOMNkWSJ3JIKXCs8piN4Rgj0&redir_esc=y#v=onepage&q&f=false">uniquely helpless</a> and dependent, wake frequently at night and prefer contact with a caregiver during the <a href="https://doi.org/10.1016/j.ajog.2017.03.032">first three months</a> of life. This biological view of infant sleep is quite different from <a href="https://pubmed.ncbi.nlm.nih.gov/32138610/">cultural and clinical</a> expectations of infant sleep in most western societies. </p>
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<img alt="Mother with baby looking despairing" src="https://images.theconversation.com/files/477395/original/file-20220803-12-fvcw74.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/477395/original/file-20220803-12-fvcw74.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/477395/original/file-20220803-12-fvcw74.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/477395/original/file-20220803-12-fvcw74.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/477395/original/file-20220803-12-fvcw74.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/477395/original/file-20220803-12-fvcw74.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/477395/original/file-20220803-12-fvcw74.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Another sleepless night.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/postnatal-depression-stressful-motherhood-concept-exhausted-2095299124">Arsenii Palivoda/Shutterstock</a></span>
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<p>Understanding normal infant sleep biology can also help parents deal with other aspects of baby sleep. Knowing that babies are developing a circadian rhythm – adjusting their waking and sleep patterns to light and dark – will help parents understand that it’s a good thing to expose babies to daylight early in the day, and that long naps in a darkened room during daytime <a href="https://www.sciencedirect.com/science/article/pii/S2352721818301372">disrupt this developing circadian rhythm</a> and are best avoided.</p>
<p>Biologically normal approaches to sleep in the first year of life can also help parents harmonise family sleep patterns. This can be done by pushing the baby’s bedtime to later in the evening, so parents can benefit from having their own sleep aligned with their baby’s longest sleep period (usually the first sleep of the night). Short daytime naps in daylight for babies can also reduce night waking and encourage them to obtain more of their sleep during night-time hours. </p>
<h2>Knowing what’s normal</h2>
<p>Friends and family can help parents have realistic expectations about baby sleep. Instead of asking new parents questions that frame babies’ normal behaviour as problematic (“does he sleep well?”), friends and family might instead ask something like “how are you coping with night time care?”, “are you getting enough help?” or “are you managing to go out?”</p>
<p><a href="https://core.ac.uk/download/pdf/153531364.pdf">Normalising questions</a> like this emphasise that night waking is expected and that it is difficult. They reinforce the importance of asking for and getting help from partners, family and friends, and that getting out of the house with the baby can be helpful (both for baby sleep and parental mental health).</p>
<p>Ultimately, <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237240">empowering parents</a> to experiment with what works for their baby and family rather than slavishly following cultural or biomedical norms reduces anxiety and improves everyone’s wellbeing. To understand what normal infant sleep involves, let your baby show you.</p>
<p><iframe src="https://action.bridged.media/?id=62eafb312e78b514b03eaf55&embed=true" width="100%" height="400px" style="border:none; overflow: hidden;"></p></iframe></p><img src="https://counter.theconversation.com/content/187747/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Helen Ball currently receives research funding from the NIHR ARC (Applied Research Collaborative) for the North East and North Cumbria. She has previously received research funding from the Economic and Social Research Council (ESRC), National Institute for Health Research (NIHR), Scottish Department of Health, Lullaby Trust, Leverhulme Trust, Nuffield Foundation, Babes in Arms Charity, and Scottish Cot Death Trust. She is affiliated with UNICEF UK Baby Friendly Initiative, Lullaby Trust, and International Society for the Study and Prevention of Infant Deaths (ISPID).</span></em></p>Understanding the evolutionary roots of baby sleep can help parents cope.Helen L. Ball, Professor of Anthropology and Director of the Parent-Infant Sleep Lab, Durham UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1865902022-07-25T18:00:19Z2022-07-25T18:00:19ZPerinatal depression: our study shows how common it is for both parents to experience it<figure><img src="https://images.theconversation.com/files/473827/original/file-20220713-24-rhl2x2.jpg?ixlib=rb-1.1.0&rect=34%2C0%2C5716%2C3828&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Both parents can struggle with depression after the birth of their child.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/tired-desperate-parents-holding-their-baby-683174032">Antonio Guillem/ Shutterstock</a></span></figcaption></figure><p>Many new parents struggle with mental health issues. Research suggests <a href="https://link.springer.com/epdf/10.1007/s00787-020-01556-x?sharing_token=Ib87QdBmKr9FubuQ1HRGB_e4RwlQNchNByi7wbcMAY43Bo6uHaOVQgQMjhRGkOY1He9hYkyOlQ1Nhf_fHa4YsQse7qM7r4UYdEBiqlKKiNUwmhWa9DWqARmdCCKvQjwmUqR2xnO2heDOa00tC5G8sQ2mzb2tXLj0cKHC-TA0IcY%3D">up to a quarter</a> of new mothers and <a href="https://www.sciencedirect.com/science/article/abs/pii/S016503271931496X?via%3Dihub">one in ten fathers</a> experience depression after the birth of their child. Although there has been greater awareness and dialogue in recent years about the mental health struggles of mothers and fathers, we don’t know very much about the experience of new parents as a unit.</p>
<p>This is something our review sought to uncover. We found that in <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2793548">one in 30 couples</a>, both parents may struggle with depression after the birth of their child. We also revealed that depression in couples persists – and might even become more common – through the first year after having a child. </p>
<p>To conduct our review, we looked at 23 studies in total, with data from almost 30,000 couples in 15 different countries. We specifically included studies which reported prevalence rates of depression in both parents during pregnancy and the first year after childbirth (known as the perinatal period). There wasn’t enough data reporting on anxiety for us to include it in our review.</p>
<p>We then grouped the studies based on whether they looked at depression during pregnancy, the early postnatal period (up to three months after delivery) or in the late postnatal period (between three to 12 months after delivery). </p>
<p>By combining the prevalence rates from each of the studies, we were able to estimate that one to two couples in every 100 experience depression during pregnancy. About <a href="https://pubmed.ncbi.nlm.nih.gov/25455248/">one in ten expectant mothers</a> suffer from depression and evidence suggests that when mothers are depressed during pregnancy, <a href="https://pubmed.ncbi.nlm.nih.gov/27826783/">there’s a higher chance for fathers to be depressed</a> as well. </p>
<p>We found that the prevalence of depression in the early postnatal period for both parents was just over one in 50 couples. Interestingly, the rate of late postnatal depression in both parents was higher – around one in 30 couples. While this difference may just be a coincidence, it appears that the later postnatal period (three to 12 months after delivery) could be a critical time for new parents – and that it’s important to make sure parents are aware it’s normal to experience postnatal depression even up to the first year after having a baby.</p>
<p>Our study also looked at some of the common factors associated with depression in couples before and after the birth of their child. Some of these factors included low relationship satisfaction, frequent quarrels and low social support. Financial struggles, unemployment and fathers working long hours were typically linked with depression in the perinatal period.</p>
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<img alt="A young couple sit on a couch facing opposite directions, both looking frustrated." src="https://images.theconversation.com/files/473829/original/file-20220713-14-kz8fjy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/473829/original/file-20220713-14-kz8fjy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/473829/original/file-20220713-14-kz8fjy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/473829/original/file-20220713-14-kz8fjy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/473829/original/file-20220713-14-kz8fjy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/473829/original/file-20220713-14-kz8fjy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/473829/original/file-20220713-14-kz8fjy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Relationship problems were a common reason for depression in new parents.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/quarrel-between-couple-love-upset-guy-1892874250">Kateryna Onyshchuk/ Shutterstock</a></span>
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<p>This research not only highlights how many people may experience depression before and after the birth of their child, but also shows us that one parent’s mental health may be affected by their partner’s. Knowing which risk factors may make a parent more likely to experience perinatal depression is also important, especially for healthcare providers and family members when it comes to providing support.</p>
<h2>Mental health struggles</h2>
<p>We know from other research just how big an impact a mother’s depression can have, not only on <a href="https://doi.org/10.1177/1745506519844044">her own health and wellbeing</a>, but even on the health of <a href="https://doi.org/10.1177/0009922818769450">their child</a>. While a healthy <a href="https://doi.org/10.1111/fare.12260">father-child relationship</a> can buffer against some of these negative impacts, there’s currently no research which has looked at what impact there might be on the child when both parents are depressed. Our study also showed that when both parents are depressed, there’s a higher chance of relationship problems and separation. </p>
<p>The postpartum visit can be a key opportunity for new parents to check in with their GP, who can screen them for any mental health problems. Your GP can offer support, provide key resources, and make sure you have the right type of treatment if you’re struggling with your mental health. There’s evidence that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002098/">family therapy</a> can also help prevent and treat perinatal depression – and this should be considered when both parents are struggling.</p>
<p>But research carried out in the UK shows that nearly <a href="http://dx.doi.org/10.1136/bmjopen-2020-036835">four out of ten new mothers</a> don’t receive a postpartum visit. Moreover, new fathers are not routinely included in care during and after pregnancy, leaving them <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1229-4">feeling excluded</a> and <a href="https://theconversation.com/becoming-a-new-parent-is-challenging-and-fathers-need-support-too-168542">isolated</a>. We hope this research will reinforce the importance of the postpartum visit for new mothers to touch base with their GP, but also as an opportunity to check in on fathers’ mental health.</p>
<p>Our research shows that perinatal depression is common for both mothers and fathers – so if you’re struggling, just know that you aren’t alone in your experience and there are many parents out there who have been in your position before and have felt the same. Talk to your GP, trusted friends or family members, and know that help is available.</p><img src="https://counter.theconversation.com/content/186590/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kara L Smythe does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Our study is the first to show how common depression is in both parents during and after pregnancy.Kara L Smythe, PhD Researcher, Sexual and Reproductive Healthcare, UCLLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1833062022-06-16T12:25:06Z2022-06-16T12:25:06ZBabies don’t come with instruction manuals, so here are 5 tips for picking a parenting book<figure><img src="https://images.theconversation.com/files/469087/original/file-20220615-18-6vr9hj.jpg?ixlib=rb-1.1.0&rect=199%2C253%2C4762%2C3152&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Evidence-based and easy to read are two important criteria.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/father-reading-with-sleeping-baby-son-royalty-free-image/601800815">JGI/Tom Grill/Tetra images via Getty Images</a></span></figcaption></figure><p>Babies don’t come with instruction manuals. Children are at once joyful, sad, confusing, predictable, generous, selfish, gentle and mean. What’s a parent to do when faced with such perplexing offspring? Given the complex interactions of parent, child and surroundings, parents often feel lost. Many may seek answers in parenting books.</p>
<p><a href="https://askwonder.com/research/avg-amount-millennial-parents-spend-parenting-books-apps-field-great-break-down-xjjsxbcdl">Parenting books are big business</a>, and there are tens of thousands of titles for sale. The big question, though, is: Do parenting books help?</p>
<p>How effective they are is a matter of debate, especially given the lack of scientific evidence regarding their usefulness. Limited research has found that <a href="https://doi.org/10.1007/s10902-006-9041-2">problem-focused self-help books may be helpful</a> to readers – think tips about time management or healthy eating. And studies find that using books independently to improve well-being – what psychologists call bibliotherapy – is <a href="https://doi.org/10.1016/j.tate.2021.103543">somewhat effective for addressing stress</a>, <a href="https://doi.org/10.2147/NDT.S152747">anxiety and depression</a>.</p>
<p>So it makes sense that reading a parenting book could be useful. In terms of quality and usefulness, however, they exist on a continuum.</p>
<p><a href="https://scholar.google.com/citations?user=20slzkIAAAAJ&hl=en">We’re scholars</a> <a href="https://scholar.google.com/citations?user=f2RwlNoAAAAJ&hl=en&oi=ao">of human development</a>, have taught thousands of students about parenting and write about family, parenting and development through the lifespan. One of us (Bethany) is the mother of six little ones, while the other of us (Denise) has two adult children, one of whom is Bethany. We believe that parents can become <a href="https://www.jstor.org/stable/45398785">critical thinkers and choose the books</a> that will be most appropriate for them. Here are five questions to think about when you’re looking for the best parenting book for you.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/469088/original/file-20220615-10847-g5wxlj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman in bookstore with toddler in baby carrier" src="https://images.theconversation.com/files/469088/original/file-20220615-10847-g5wxlj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/469088/original/file-20220615-10847-g5wxlj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/469088/original/file-20220615-10847-g5wxlj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/469088/original/file-20220615-10847-g5wxlj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/469088/original/file-20220615-10847-g5wxlj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/469088/original/file-20220615-10847-g5wxlj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/469088/original/file-20220615-10847-g5wxlj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">With so many books to choose from, put in some effort to find a good fit.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/young-asian-mother-reading-books-to-lovely-little-royalty-free-image/1147930346">d3sign/Moment via Getty Images</a></span>
</figcaption>
</figure>
<h2>1. Who wrote it and why?</h2>
<p>A good parent doesn’t need a Ph.D.; neither does an author. However, an advanced degree in an area related to parenting helps in understanding and interpreting relevant research.</p>
<p>Another consideration is the experience of the author. Having one or a dozen children does not make someone an expert. Doing more parenting doesn’t necessarily make you better at it. Not having a child doesn’t disqualify someone from being an expert, either, but should be thoughtfully considered. We taught parenting classes before having children, and it’s fair to say that our own parenting experiences have added depth, insight and even grace to what we teach.</p>
<p>The reason someone wrote a parenting book can also be informative. Advice from authors who write out of angst about their own upbringing or who failed at parenting should be taken with a grain of salt. </p>
<p>Finally, don’t let celebrities’ books fool you. Most of these are written by <a href="https://professionalghost.com/blog/how-common-are-ghostwriters/">ghostwriters</a> and are primarily designed to sell books or build a brand.</p>
<h2>2. Is it based on science?</h2>
<p>Psychology researcher and <a href="https://www.simonandschuster.com/books/The-Ten-Basic-Principles-of-Good-Parenting/Laurence-Steinberg/9780743251167">parenting expert Laurence Steinberg</a> writes that scientists have studied parenting for over 75 years, and findings related to effective parenting are among the most consistent and longstanding in social science. If you notice inconsistencies between parenting books, it’s because “<a href="https://www.simonandschuster.com/books/The-Ten-Basic-Principles-of-Good-Parenting/Laurence-Steinberg/9780743251167">few popular books are grounded in well-documented science</a>.”</p>
<p>How can you tell if a book is grounded in science? Look for citations, names of researchers, sources and an index. Also, learn the basic principles of effective parenting determined through decades of research and <a href="https://www.newswise.com/articles/ten-basic-principles-of-good-parenting-science-of-raising-children">outlined by Steinberg</a>. They include: set rules, be consistent, be loving, treat children with respect, and avoid harsh discipline.</p>
<p>If the book you’re considering is not consistent with these guidelines, rethink its parenting advice. Likely it’s based not on science but opinion or personal belief. Opinion and belief have a place, but science is better in this space.</p>
<h2>3. Is it interesting to read?</h2>
<p>If the book is not interesting, you are <a href="https://doi.org/10.1080/10862969009547717">unlikely to finish it, much less learn from it</a>. Before taking a book home, read the first page and flip to a page in the middle to see if it grabs your attention. Try to find books that you can read in small bites, skip around in, and return to in the future.</p>
<p>Avoid books that contain “psychobabble,” pseudoscientific jargon that has an air of authenticity but lacks clarity. For example, the publisher’s description of the book “<a href="https://www.goodreads.com/book/show/603436.Indigo_Children">The Indigo Children: The New Kids have Arrived</a>” reads, “The Indigo Child is a child who displays a new and unusual set of psychological attributes that reveal a pattern of behavior generally undocumented before. This pattern has common yet unique factors that demand that parents and teachers change their treatment and upbringing of them in order to achieve balance. To ignore these new patterns is to potentially create great frustration in the minds of these precious new lives.” Pass.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/469089/original/file-20220615-11210-leelbp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="two men sit on bed with baby with a tall bookshelf against the wall" src="https://images.theconversation.com/files/469089/original/file-20220615-11210-leelbp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/469089/original/file-20220615-11210-leelbp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/469089/original/file-20220615-11210-leelbp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/469089/original/file-20220615-11210-leelbp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/469089/original/file-20220615-11210-leelbp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/469089/original/file-20220615-11210-leelbp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/469089/original/file-20220615-11210-leelbp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Even a shelf full of books can’t cover your family’s exact – and always changing – circumstances.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/fathers-starting-the-day-with-newborn-royalty-free-image/1160661769">Willie B. Thomas/DigitalVision via Getty Images</a></span>
</figcaption>
</figure>
<h2>4. Is it realistic?</h2>
<p>Run, don’t walk, from any book that tells you its method always works or any failure is because of you – or worse yet, ignores failure. </p>
<p>It’s impossible to provide advice for every single parent, child and situation! An effective parenting book appreciates context and complexity and informs the reader that not all answers are in the book. No parent is perfect, but <a href="https://doi.org/10.1177/0963721413504106">recognizing weaknesses and failures leads to growth and improvement</a>, and no child is completely malleable. Even parents who do everything right may have children who become wayward.</p>
<p>Make sure the book provides you with detailed <a href="https://doi.org/10.1126/science.abj9957">instructions and things to do</a>, as well as ways to track improvements. In other words, make sure it is actionable.</p>
<p>Finally, a parenting book should respect a parent’s instincts. </p>
<h2>5. Does it motivate and inspire hope?</h2>
<p>Some parenting books offer insights related to general behavior, like “<a href="https://www.newharbinger.com/9781684033881/raising-good-humans/">Raising Good Humans</a>.” Others offer insights for specific issues, like “<a href="https://www.platypusmedia.com/product-page/safe-infant-sleep-expert-answers-to-your-cosleeping-questions">Safe Infant Sleep: Expert Answers to Your Cosleeping Questions</a>.” Likely, you will be more motivated to read a book that reflects your specific needs and values and leaves you feeling hopeful.</p>
<p>A word of caution, however. One study found that parenting books that stress strict routines for infant sleep, feeding and general care might actually make parents <a href="https://doi.org/10.1080/03004430.2017.1378650">feel worse by increasing depression, stress and doubt</a>. Parenting research does not support overly strict routines, and it’s easy to understand why most of these parents did not find such books useful.</p>
<h2>Remember to trust yourself</h2>
<p>When you read a parenting book, the goal is to feel empowered, more confident, excited and even relieved. You are not alone, nor are you the only parent with questions.</p>
<p>Psychologist <a href="https://psychology.jrank.org/pages/659/Edward-F-Zigler.html">Edward Zigler</a> described parenting as “the <a href="https://www.worldcat.org/title/handbook-of-parenting-volume-3-status-and-social-conditions-of-parenting/oclc/967239514&referer=brief_results">most challenging and most complex</a> of all the tasks of adulthood.”</p>
<p>Yes, parenting can be tough. In your parenting adventures, you’ll likely need all the resources and tools you can muster. With thoughtful and critical explorations, you can find books that enhance your personal wisdom and intuition to help in raising these delightfully complicated little humans.</p><img src="https://counter.theconversation.com/content/183306/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Being a parent can be tricky, and many turn to parenting guides for help in figuring out what to do. Two human development scholars have tips for picking a book that will be useful for you.Denise Bodman, Principal Lecturer in Social and Family Dynamics, Arizona State UniversityBethany Bustamante Van Vleet, Principal Lecturer in Family and Human Development, Arizona State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1821412022-05-25T01:01:42Z2022-05-25T01:01:42ZSurprise! How men react when becoming a dad isn’t part of the plan<figure><img src="https://images.theconversation.com/files/460488/original/file-20220429-13-qbw5dq.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C663&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-woman-hands-hiding-pregnancy-test-1195326700">Shutterstock</a></span></figcaption></figure><p>For many dads, having a child is unplanned. What happens next can vary. One man said:</p>
<blockquote>
<p>We broke up and she called me soon after to tell me she was pregnant […] she just asked me if I wanted to be in our baby’s life and I accepted without thinking twice.</p>
</blockquote>
<p>Another said:</p>
<blockquote>
<p>I wanted to have an abortion, since we weren’t ready, but it wasn’t my choice, it was hers […] but the resentment was there for a long time.</p>
</blockquote>
<p>These two comments came from tens of thousands of posts on the social media site Reddit we analysed as part of <a href="https://www.sciencedirect.com/science/article/pii/S2667321522000476?via%3Dihub">our research</a> into men’s experiences of unplanned pregnancy.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-studied-100-years-of-australian-fatherhood-heres-how-todays-dads-differ-from-their-grandfathers-166348">We studied 100 years of Australian fatherhood. Here's how today's dads differ from their grandfathers</a>
</strong>
</em>
</p>
<hr>
<h2>Unplanned pregnancies are common</h2>
<p>Having an unplanned child is more common than you might think. In Australia <a href="https://pubmed.ncbi.nlm.nih.gov/26456762/">40% of pregnancies</a> are mis-timed, unexpected or unwanted. That’s an estimate comparable with rates <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30029-9/fulltext">worldwide</a>.</p>
<p>Most research on the impact of unplanned pregnancies focuses on mothers. We wanted to know about the experiences of dads. So we turned to two forums specifically for <a href="https://www.reddit.com/r/daddit/">new</a> and <a href="https://www.reddit.com/r/predaddit/">expecting dads</a> on Reddit.</p>
<p>We “scraped” tens of thousands of posts, spanning a year, then applied an innovative <a href="https://pubmed.ncbi.nlm.nih.gov/30744717/">machine learning</a> technique to group the data into meaningful topics. This allowed us to identify themes in the men’s online discussions.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/machine-learning-is-changing-our-culture-try-this-text-altering-tool-to-see-how-159430">Machine learning is changing our culture. Try this text-altering tool to see how</a>
</strong>
</em>
</p>
<hr>
<h2>Here’s what we found</h2>
<p><a href="https://www.sciencedirect.com/science/article/pii/S2667321522000476?via%3Dihub">Our research showed</a> men who reluctantly or unexpectedly became fathers experienced a complex range of emotions and reactions. Many needed support. </p>
<p>The dads in our study posted to Reddit using pseudonyms. So they were free to be honest and raw as they shared their emotions on a topic many consider taboo.</p>
<p>Some were “filled with regret”, “sadness”, “guilt” and hopelessness of a “never-ending, soul-crushing grind”. Some lacked bonds with their infants, one feeling “like the tin man without a heart”.</p>
<p>One man said:</p>
<blockquote>
<p>I keep on having really bad breakdown episodes. There are days when I just sit and cry thinking how miserable my life has become.</p>
</blockquote>
<h2>Unplanned fatherhood and postnatal depression</h2>
<p>Earlier research shows it’s common for dads to have <a href="https://www.sciencedirect.com/science/article/pii/S026661381930213X?casa_token=aFeik2hGNskAAAAA:jD_01eW0wFce3gXn9cpmIQV5prFnISfFZRQ_n6W41w19po1iP5evTq6rbR_h9xIDvbvu7FBL94A">short periods of negative thoughts</a> after their baby is born. Feelings of loss about their previous life are common.</p>
<p>However, persistent negative and intense emotions may indicate depression and anxiety at this time.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Baby in cot with father in background clutching cushion, holding head" src="https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/461490/original/file-20220505-19-yssztk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Unplanned fatherhood increases a man’s risk of postnatal depression.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cute-baby-bed-young-father-suffering-1656784711">Shutterstock</a></span>
</figcaption>
</figure>
<p>In fact, unintended fatherhood is linked to an <a href="https://psycnet.apa.org/record/2012-26354-019">increased</a> <a href="https://www.sciencedirect.com/science/article/pii/S0277953608005789?casa_token=cUY_BmkyG1AAAAAA:jnaSyT80P963Q7q9-IZXrzO2Djb2tLCuMptqhwKUFUkmzuS1qeAY3yzpiK6n6fyuGlvmRLW2X6U">risk</a> of a man having postnatal depression.</p>
<p>Paternal depression is, in turn, linked to a higher risk of depression <a href="https://pubmed.ncbi.nlm.nih.gov/20483973/">in their partners</a> and more behavioural problems <a href="https://www.mja.com.au/system/files/issues/195_11_121211/fle10192_fm.pdf">in their children</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/dads-get-postnatal-depression-too-55829">Dads get postnatal depression too</a>
</strong>
</em>
</p>
<hr>
<h2>Let’s debunk some myths</h2>
<p>Like earlier research, ours debunks the myth that <a href="https://psycnet.apa.org/record/2020-29612-001">men do not seek help</a> when in need. Men sought and received advice and support from other dads about everything from night feeds and nappies to reassurance that what they were feeling was normal.</p>
<p>Studies show <a href="https://pubmed.ncbi.nlm.nih.gov/21464468/">peer support</a>, often online, can be a foot-in-the-door for men who feel uncomfortable disclosing vulnerability. This is particularly important for a taboo subject such as unwanted parenthood. </p>
<p>In our study, not all men were distressed. Some reported feeling happy “but freaking out” and simultaneously “scared, hopeful, excited, terrified”.</p>
<p>Sharing experiences allowed these fathers to validate and normalise the full spectrum of their emotions and sometimes re-frame a sense of hopelessness. </p>
<p>Men told each other “you are not alone”, “I felt the same”, “it does get better” and “it’s not as bad as people say”.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/childrens-well-being-goes-hand-in-hand-with-their-dads-mental-health-102347">Children’s well-being goes hand in hand with their dads’ mental health</a>
</strong>
</em>
</p>
<hr>
<h2>How to reduce the stigma</h2>
<p>In this study and <a href="https://journals.sagepub.com/doi/full/10.1177/0265407519864444">our earlier research</a> men said they were concerned that not wanting children would be seen as abnormal.</p>
<p>We hope our work raises awareness that desire for children is not universal. We can do more to normalise and destigmatise varied narratives that represent how people feel about parenthood. </p>
<p>When it comes to family planning, a first step is to include men in discussions about reproductive health before they become fathers and are expecting a child. </p>
<p><a href="https://static1.squarespace.com/static/56e1ed8d3c44d863de3040ee/t/6271c31d5e3a870ef25d1df1/1651622690479/MT2021-09-071-MACDONALD.pdf">Pre-conception planning</a> with health professionals involves becoming physically and psychologically ready for parenthood and is important for mothers, fathers and, ultimately, their offspring. </p>
<p>Once the baby is born, it is important dads have access to support. Family and health-care systems are mainly focused on mothers and infants, and could be better <a href="https://www.healthymale.org.au/resources-tools/current-research-projects-studies/plus-paternal/case-for-change">equipped, resourced and trained</a> to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165032720330111">detect fathers at risk of mental health problems</a>. <a href="https://coastfraseridpscd.ca/wp-content/uploads/2015/07/Zero-to-3-May-2015-Issue.pdf#page=62">Father-inclusive practice</a> is beneficial to fathers, mothers and children.</p>
<h2>When things go right</h2>
<p>When fathers have access to the right help at the right time, it can make all the difference. One man said:</p>
<blockquote>
<p>I ended up going to a psychiatrist after a suicide attempt. It did some good, it faced me with my own immaturity. May I suggest trying it? Everybody is different, but it seriously helped in my case.</p>
</blockquote>
<hr>
<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em></p><img src="https://counter.theconversation.com/content/182141/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqui Macdonald is convener of the Australian Fatherhood Research Consortium.</span></em></p><p class="fine-print"><em><span>Imogene Smith does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Most research on the impact of unplanned pregnancies focuses on mothers. So we turned to Reddit to find out what dads really thought.Imogene Smith, Casual academic, provisional psychologist and Doctor of Psychology (Clinical) candidate, Deakin UniversityJacqui Macdonald, Senior lecturer and research fellow in psychology, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1459732020-09-25T09:56:56Z2020-09-25T09:56:56ZWorried about negative thoughts as a new parent? You’re not alone<figure><img src="https://images.theconversation.com/files/360002/original/file-20200925-16-11r5zw9.jpg?ixlib=rb-1.1.0&rect=15%2C0%2C5160%2C3453&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Many new parents often feel they have to hide how they really feel.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/parents-home-hospital-newborn-baby-nursery-627703319">Monkey Business Images/ Shutterstock</a></span></figcaption></figure><p>If you believe what the media tells us, we should feel nothing apart from overwhelming love, <a href="https://www.romper.com/p/17-instagram-captions-for-babys-arrival-that-sum-up-all-the-sweetness-of-those-first-moments-18705744">gratitude</a> and excitement immediately when our baby is born. Although becoming a new parent might indeed be a time of happiness, feeling a far more <a href="https://psycnet.apa.org/record/2016-38769-001">complex array of emotions</a> is actually more common than you might think. </p>
<p>Research shows that overall happiness actually <a href="https://ideas.repec.org/a/spr/jhappi/v14y2013i2p501-524.html">drops in the first year</a> of having a baby, especially for women. Although parents may love their babies very much, it’s common to not love <a href="https://psycnet.apa.org/record/2002-11235-010">the things that come alongside it</a>, such as money worries, sleepless nights and feeling disconnected from your partner or friends. </p>
<p>However, parents often hide how they <a href="https://www.diva-portal.org/smash/get/diva2:1009517/FULLTEXT02.pdf">really feel</a>, believing these thoughts are wrong, and that sharing them would have them labelled a “bad parent”. Worries such as this can be a core part of not feeling like a good enough parent and are also common in <a href="https://search.informit.com.au/documentSummary;dn=909929185761432;res=IELAPA">postnatal depression</a>. </p>
<p>The mental health of new parents and the unexpected things that can happen in the first year of parenting is the subject of <a href="https://www.pinterandmartin.com/lets-talk-about-the-first-year-of-parenting">my latest book</a>. I spoke with more than 500 parents who told me how they honestly felt after their baby was born. </p>
<p>What was immensely clear from their stories is that there’s no one “right way” to feel once you have a baby. Alongside the positives, parents felt a whole host of emotions they weren’t expecting, often saying this was the first time they had spoken openly about their feelings. Here were some of the most common things people felt:</p>
<h2>1. Not loving your baby instantly</h2>
<p>The media would have us believe that the moment a baby is born, parents fall madly in love with them. Although this can happen, many parents talked about feeling disconnected or so exhausted they couldn’t think about loving anyone. </p>
<p>Others felt shock that a baby was actually here. It can be especially difficult when parents have had a <a href="https://www.tandfonline.com/doi/abs/10.1080/02646830802350831">traumatic pregnancy or birth</a>, <a href="https://www.sciencedirect.com/science/article/pii/S001502829900583X">IVF or previous loss</a>, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114875/">premature baby</a>. </p>
<p>It’s normal for bonding to take time. However, things like <a href="https://www.sciencedirect.com/science/article/abs/pii/S0884217515311448">skin to skin contact</a>, holding your baby closely <a href="https://www.sciencedirect.com/science/article/abs/pii/S0190740919311260">in a sling</a>, or even a giving them a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165032707003886">gentle baby massage</a> are all shown to help improve bonding – and mental health. </p>
<h2>2. Feeling incompetent and overwhelmed</h2>
<p>Another common emotion was feeling terrified by the responsibility of being a new parent. Many felt shocked that they were now actually expected to care for this baby, despite no tests or training. Parents remembered feeling like everyone else knew what to do, but they didn’t. This feeling is likely exacerbated by us now <a href="https://www.theguardian.com/commentisfree/2018/mar/31/late-motherhood-is-on-the-rise-but-as-one-who-knows-it-has-its-downsides">having babies later</a>, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/brb3.107">living away from family</a>, and often not really being around babies until we have our own. </p>
<p>But many people feel this way. And babies are resilient, so it’s okay if you don’t <a href="https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=3.%09Woodhouse%2C+S.+S.%2C+Scott%2C+J.+R.%2C+Hepworth%2C+A.+D.%2C+%26+Cassidy%2C+J.+%282020%29.+Secure+base+provision%3A+A+new+approach+to+examining+links+between+maternal+caregiving+and+infant+attachment.+Child+Development%2C+91%281%29%2C+e249-e265.&btnG=">do everything “perfectly”</a> all the time.</p>
<figure class="align-center ">
<img alt="Two parents hold a crying baby." src="https://images.theconversation.com/files/360003/original/file-20200925-20-tidzkj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/360003/original/file-20200925-20-tidzkj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/360003/original/file-20200925-20-tidzkj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/360003/original/file-20200925-20-tidzkj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/360003/original/file-20200925-20-tidzkj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/360003/original/file-20200925-20-tidzkj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/360003/original/file-20200925-20-tidzkj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It’s normal to feel overwhelmed.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-asian-family-consisting-father-mother-1652764228">JR-50/ Shutterstock</a></span>
</figcaption>
</figure>
<p>If you’re feeling this way, talking to other new parents or with your health visitor or midwife may help reassure you of just how common these feelings are. However, if these thoughts are affecting you significantly, do consider <a href="https://www.parenthoodinmind.co.uk/">talking to a therapist</a> who specialises in supporting new parents. </p>
<h2>3. Grieving for your former life</h2>
<p>The build-up to having a baby is often all about the birth and buying things for the baby. When the baby arrives, your life suddenly changes.</p>
<p>It’s normal to be shocked, feel regret at how tough some parts can be, and to grieve for your old life – even though you wouldn’t actually swap back to it. Part of this, especially for mothers, was feeling like they’d lost their identity and simply becomes someone’s “mum”, their days filled with caring for their baby on repeat. </p>
<p>But missing your old life does not mean you don’t love your baby or are a bad parent. And it does <a href="https://onlinelibrary.wiley.com/doi/abs/10.1177/0884217503255199?casa_token=5gRbDY2rk4kAAAAA:D5IUWUy5YQ3kmOKKt01EbKoIftd4tGsPphH5JZwDNsB8ba1OzitTawDdBdrsd3MKtf7QM9zcoAD8">get easier over time</a> as you transition into your new normal. </p>
<h2>4. Feeling trapped – but not wanting to be separated</h2>
<p>Parents also talked about wanting a break while simultaneously not wanting to be separated from their baby. </p>
<p>Mothers talked about jealousy of their partner leaving the house for work, yet dreaded being separated from their baby to do the same. Some counted down the clock until bedtime and then immediately missed their baby. You might find people get exasperated at you for feeling this way – ignore them. You don’t have to leave your baby if you don’t want to. What you probably need is <a href="https://www.mother.ly/love/14-ways-to-really-help-a-new-mom">more support in other ways</a>, such as a hot meal, a nap or simply some adult company. </p>
<p>If you’re a new parent and struggling, it’s important to remember that negative and mixed emotions are a normal part of life. Talking to other parents may help you see you aren’t alone in feeling this way. Having negative emotions about people and the things we love is also normal. And, perhaps most importantly, people lie on social media. Research shows it’s common for new parents to feel they have to share positive messages to the point they <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321197/">embellish or even lie</a> to create a certain image to the world. Let’s not fall for it any more. </p>
<p>Altogether, what was clear from my research was the complexity and variability in what parents felt. Emotions could change from one moment to the next, or come all at once. Being a parent certainly isn’t easy – and parents should know that it’s okay to feel this way.</p><img src="https://counter.theconversation.com/content/145973/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Brown has previously received funding from the ESRC, NIHR, HEFCW, Infant feeding charities and Public Health Wales. She is a trustee for First Steps Nutrition Trust. She is author of six infant feeding and parent books published by Pinter and Martin Ltd.</span></em></p>Here are four thoughts and feelings it’s common to have when you have a new baby.Amy Brown, Professor of Child Public Health, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1430152020-08-25T10:55:17Z2020-08-25T10:55:17ZFive ways to support new parents returning to work during the pandemic<figure><img src="https://images.theconversation.com/files/354592/original/file-20200825-20-dl7tk2.jpg?ixlib=rb-1.1.0&rect=819%2C122%2C4644%2C3080&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/businesswoman-mother-woman-toddler-working-computer-660321352">Evgeny Atamanenko/Shutterstock</a></span></figcaption></figure><p>Returning to work after having a baby is highly taxing under normal circumstances, but it’s especially tough now. Returning parents currently face a triple whammy of readjusting to work, sorting out childcare and coping with pandemic-related restrictions that weren’t there when they went on leave.</p>
<p><a href="https://theconversation.com/working-parents-dealing-with-coronavirus-quarantines-will-face-psychological-challenges-134498">It’s a lot of pressure.</a> For many at work, the pandemic has meant shifting to home working while at the same time caring for children because nurseries and schools are shut. The pandemic may have also <a href="https://www.bbc.com/worklife/article/20200630-how-covid-19-is-changing-womens-lives">exacerbated existing inequalities</a> in families around the <a href="https://www.unwomen.org/en/digital-library/publications/2020/04/policy-brief-the-impact-of-covid-19-on-women">division of labour</a>, <a href="https://www.eurofound.europa.eu/publications/blog/covid-19-fallout-takes-a-higher-toll-on-women-economically-and-domestically">gender roles</a> and <a href="https://www.tandfonline.com/doi/full/10.1080/15487733.2020.1776561">unpaid care work</a>. For some, closed offices will have severed access to colleagues and opportunities too.</p>
<p>How, then, can we help new parents returning to work for the first time in these unusually difficult circumstances? In this article, we offer five bits of advice – drawn from our <a href="https://www.routledge.com/Navigating-the-Return-to-Work-Experience-for-New-Parents-Maintaining-Work-Family/Karanika-Murray-Cooper/p/book/9780367223014">recent book</a> that brings together a number of experts on issues surrounding parental return-to-work – to help both new parents and their managers handle the transition back into work during the pandemic. </p>
<h2>1. Review changing needs and demands</h2>
<p>A good fit between <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/joms.12433">our needs and job requirements</a> is important for wellbeing, job satisfaction and productivity. Both needs and job requirements can change over time and so, too, can the fit between them. </p>
<p>Taking time to do a periodic review in response to major life changes – such as parenthood and the pandemic – is important. This should lead to a discussion between employee and line manager to adjust work to fit the circumstances, ensure that any resources needed are available, and maintain a good work-life balance and productivity.</p>
<h2>2. Plan ahead</h2>
<p>Organise both parental leave and the return to work in advance.</p>
<p>It may sound like common sense, but not many parents have an open discussion with their managers or employers ahead of time to plan their leave and handover tasks or to adjust their work ahead of a gradual or a full return. The pandemic restrictions make such careful planning essential, as access to manager or colleague support is not as immediate. </p>
<p>Enforced working from home also means the physical and temporal boundaries between work and home are nonexistent. This may necessitate redesigning how and when the job is done, in order to organise working hours, breaks and family time in a way that they fit together. Balancing work and family demands may also require being more structured with home-based work. </p>
<h2>3. Beware of stereotypes</h2>
<p>Stereotypes of mothers (including pregnant women) <a href="https://www.apa.org/science/about/psa/2015/09/mothers-work">tend to be negative</a> and can contribute to the <a href="https://www.tuc.org.uk/sites/default/files/Pay_and_Parenthood_Touchstone_Extra_2016_LR.pdf">“motherhood wage penalty”</a> – the pay gap between working
mothers and similar women without dependent children. Stereotypes of fathers, on the other hand, can be positive and contribute to a <a href="https://www.bbc.co.uk/news/business-36126584">“fatherhood bonus”</a>. </p>
<figure class="align-center ">
<img alt="A man typing on a laptop with his baby sitting on his knee." src="https://images.theconversation.com/files/354398/original/file-20200824-14-1xijugq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/354398/original/file-20200824-14-1xijugq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/354398/original/file-20200824-14-1xijugq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/354398/original/file-20200824-14-1xijugq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/354398/original/file-20200824-14-1xijugq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/354398/original/file-20200824-14-1xijugq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/354398/original/file-20200824-14-1xijugq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">At age 42, UK fathers working full time earn 22% more than similar men without children who work full time.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/father-working-home-on-laptop-baby-627677918">Monkey Business Images/Shutterstock</a></span>
</figcaption>
</figure>
<p>The loss of social time and face-to-face contact during both parental leave and the pandemic may <a href="https://www.annualreviews.org/doi/abs/10.1146/annurev.psych.56.091103.070137">exacerbate stereotypes</a> and their <a href="https://theconversation.com/the-terrifying-power-of-stereotypes-and-how-to-deal-with-them-101904">negative impacts on performance</a>. There’s a risk that this then could lead to differential treatment and indirect discrimination.</p>
<p>So to help stop stereotypes from taking hold, organisations should make sure that <a href="https://www.taylorfrancis.com/books/e/9780429274336/chapters/10.4324/9780429274336-14">parents are included and listed to</a> when they return – for example by running parent forums or committees and scheduling meetings outside times of the day where family commitments are more likely.</p>
<p>And to make sure that stereotypes don’t lead to unfair treatment, managers should be transparent about access to resources, take into account career breaks in career promotions, and monitor performance evaluation data and criteria to make sure they’re free from bias.</p>
<h2>4. Identify skills relevant to both parenting and work</h2>
<p>Parenthood is a period of <a href="https://www.taylorfrancis.com/books/e/9780429274336/chapters/10.4324/9780429274336-12">intensive informal training</a> when important transferable skills are developed. These include person-related skills (negotiation, perspective-taking), tangible skills (work scheduling, managing multiple demands) and personal resources (such as <a href="https://www.annualreviews.org/doi/abs/10.1146/annurev-orgpsych-032516-113324">“psychological capital”</a> – hope, self-efficacy, optimism and resilience). </p>
<p>Such personal strengths are essential for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0191886910003946">wellbeing</a>, job satisfaction and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118977620.ch3">performance</a>. Resilience would be a useful skill for a worker at any time, but the uncertainty and added stresses of the pandemic have made it especially important. </p>
<figure class="align-center ">
<img alt="A younger woman and an older woman sitting and talking at work" src="https://images.theconversation.com/files/354400/original/file-20200824-24-1jjw5li.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/354400/original/file-20200824-24-1jjw5li.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/354400/original/file-20200824-24-1jjw5li.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/354400/original/file-20200824-24-1jjw5li.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/354400/original/file-20200824-24-1jjw5li.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/354400/original/file-20200824-24-1jjw5li.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/354400/original/file-20200824-24-1jjw5li.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Mentoring can be done in person or remotely and with mentors inside or outside of the organisation.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/diverse-old-young-female-colleagues-talking-1332825527">fizkes/Shutterstock</a></span>
</figcaption>
</figure>
<p>Coaching or mentoring can help returning parents to identify that they have these unacknowledged skills that will help them in the current climate. Managers should help staff to recognise and use them. </p>
<h2>5. Make work-life balance a shared responsibility</h2>
<p>A workplace that promotes good work-life balance can have <a href="https://www.um.edu.mt/library/oar/bitstream/123456789/31996/1/ERSJ%2c_13%281%29_-_A14.pdf">tremendous benefits</a> for the health, wellbeing and performance of the whole workforce. Good work-life balance signals that an organisation cares for its people. </p>
<p>Formal policies on work-life balance are important – but alone are inadequate. Employers should go beyond formal policies to promote a family-friendly culture that is free of negative stereotypes, rich in collegiality, and supportive and inclusive of all employees.</p>
<p>A good first step for employers would be to let staff tailor how they get their work done according to their needs – for instance by setting their own hours and breaks. Known as <a href="https://hbr.org/2020/03/what-job-crafting-looks-like">“job crafting”</a>, this is a star ingredient for an <a href="https://positiveorgs.bus.umich.edu/wp-content/uploads/What-is-Job-Crafting-and-Why-Does-it-Matter1.pdf">engaged, productive and resilient workforce</a>. As well as contributing to staff wellbeing, this sort of flexibility is needed to handle the challenges of the pandemic too.</p><img src="https://counter.theconversation.com/content/143015/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Parents and managers can work together to plan ahead, avoid returnees feeling excluded and maintain a good work-life balance.Maria Karanika-Murray, Associate Professor in Occupational Health Psychology, Nottingham Trent UniversityCary Cooper, Professor of Organisational Psychology and Health, University of ManchesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1222802020-03-27T12:14:12Z2020-03-27T12:14:12ZScreen time that supports new parents and young kids can enhance family health<figure><img src="https://images.theconversation.com/files/323436/original/file-20200326-133027-10bwr7o.jpg?ixlib=rb-1.1.0&rect=0%2C307%2C4451%2C3351&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Babies don't come with instruction manuals... mobile health apps can help new parents.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/new-jersey-jersey-city-woman-texting-and-holding-royalty-free-image/525445885">Tetra Images via Getty Images</a></span></figcaption></figure><p>Screen time for little kids takes a lot of heat under normal conditions. The American Academy of Pediatrics’ official recommendations urge families to be <a href="https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Children-and-Media-Tips.aspx">thoughtful and judicious about screen time</a> for youngsters from birth to age five. And there is evidence that too much technology can lead to <a href="https://theconversation.com/why-its-wrong-for-pediatricians-to-eliminate-daily-screen-time-recommendations-49408">loss of child development opportunities</a>.</p>
<p>But technology can also connect families to important parenting and educational opportunities, especially at a time when people are sheltering in place and avoiding health care facilities for all but the most pressing concerns. The current generation of parents are <a href="https://doi.org/10.1007/978-3-662-46590-5_2">digital natives</a> themselves, having grown up in an era when internet was readily accessible. They often prefer technological solutions for their families.</p>
<p>We are <a href="https://scholar.google.com/citations?hl=en&authuser=2&user=DQ0Q4ekAAAAJ">a professor of social work</a> and <a href="https://keck.usc.edu/faculty-search/ashwini-lakshmanan/">a neonatologist</a> interested in how using internet-supported technologies – including apps, voice and text messaging, videoconferencing and e-learning platforms – can ease the parenting burden and promote healthy development. Reducing burdens on parents and increasing access to parent support are vital elements in helping families raise healthy children.</p>
<h2>Trusted info within arm’s reach</h2>
<p>Users can access apps, websites and programs from their cellphones or computers to receive information about medical tests, screenings and how to make healthier choices.</p>
<p>Phone apps can put trusted medical information right into a parent’s hand. Users can skip the hassle of having to visit a clinic or class. Health care providers recommend free apps like <a href="http://nicu2home.com">NICU2Home</a>, Providence Hospital Systems’ <a href="https://www.providence.org/services/circle-app">Circle</a> and March of Dimes’ <a href="https://www.marchofdimes.org/nicufamilysupport/my-nicu-baby-app.aspx">My NICU Baby</a> to their patients as sources of tips and helpful videos about how to care for a baby. The apps can help do things like track breastfeeding sessions, baby’s sleep patterns and baby’s weight; teach medical terminology; and connect families to others with similar experiences.</p>
<p>App can also provide task lists that ease a family’s transition from hospital to home with a newborn. For example, these apps can tell families about to be discharged from a NICU what supplies and special equipment they will need to have at home to support their baby after leaving the hospital. Having access to this information in an app, rather than a paper handout from a doctor, means it can be easily accessed on demand and won’t get lost in the shuffle of family life.</p>
<figure>
<iframe src="https://player.vimeo.com/video/310900917" width="500" height="281" frameborder="0" webkitallowfullscreen="" mozallowfullscreen="" allowfullscreen=""></iframe>
<figcaption><span class="caption">Children’s Hospital Los Angeles produced the Baby Steps LA app to help patient families.</span></figcaption>
</figure>
<p>One of us (Dr. Lakshmanan) created the app Baby Steps LA to help families and children with special health care needs at Children’s Hospital Los Angeles. The app includes information about how social factors like housing, insurance and food security can influence health and offers related resources.</p>
<p>There are also several apps that focus on the importance of peer support groups and how important they can be <a href="https://doi.org/10.1097/NMC.0000000000000489">for new mothers</a>. </p>
<p>Cellphones can potentially help new parents, even without specific apps installed. One study found that new mothers who received text messages with tips about breastfeeding and child development while enrolled in the Supplemental Nutrition Program for Women, Infants, and Children breastfed their children <a href="https://doi.org/10.1111/mcn.12488">more consistently and for a longer period of time</a>. </p>
<p>Text messaging chatbots like <a href="https://redtri.com/parentspark-interactive-chatbox-teach-you-to-be-better-parent/">ParentSpark</a> use artificial intelligence and user patterns to respond to parents’ queries on topics like feeding and exercise, helping inform their choices and teach new strategies.</p>
<p>Families can even turn to <a href="https://www.ncbi.nlm.nih.gov/pubmed/18999101">video games to help prepare them</a> for discharge from the hospital or to learn about medical conditions.</p>
<h2>Connecting to live experts via screens</h2>
<p><a href="https://www.healthit.gov/faq/what-telehealth-how-telehealth-different-telemedicine">Telehealth</a> is an important option for families with young children, because it expands access to medical, mental health and developmental care options, especially in areas where there are limited numbers of specialty providers. Parents and their children can videoconference with experts, reducing time spent traveling and in waiting rooms.</p>
<p>The expansion of <a href="https://www.healthrecoverysolutions.com/blog/telehealth-autism-diagnosis">autism services on telehealth platforms</a> is a prime example of how this technology can meet the needs of families with young children. Families can access screening, early diagnosis, applied behavior analysis, speech language pathology, parent training and overall treatment planning from home by logging into a videoconferencing platform and speaking to a live provider.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/ExMZtrH1Jm4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Live suggestions via on-screen interactions can help with parenting.</span></figcaption>
</figure>
<p>Families can also access parent support and parent training, including developmental assessments, using telehealth. One of us (Dr. Traube) designed a service called <a href="https://pat.usc.edu">Virtual Home Visitation</a> that gives families direct access to a parenting coach who guides them through activities that support their child’s development using videochat technology.</p>
<p>These services can be difficult to find in local communities. But, through weekly screen interactions with a parenting coach, families can promote their child’s development, ensure any developmental delays are quickly identified and find intervention options early.</p>
<h2>Online content aimed at kids</h2>
<p>Plenty of research indicates that <a href="https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Children-and-Media-Tips.aspx">young children should not</a> interact with video games or content to the exclusion of books or in the absence of an adult to coach them. </p>
<p>But thoughtfully built educational platforms can be a productive way for parents to use technology to support their child’s early learning. <a href="https://doi.org/10.1542/peds.2014-2251">When designed with child development research in mind</a>, content platforms offering games, e-books, and videos can help kids build motor, socio-emotional and cognitive skills, as well as help to reduce skill gaps in important foundational areas like color, letter and number recognition.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/323437/original/file-20200326-133001-1pfny1t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/323437/original/file-20200326-133001-1pfny1t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/323437/original/file-20200326-133001-1pfny1t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/323437/original/file-20200326-133001-1pfny1t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/323437/original/file-20200326-133001-1pfny1t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/323437/original/file-20200326-133001-1pfny1t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/323437/original/file-20200326-133001-1pfny1t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/323437/original/file-20200326-133001-1pfny1t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A crucial component in young children’s screen time is a parent’s close involvement and supervision.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/man-boy-and-young-girl-sitting-on-a-grey-sofa-royalty-free-image/910586842">Mint Images via Getty Images</a></span>
</figcaption>
</figure>
<p>For example, studies suggest that well-designed e-books can <a href="https://files.eric.ed.gov/fulltext/ED560635.pdf">support early literacy</a>. Thoughtful use of highlighting, or animating relevant parts of picture or text, and interactive features including dictionaries, word readouts or learning games can help with word learning and reading.</p>
<p>When parents assess e-learning platforms, they should <a href="https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Children-and-Media-Tips.aspx">evaluate them on the basis</a> of whether they are engaging, actively involve the child, have meaningful content, and demonstrate or encourage social interaction. Organizations including <a href="https://pbskids.org/">Public Broadcasting Service</a> and <a href="https://www.sesamestreet.org/">Sesame Workshop</a> focus on early childhood and have invested a lot of research into developing trustworthy e-platforms.</p>
<p><a href="https://doi.org/10.1056/NEJMp1713180">Over two-thirds of Americans use mobile health applications</a> and the iTunes and Android app stores offer more than 165,000 of them. All of these technologies offer health care providers an opportunity to meet families where they are whenever they need us. Done right, they could lead to sustainable improvements in child health and development.</p>
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<p class="fine-print"><em><span>Dorian Traube receives funding from the Overdeck Family Foundation, Gary Community Investments, Parsons Foundation, and Queenscare Foundation. </span></em></p><p class="fine-print"><em><span>Ashwini Lakshmanan receives funding from the Sharon D. Lund foundation and the Zumberge Diversity and Inclusion Award. She previously received funding from the National Institutes of Health, the Packard foundation for Children's Health and the Confidence Foundation.</span></em></p>Mobile health apps, teleconferencing with experts and thoughtfully designed educational platforms can all help families during the chaotic and confusing early years.Dorian Traube, Associate Professor of Social Work, University of Southern CaliforniaAshwini Lakshmanan, Assistant Professor of Clinical Pediatrics, University of Southern CaliforniaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1083232019-02-20T11:38:34Z2019-02-20T11:38:34ZPaid family leave is an investment in public health, not a handout<figure><img src="https://images.theconversation.com/files/259179/original/file-20190214-1751-uhky3n.jpg?ixlib=rb-1.1.0&rect=724%2C0%2C4500%2C3050&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Protected time for new families could pay health dividends later.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/parents-their-newborn-baby-boy-on-729856267">Jacob Lund/Shutterstock</a></span></figcaption></figure><p>Most Americans – <a href="https://www.nationalreview.com/corner/the-president-and-women-in-white-have-paid-leave-in-common/">on both sides of the political aisle</a> – <a href="http://fortune.com/2016/04/15/an-overwhelming-majority-of-americans-support-paid-parental-leave/">say they support</a> <a href="https://www.huffingtonpost.com/entry/ivanka-paid-parental-leave-hearing_us_5b467744e4b022fdcc55b790">paid parental leave</a>. However, we haven’t yet found the political will to make it happen. In part, that’s because the discussion always seems to start with the question, “<a href="https://www.nytimes.com/2019/01/06/upshot/a-california-dream-for-paid-leave-has-an-old-problem-how-to-pay-for-it.html">How do we pay for it</a>?” </p>
<p>That question goes only halfway, though. <a href="https://scholar.google.com/citations?user=q676bXMAAAAJ&hl=en&oi=ao">As a researcher who focuses on stress and health within families</a>, I believe there’s a more important question to ask: “How do we pay for the lack of parental leave?” In other words, how does the stress of a rapid return to work affect parents, and in turn, cost society as a whole? Recently, I <a href="http://dx.doi.org/10.1037/amp0000376">sought to answer this question</a> by <a href="https://doi.org/10.31234/osf.io/64f37">delving into research</a> on the many changes that new parents experience in the first weeks, months, and years after the birth of a new child – and the possibility that all these changes might not just compromise children’s well-being, but also put parents’ long-term health at risk. </p>
<h2>A global outlier</h2>
<p>How fast should women “bounce back” after giving birth? Instantly, at least according to celebrity magazines. And many workplaces in the United States deliver the same message. The typical American maternity leave <a href="https://www.today.com/health/two-weeks-after-baby-more-new-moms-cut-maternity-leave-4B11229443">lasts only 10 weeks</a>, and a quarter of new mothers <a href="http://inthesetimes.com/article/18151/the-real-war-on-families">return to work within two weeks</a> of delivering a child.</p>
<p><iframe id="TJFvx" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/TJFvx/3/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>The U.S. is <a href="https://www.worldpolicycenter.org/policies/is-paid-leave-available-to-mothers-and-fathers-of-infants/is-paid-leave-available-for-fathers-of-infants">one of the only countries in the world</a> that does not <a href="https://www.npr.org/sections/itsallpolitics/2015/07/15/422957640/lots-of-other-countries-mandate-paid-leave-why-not-the-us">guarantee paid leave to new parents</a>. The 1993 Family Medical and Leave Act provides for unpaid leave – but almost half of U.S. workers are not eligible, and many cannot afford time off without pay. Compare this to the rest of the globe, where <a href="https://www.thisisinsider.com/maternity-leave-around-the-world-2018-5">paid maternity leave is standard</a>, averaging 18 weeks internationally and extending beyond six months in many developed countries.</p>
<h2>New parent stress, long-term effects?</h2>
<p><a href="https://doi.org/10.1093/oxfordhb/9780190628963.013.23">Economists have examined paid family leave policies</a> and measured their impact on worker retention and productivity, as well as health outcomes. But their studies typically focus on population-level trends. As a psychologist whose work takes a more intimate look at family processes, I wondered: How does the stress of work-family conflict affect the well-being of new parents?</p>
<p>I reached out to Stanford economist and family leave policy expert <a href="https://scholar.google.com/citations?user=vuOKLC4AAAAJ&hl=en&oi=ao">Maya Rossin-Slater</a> to help digest the body of research on health and family leave. Together with developmental neuroscientist Diane Goldenberg, we reviewed existing studies and proposed future directions for research and policy in a <a href="http://dx.doi.org/10.1037/amp0000376">recent paper published in American Psychologist</a>. </p>
<p>Psychologists already know that the transition to parenthood is a high-risk time for <a href="https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml">mental health problems</a> like anxiety and depression. New parents are about <a href="https://www.postpartumdepression.org/resources/statistics/">twice as likely to report clinically significant depression</a> as are adults at other life stages.</p>
<p>Physical health risks may worsen during this time as well. For example, obesity: <a href="https://www.fitpregnancy.com/pregnancy/pregnancy-health/how-pregnancy-weight-gain-could-contribute-obesity-epidemic">many mothers gain in excess</a> of physician-recommended weight guidelines during pregnancy, and may struggle to <a href="https://www.laboratoryequipment.com/article/2019/01/changes-metabolism-lead-postpartum-weight-gain">lose this weight after birth</a>. New fathers also gain weight: <a href="https://digest.bps.org.uk/2018/07/25/weight-gain-in-new-fathers-is-a-real-phenomenon-thats-been-subjected-to-a-striking-lack-of-research/">“Dad bod” is real</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/258587/original/file-20190212-174873-k8rl48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/258587/original/file-20190212-174873-k8rl48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/258587/original/file-20190212-174873-k8rl48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/258587/original/file-20190212-174873-k8rl48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/258587/original/file-20190212-174873-k8rl48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/258587/original/file-20190212-174873-k8rl48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/258587/original/file-20190212-174873-k8rl48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/258587/original/file-20190212-174873-k8rl48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Dads have big adjustments during this transition, too.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/0mRerwRVqVA">Zach Vessels/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Stress influences both mental health and weight gain, and may also <a href="https://www.sciencedaily.com/releases/2012/04/120402162546.htm">affect immune and inflammatory processes</a> that can contribute to long-term health risks. Costly chronic diseases like heart disease and cancer drain the economy, and yet few researchers have zeroed in on the transition to parenthood as a potential inflection point in risk for these diseases. Are these risks magnified when parents lack protected time to recover from birth and adjust to parenthood? If so, the U.S. may be setting up new parents – and especially low income parents – to fail. </p>
<p>In making sense of the research that speaks to health in parents, we started by first identifying what changes over the transition to parenthood in order to spotlight potential areas of vulnerability.</p>
<h2>Neurobiological changes</h2>
<p>At the neurobiological level, researchers are finding that new parents’ hormones and brains may be particularly changeable – what scientists call plastic.</p>
<p>Research on rodents has found that <a href="https://doi.org/10.1038/nrn2280">pregnancy hormones remodel the maternal rat brain</a>, helping prep the mother-to-be for infant care. Human mothers also show dramatic changes in hormones across pregnancy and the postpartum period. One neuroimaging study scanned women pre-pregnancy and then tracked them over several years, scanning them again after childbirth. Surprisingly, <a href="https://www.scientificamerican.com/article/pregnancy-causes-lasting-changes-in-a-womans-brain/">women’s brains actually shrunk</a> over the transition to motherhood, showing reductions in volume particularly in areas linked with social cognition. Pruning may have helped these areas work more efficiently to support caregiving, since women who lost more brain volume also reported stronger attachment to their infants. </p>
<p>Fathers may also undergo neurobiological transformation across the transition to parenthood. Studies have found <a href="https://theconversation.com/postpartum-depression-can-affect-dads-and-their-hormones-may-be-to-blame-81310">decreased testosterone in new dads</a> and <a href="https://doi.org/10.1080/17470919.2014.933713">changes in men’s brain volume</a> in early parenthood, for example. </p>
<p>These neurobiological changes may shape parents’ long-term health, although research evidence is still scant. Scientists also don’t know much about how stress affects the neural and hormonal changes that can accompany parenthood. But what we do know is that new parents are undergoing big biological changes, making this time a sensitive window for the brain. </p>
<h2>Psychological and social change</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/258354/original/file-20190211-174857-1wgult6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/258354/original/file-20190211-174857-1wgult6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/258354/original/file-20190211-174857-1wgult6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/258354/original/file-20190211-174857-1wgult6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/258354/original/file-20190211-174857-1wgult6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/258354/original/file-20190211-174857-1wgult6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/258354/original/file-20190211-174857-1wgult6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/258354/original/file-20190211-174857-1wgult6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A new baby can come with a lot of shocks to the system.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/XHF_paR2PUE">Jessica To'oto'o/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
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<p>Although many parents eagerly await the arrival of their new baby, becoming a parent can also be challenging, isolating and even overwhelming. Infants require constant care, which can be cognitively and emotionally taxing and physically exhausting. For parents who must return to work soon after birth, the scramble to find trustworthy childcare can also take a financial toll. </p>
<p>Large studies have found that <a href="https://theconversation.com/have-children-heres-how-kids-ruin-your-romantic-relationship-57944">well-being takes a dip</a> during early parenthood; one found that becoming a parent spurred a <a href="https://doi.org/10.1007/s13524-015-0413-2">larger decline in happiness</a> than events like divorce, unemployment or the death of a partner. <a href="https://www.psychologytoday.com/us/blog/home-base/201602/can-you-babyproof-your-relationship">Couples’ relationship satisfaction also nosedives</a> in the postpartum period, as they adjust to new roles and responsibilities.</p>
<p>All of these psychological changes may set parents up for heightened mental health risk, reflected in the elevated prevalence of depression and anxiety during this time. </p>
<h2>Behavioral change</h2>
<p>Parents’ everyday routines are upended after a baby’s arrival.</p>
<p>Take sleep. Anyone who has lived with an infant knows they wake up often at night. It’s been estimated that <a href="https://doi.org/10.1093/aje/kws246">parents lose about 80 hours</a> of sleep a year for the first few years of a child’s life. Fathers may actually <a href="https://www.npr.org/sections/health-shots/2016/04/05/473002684/for-new-parents-dad-may-be-the-one-missing-the-most-sleep">wind up more sleep-deprived than mothers</a>, in part because they return to the workplace sooner. </p>
<p>New parents also report <a href="https://doi.org/10.1542/peds.2010-3218">lower levels of physical exercise, may eat less healthy diets</a> and have fewer opportunities to pursue hobbies and get together with friends. Given that sleep, exercise and other healthy routines are strongly linked with well-being, these changes might help explain why new parents show heightened health risks across so many domains. In particular, scientists know that poor sleep increases vulnerability to <a href="https://doi.org/10.1016/j.beem.2010.07.001">disease</a>, <a href="https://doi.org/10.1093/sleep/28.10.1289">obesity</a> and <a href="https://doi.org/10.1002/da.1041">mood disorders</a>, so sleep deprivation in the postpartum period may be a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1160560/">key driver</a> of the risks that new parents experience. </p>
<h2>Risk and vulnerability</h2>
<p>So what can one conclude from all of this research? Like many windows of dynamic developmental change, the transition to parenthood is a time of transformation that can spur growth – but also brings vulnerability.</p>
<p>Changes in stress physiology, <a href="https://doi.org/10.1001/jama.298.14.1685">obesity, inflammation</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181963/">mental health</a> contribute to a <a href="https://doi.org/10.1001/jama.298.14.1685">cascade of risks that predict costly cardiac and metabolic diseases</a> down the road. Paid family leave requires significant investment, but might save taxpayers money if it lessens the burden of these chronic diseases on the economy. And our review focused on parents’ health in adulthood, not even scratching the surface of the potential benefits to children that paid family leave policy can bring. For example, mothers with access to leave <a href="https://doi.org/10.1111/birt.12230">breastfeed longer</a>, and family leave has been linked with lower rates of <a href="https://doi.org/10.1002/pam.22012">ADHD and obesity in young children</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/259181/original/file-20190214-1754-1yh94n0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/259181/original/file-20190214-1754-1yh94n0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/259181/original/file-20190214-1754-1yh94n0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/259181/original/file-20190214-1754-1yh94n0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/259181/original/file-20190214-1754-1yh94n0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/259181/original/file-20190214-1754-1yh94n0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/259181/original/file-20190214-1754-1yh94n0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/259181/original/file-20190214-1754-1yh94n0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Investment in family leave now, payoffs in better health later?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/asian-parents-newborn-baby-close-portrait-733313083">paulaphoto/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Research finds that <a href="https://www.webmd.com/balance/news/20180504/loneliness-rivals-obesity-smoking-as-health-risk">loneliness is worse for your health</a> than smoking cigarettes, suggesting that connections with others may play a profound role in population health. Public health investment has led to <a href="https://www.usatoday.com/story/news/nation/2018/06/18/smoking-united-states-cigarette-sales/713002002/">dramatic declines in smoking</a> over the last four decades, but hasn’t yet truly tackled <a href="https://doi.org/10.1037/amp0000103">social cohesion as a public health challenge</a>. What better place to start than by facilitating the first and arguably most important set of social connections – those that blossom within a new family.</p>
<p>This topic is personal for me. When my first child was born, I was a psychotherapy intern at a veterans hospital. As a federal employee, I didn’t qualify for state disability and, as a contract employee, couldn’t access Department of Veterans Affairs leave. My husband, a freelancer, could not take time off without losing income, and I couldn’t quit my job – we needed the health insurance. My wonderful supervisors let me take unpaid time off. But money was tight. Nearby daycares had yearlong wait lists and cost half our combined income. I’m an Ivy League grad with a doctorate, one of the lucky ones, but could barely afford the cost of having a child in the United States. </p>
<p>It doesn’t have to be this way. If Americans reconceptualize parents as a precious national resource, child-rearing as an enterprise that secures the long-term future of the U.S. economy and the transition to parenthood as a window for long-term health, then we can decide as a society that family leave is worth the investment. And there is hope on the horizon: Less than a year after Tammy Duckworth became the <a href="https://chicago.suntimes.com/news/tammy-duckworth-birth-girl-first-senator-have-baby-maile-pearl-bowlsbey-office/">first senator to give birth while in office</a>, the 2018 midterm elections <a href="https://www.workingmother.com/number-working-moms-in-congress-will-double-in-2019">doubled the number of working mothers in Congress</a>. When President Trump mentioned paid family leave in his <a href="https://www.foxbusiness.com/politics/at-sotu-trump-says-federal-budget-will-include-paid-family-leave">State of the Union address</a>, legislators from both parties applauded – a rare moment of unity in an otherwise divided Congress. At long last, the United States’ status as a global outlier on family leave policy may be coming to an end.</p><img src="https://counter.theconversation.com/content/108323/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Darby Saxbe receives funding from the National Science Foundation. </span></em></p>The transition to parenthood comes with plenty of stress. A psychology researcher suggests that paid family leave could help lift some of the burden – with positive health benefits down the road.Darby Saxbe, Assistant Professor of Psychology, USC Dornsife College of Letters, Arts and SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1004322018-08-22T10:36:36Z2018-08-22T10:36:36ZHow many babies in the US are wanted? Why it’s so hard to count unintended pregnancy<figure><img src="https://images.theconversation.com/files/231696/original/file-20180813-2906-skea7q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Demographers struggle to measure unintended fertility.</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/woman-pregnant-in-black-and-white-striped-shirt-standing-near-bare-tree-952597/">Leah Kelley/pexels</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Do you know the story about your conception? I do. According to my parents, I was the “best mistake” they ever made. I wouldn’t suggest asking your parents, because you might hear something that you aren’t happy about. My parents’ answer included a contraceptive failure and a washing machine.</p>
<p>My personal story is fairly common – the unintended birth, not the washing machine. In the mid to late 2000s, <a href="https://www.cdc.gov/nchs/data/nhsr/nhsr055.pdf">an estimated 37 percent of births were unintended</a>. Twenty-three percent were mistimed, like me: My parents wanted to have a child at some point, but not then. The rest were unwanted. </p>
<p>However, unintended births are hard to count. It’s very difficult to measure whether a conception was intended. But having the data is important: Accurate measurements of unintended fertility allow researchers to assess population growth, women’s reproductive autonomy and the impacts of unintended births. It can also show how policy changes affect unintended pregnancy. For example, if Roe v. Wade were to be overturned, researchers would want to understand the impact on fertility.</p>
<p>Researchers who want to know what couples are thinking at conception have two major strategies: asking women years before or sometime after pregnancy. But both strategies have substantial flaws. This highlights how difficult it is to measure theoretical concepts – especially such emotional and complex ones as the decision to have a baby.</p>
<h2>Differing measurements</h2>
<p>Figuring out what people are thinking right before they got pregnant is difficult without surveyors constantly knocking on bedroom doors.</p>
<p>Because it’s invasive, costly and just plain weird and impossible to pursue women at the moment they become pregnant, many demographers ask women after they’ve become pregnant or had a child. For example, <a href="https://www.cdc.gov/prams/pdf/questionnaire/Phase-8-Core-Questions-508.pdf">one government survey</a> asks, “Thinking back to just before you got pregnant with your new baby, how did you feel about becoming pregnant?” Intended births include mothers who reported they wanted to become pregnant then or sooner. Unintended births include both mistimed (i.e., “I wanted to be pregnant later”) and unwanted births (i.e., “I didn’t want to be pregnant then or at any time in the future”). </p>
<p>But there are some problems with retrospective questions. Researchers suspect that women may rationalize their past behavior by providing a socially desirable response or one that reflects their current situation or worldview. After women become emotionally attached to their baby, they may not want to say their baby was mistimed or unwanted. It’s easy to imagine a woman who is happy in her role as a mother – or believes she should be – saying that she wanted a child at conception even if she actually didn’t. The opposite could also occur. My colleague and I found <a href="http://dx.doi.org/10.4054/DemRes.2018.39.3">evidence for both types of rationalization</a>, though the former was more common.</p>
<p>Some demographers suggest asking before conception. This means asking people about their intent to have children in the future, then <a href="http://dx.doi.org/10.1353/dem.2007.0043">looking at what happens later</a>. If someone said she didn’t want another baby but had one later, then that birth would be considered unwanted.</p>
<p>In this prospective strategy, women have fewer reasons to misreport, so this might provide a better estimate of intent at conception. Indeed, this method suggests that the percent of unwanted births is much higher: 26 percent, as opposed to the 9 percent estimated through <a href="http://dx.doi.org/10.4054/DemRes.2018.39.3">retrospective measures</a>.</p>
<p>But the prospective strategy is also flawed. Women could have changed their minds between their answer and conception. In the <a href="https://www.bls.gov/nls/nlsy79.htm">data used in my research</a>, women were asked the prospective question every two years. A lot can change in two years. While retrospective measures underestimate unwanted births, prospective measures overestimate unwanted births.<br>
An issue of both strategies is that women may not have certain unambiguous intentions or preferences at conception. People could have both <a href="https://doi.org/10.1363/4423612">strong positive and strong negative feelings</a> about having a child or <a href="http://dx.doi.org/10.1553/populationyearbook2011s99">feel uncertain</a> at conception. Intentions <a href="https://www.guttmacher.org/journals/psrh/1999/09/forum-intended-pregnancies-and-unintended-pregnancies-distinct-categories-or">might not be discrete categories, instead existing on a continuum</a>. And there might be <a href="http://dx.doi.org/10.1023/A:1009575514205">different aspects of intentions</a>, such as how much planning someone does for a baby and how happy someone is about a pregnancy.</p>
<p>Perhaps the most vexing assumptions of both strategies is that women have conscious intentions or preferences at the time of conception. Certainly, for some, childbearing is a conscious decision. But others may have motivations that are not connected to a conscious intent for childbearing. For example, <a href="https://doi.org/10.1007/s10461-005-3902-2">not using condoms can signify trust</a> between partners. Some couples who have unconscious desires for a child may not use birth control consistently or effectively, but others may be guided by different motivations. People start to <a href="http://doi.org/10.1007/s11113-016-9395-z">think consciously about childbearing</a> over time, in tandem with developments in other domains such as relationships and work, but some people get pregnant before they’ve made fertility plans. </p>
<h2>A better way?</h2>
<p>Should demographers keep on trying to measure unintended fertility? Some may say the best way to push forward is to abandon this concept because it’s constraining researchers’ thinking about fertility decision-making. </p>
<p>However, retrospective questions have been helpful in a lot of ways. They highlight <a href="https://doi.org/10.1016/j.contraception.2011.07.013">socioeconomic and racial or ethnic disparities</a>, as well as a link between unintended pregnancy and <a href="https://pdfs.semanticscholar.org/b353/b02ae6cad716a7f64ca48b3edae63544c03e.pdf">poor health</a>. Even if retrospective measures don’t quite capture what demographers want to know, they can help pinpoint women who might need some extra help coping after birth.</p>
<p>There may be yet another, better way to measure intended fertility. It would require a careful balance. If the measure isn’t complex enough, we might miss how people really make decisions about fertility. If it’s too complex, it can become incomprehensible. </p>
<p>More broadly, researchers need to decide how much error they’re willing to tolerate. Many theoretical concepts are measured in ways that might not completely reflect the underlying concept. Social scientists need to interrogate important concepts like unintended fertility, but also need to use clear measures that adequately capture reality – even if they aren’t perfect.</p><img src="https://counter.theconversation.com/content/100432/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather M. Rackin does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>It’s very difficult to measure whether a conception was intended. But those data are vital to understanding women’s choices.Heather M. Rackin, Assistant Professor of Sociology, Louisiana State University Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/898752018-01-30T14:49:03Z2018-01-30T14:49:03ZDoes having children make us care more about the environment?<figure><img src="https://images.theconversation.com/files/203980/original/file-20180130-107676-13p5oa5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Happy families.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/334715429?src=YHEtgJ7v5vO4NmQcJ8Bvfw-1-87&size=huge_jpg">Shutterstock</a></span></figcaption></figure><p>Psychologists have long been looking into the <a href="https://doi.org/10.1080%2F13504620220145401">gap between our intentions and behaviour</a> when it comes to the environment. Many of us say that we are <a href="https://orca.cf.ac.uk/98660/7/EPCC.pdf">concerned about climate change</a>, for example, and yet few take any action beyond <a href="http://rsta.royalsocietypublishing.org/content/375/2095/20160376">household recycling</a>.</p>
<p>Researchers think that one of the main barriers to action may be <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1539-6924.2011.01695.x/full">psychological distance</a>. The most severe impacts of climate change will not be felt by us, but by <a href="https://theconversation.com/inaction-on-climate-change-risks-leaving-future-generations-530-trillion-in-debt-81134">future generations</a>, and it can be difficult for us to consider the long-term consequences of our day-to-day actions.</p>
<p>So what could make us care more about how our behaviour risks the future of the environment? Perhaps having someone whose future we are invested in reminds us that the world will continue long after we are gone? It is possible that having children can bridge the distance between ourselves and the future. And maybe, just maybe, children, as an extension of ourselves, can make us think more about the next generation and the world we are leaving for them. </p>
<p>It sounds like a promising theory – but <a href="http://dx.doi.org/10.1007/s11111-017-0291-1">our latest research</a> has found that this is not necessarily the case.</p>
<h2>Positive legacy</h2>
<p>Wanting to leave a positive legacy for future generations is one of the key stages of psychologist Erik Erikson’s <a href="https://books.google.co.uk/books?hl=en&lr=&id=SKidSuluprgC&oi=fnd&pg=PP2&dq=Erikson,+E.+H.+(1950).+The+life+cycle+completed.+New+York:+Norton.&ots=E60iywJiIH&sig=36bwqGDGaDOfBaa3bORy6e0FhuE#v=onepage&q=Erikson%2C%20E.%20H.%20(1950).%20The%20life%20cycle%20completed.%20New%20York%3A%20Norton.&f=false">theory of psychosocial development</a>. It may be that by having children we may not only consider the material or financial legacy we are leaving them, but also the quality of their environment. This is what we call the “<a href="http://dx.doi.org/10.1007/s11111-017-0291-1">legacy hypothesis</a>”.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/203982/original/file-20180130-107683-60zbll.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/203982/original/file-20180130-107683-60zbll.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=412&fit=crop&dpr=1 600w, https://images.theconversation.com/files/203982/original/file-20180130-107683-60zbll.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=412&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/203982/original/file-20180130-107683-60zbll.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=412&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/203982/original/file-20180130-107683-60zbll.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=518&fit=crop&dpr=1 754w, https://images.theconversation.com/files/203982/original/file-20180130-107683-60zbll.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=518&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/203982/original/file-20180130-107683-60zbll.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=518&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Green hands.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/concept-generation-development-elderly-man-baby-529502029?src=YHEtgJ7v5vO4NmQcJ8Bvfw-1-66">Shutterstock</a></span>
</figcaption>
</figure>
<p>And parenthood, and the way we think about the future, can affect the way we feel about the environment. We know that focusing on the future makes us <a href="http://doi.org/10.1080/00207594.2011.647029">care more about environmental protection</a>. In one study, researchers found that asking people explicitly about <a href="http://journals.sagepub.com/doi/abs/10.1177/0956797614561266">the legacy they would like to leave</a> for future generations increased their concern about climate change and other environmental problems. In another, they found that <a href="http://doi.org/10.1111/j.0272-4332.2004.00415.x">asking participants to take a parental role perspective</a> did the same.</p>
<p>There is however little direct evidence that becoming a parent changes our environmental attitudes and behaviour. Although some have found a “motherhood effect” – where mothers show greater concern about the environment <a href="https://www.econbiz.de/Record/sociological-perspectives-official-journal-of-the-pacific-sociological-association/10000349458">than fathers</a> – these differences are often explained by the perceived <a href="https://theconversation.com/does-becoming-a-mother-make-women-greener-19390">social role of women</a> as nurturers and carers of children. </p>
<h2>A false hypothesis?</h2>
<p>In our study, we set out to test the idea that having children can make people care more about the environment. Using data from the <a href="https://www.understandingsociety.ac.uk/">Understanding Society survey</a> – collected over the course of three years from 40,000 UK households – we looked at whether people who had new children changed their environmental attitudes and behaviour, compared to those who did not have new children in the same period.</p>
<p>We found that having a new child actually decreased people’s environmental attitudes and behaviour – although these changes were very small. Even among first-time parents and first-time mothers, we found a small number of negative changes. These groups were less likely to wear more clothes instead of more heating, use public transport, or share a car with others.</p>
<p>Only first-time parents who were already concerned about the environment had a small increase in their desire to have a greener lifestyle, but this did not lead to any actual changes in behaviour.</p>
<p>Although our results show that people may not naturally become more concerned about the environment after having a new child, it must be said that becoming a parent brings various changes that make it more difficult to act in an environmentally friendly way. Parenthood can change a person’s entire outlook, as the child’s immediate well-being becomes the central focus in one’s life. And any parent can tell you about the time crunch that comes with looking after a newborn. So it’s understandable that we may want to drive more, or turn up the heating, in order to look after our little ones.</p>
<p>What all of this means is that we cannot just assume being a parent will make people care more about the environment. Though they may be more receptive to climate change messages, parents need to be as conscious as everyone else about their actions. We already know that the transition to parenthood is a good time to form new and <a href="https://theconversation.com/moving-house-can-make-you-healthier-happier-and-greener-too-59108">more sustainable habits</a> but it will have to be an active effort on their part.</p><img src="https://counter.theconversation.com/content/89875/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gregory Thomas receives funding from the ESRC. </span></em></p><p class="fine-print"><em><span>Wouter Poortinga receives funding from the ESRC, National Institute for Health Research, the Leverhulme Trust, Welsh Government, and Carmarthenshire County Council. </span></em></p>Parents only want the best for their children, but caring for the environment doesn’t happen overnight.Gregory Thomas, Research associate, Environmental and Social Psychology, Cardiff UniversityWouter Poortinga, Professor of Environmental Psychology, Cardiff UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/893572018-01-22T11:28:19Z2018-01-22T11:28:19ZWhen a mom feels depressed, her baby’s cells might feel it too<figure><img src="https://images.theconversation.com/files/202172/original/file-20180116-53307-epjvhk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">At just 18 months old, young children can show biological evidence of added stress.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/little-boy-kid-blue-jeans-crying-297378290?src=G6FVz2rzEYQtdFqhHufgMg-1-28">Coy_Creek/shutterstock.com</a></span></figcaption></figure><p>An estimated <a href="https://www.cdc.gov/reproductivehealth/depression/index.htm">1 in 9 women</a> experience symptoms of postpartum depression. These symptoms – including mood swings, fatigue and reduced interest in activities – can make it difficult for mothers to bond with their newborns.</p>
<p>Early relationships between mothers and their infants can <a href="https://doi.org/10.1001/jama.2009.754">influence health</a> across the lifespan, for better or worse. For example, adults who report more household dysfunction and abuse during their childhood are <a href="https://doi.org/10.1016/S0749-3797(98)00017-8">more likely to suffer disease as adults</a>. Those with healthy and supportive relationships during early life <a href="https://www.ncbi.nlm.nih.gov/pubmed/11931522">are better at handling stress and regulating their emotions</a>.</p>
<p>However, scientists do not completely understand how these environments get “under the skin” to <a href="http://doi.org/10.1126/scisignal.2003580">shape health</a>. Our <a href="https://doi.org/10.1016/j.psyneuen.2017.11.008">2017 paper</a> showed a possible link between increasing depression symptoms in mothers and cellular damage in their infants.</p>
<h2>Telomeres and health</h2>
<p>How does stress affect our cells? One area of burgeoning research focuses on <a href="https://www.nature.com/articles/490169a">telomeres</a>. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/202463/original/file-20180118-158513-1l0h5mr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/202463/original/file-20180118-158513-1l0h5mr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/202463/original/file-20180118-158513-1l0h5mr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=639&fit=crop&dpr=1 600w, https://images.theconversation.com/files/202463/original/file-20180118-158513-1l0h5mr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=639&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/202463/original/file-20180118-158513-1l0h5mr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=639&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/202463/original/file-20180118-158513-1l0h5mr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=803&fit=crop&dpr=1 754w, https://images.theconversation.com/files/202463/original/file-20180118-158513-1l0h5mr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=803&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/202463/original/file-20180118-158513-1l0h5mr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=803&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The 46 human chromosomes are shown in blue, with the telomeres appearing as white pinpoints.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/nihgov/24190672366/">NIH Image Gallery</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>Telomeres are caps at the end of our DNA that protect chromosomes. They’re analogous to the plastic tips at the end of shoelaces that keep laces from unraveling. In essence, these plastic caps keep laces functional. The same can be said of your telomeres.</p>
<p>Since the length of telomeres is affected by our genetics and age, they’re sometimes thought of as part of a “biological clock” that reflects the age of our cells. As telomeres shorten over time, people are more likely to experience a host of <a href="https://www.nature.com/articles/490169a">negative health outcomes</a>, such as cardiovascular disease, dementia, diabetes, cancer, obesity and <a href="https://doi.org/10.1093/jnci/djv074">even death</a>.</p>
<p>Interestingly, telomeres can degrade more quickly when a person suffers from <a href="https://doi.org/10.1111/j.1467-8721.2009.01596.x">psychological stress</a>. When we experience stress, our bodies release a hormone called cortisol, which influences our emotional responses as well as our energy metabolism, learning and memory. This may be one <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557830/">mechanism</a> that connects psychological stress to telomere length and ultimately physical health. Cells that are exposed to cortisol have shorter telomeres and <a href="https://doi.org/10.1016/j.bbi.2007.12.004">less telomerase</a>, which is the enzyme responsible for maintaining the ends of telomeres. </p>
<p>This process may explain how psychological stress is converted to biological “wear and tear.” Indeed, <a href="https://www.nature.com/articles/mp2014119">adolescents with depressed mothers</a> have heightened cortisol stress responses and shorter telomeres than their peers, even when the adolescents themselves are not depressed.</p>
<h2>Our study</h2>
<p>We examined whether increasing maternal depressive symptoms affected infant stress and later cell health. </p>
<p>Infancy is a sensitive period, when individuals are strongly influenced by their environment. One way to study how early stress may influence health is to look at how infants respond to their parents’ stress. Studies suggest that infants exposed to maternal depression may be <a href="https://doi.org/10.1097/CHI.0b013e3181b21651">less likely to engage socially and experience more negative emotion</a>.</p>
<p>For our study we recruited 48 mothers with 12-week-old infants and followed these families until the infants were 18 months old. At 6 and 12 months of age, the infants were brought to the lab to engage in mildly stressful tasks. For example, in the “still face experiment,” mothers alternated between playing with their infant and not reacting to their infant’s bids for attention. This can <a href="https://www.washingtonpost.com/blogs/she-the-people/wp/2013/09/16/affects-of-child-abuse-can-last-a-lifetime-watch-the-still-face-experiment-to-see-why/">elicit stress</a> in infants, as they rely on their caregivers to not only feed them, but to also soothe their emotions.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/apzXGEbZht0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">An example of the ‘still face experiment.’</span></figcaption>
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<p>During each visit, we measured infants’ stress by collecting saliva samples to look at changes in cortisol. We also collected information on how many depression symptoms mothers were feeling. Finally, when the infants were 18 months of age, we brought the families back into our lab and collected saliva to measure the length of the infant’s telomeres.</p>
<p>Worsening depression symptoms in mothers related to greater infant cortisol stress responses between 6 and 12 months of age. In addition, infants with higher cortisol stress responses were more likely to have shorter telomeres at 18 months of age, indicating greater cellular wear and tear.</p>
<h2>Better mental health</h2>
<p>While these findings are preliminary and should be replicated with a larger group of infants, our results highlight how patterns of health across the lifespan may be influenced in the first 18 months of life. This early stress may put young children on track for the early onset of poor health outcomes. </p>
<p>The silver lining is that infancy is a sensitive developmental period, when humans are especially responsive to their environments. Fostering positive experiences between infants and their mothers – as well as providing affordable, scientifically supported treatment services for mothers experiencing depression – may allow infants to move toward a healthier life trajectory.</p>
<p>In our view, these results show how important it is to fund effective maternal mental health treatment and early childhood policies.</p><img src="https://counter.theconversation.com/content/89357/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Benjamin W. Nelson received funding from the Mind and Life Institute to conduct this research.</span></em></p><p class="fine-print"><em><span>Heidemarie Laurent received funding from the Society for Research on Child Development to conduct this study.</span></em></p><p class="fine-print"><em><span>Nick Allen does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>At less than 2 years old, children of mothers with increasing depressive symptoms can show signs of added stress and quicker cellular aging.Benjamin W. Nelson, Doctoral Student in Clinical Psychology, University of OregonHeidemarie Laurent, Assistant Professor of Psychology, University of Illinois at Urbana-ChampaignNick Allen, Professor of Psychology and Director of the Center for Digital Mental Health, University of OregonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/839922017-09-15T13:36:28Z2017-09-15T13:36:28ZAre baby advice books making mothers depressed and anxious?<figure><img src="https://images.theconversation.com/files/186208/original/file-20170915-8102-63ggqp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Seeking advice.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/pregnant-woman-belly-reading-book-expecting-658482742?src=Z9oGtEYKntM_gd4E5zM0fw-1-2">A and I Kruk/Shutterstock</a></span></figcaption></figure><p>Becoming a new parent certainly ranks up there in the exhaustion and anxiety stakes. Countless parents find themselves questioning at 3am whether their baby is feeding too much, if they should be sleeping through the night by now, and wondering if there is anything else they should be doing differently. Social media posts <a href="http://www.newstatesman.com/internet/2013/07/babies-are-brilliant-whats-behind-increasing-trend-social-media-baby-bragging">often boast</a> of sleeping, contented babies while in reality many parents feel unable to put their baby down. Some want a miracle solution – and quickly. </p>
<p>Ever since the publication of Dr Benjamin Spock’s multi-million selling baby and childcare title, the <a href="http://www.bbc.co.uk/news/world-us-canada-14534094">Common Sense Book of Baby and Child Care</a>, countless self-proclaimed experts have purported incredible solutions for infant sleep, feeding and care. Generations of parents have turned to books such as Dr Spock’s for advice over the years, but the thing is – beyond anecdotal evidence – we don’t actually know whether these books work.</p>
<p>The elephant in the room with many of these books is that actually, despite their popularity, they are not based on evidence. Some of them actually go against what we know about promoting <a href="http://www.psy.miami.edu/faculty/dmessinger/c_c/rsrcs/rdgs/attach/ainsworth.1979.amer_psych.pdf">positive, healthy infant attachment</a>, well-being and health. In fact <a href="http://www.tandfonline.com/doi/abs/10.1080/03004430.2017.1378650?journalCode=gecd20">our recent research</a> has suggested that some books’ impact on maternal well-being is not good, and that there is a link between their use and an increased likelihood of symptoms of depression and anxiety.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/186207/original/file-20170915-8121-xkrvaq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/186207/original/file-20170915-8121-xkrvaq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/186207/original/file-20170915-8121-xkrvaq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/186207/original/file-20170915-8121-xkrvaq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/186207/original/file-20170915-8121-xkrvaq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/186207/original/file-20170915-8121-xkrvaq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/186207/original/file-20170915-8121-xkrvaq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Health is more important that perfect photos.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/adorable-happy-baby-colorful-towel-399052159?src=0vbjgWpB88zPhgtyR0nW6Q-1-38">Oksana Kuzmina/Shutterstock</a></span>
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<p>The problem is that these there is a potential mismatch between expectations of what the books offer and the reality of being a parent. Our research found that mothers’ experience of following books’ advice played an important part in their well-being. If they found the books useful, the mothers’ well-being was not affected, but if they didn’t find them useful, they were at a higher risk of depression and anxiety. Unfortunately only around a fifth of mothers in the study found them useful – 22% reported feeling more in control – while over 50% found them harmful in some way, and 53% felt more anxious). </p>
<p>Only one in ten of the participants felt that the advice in the books made them less tired, while one in six actually reported feeling like a failure because of them. The promised nights of sleep did not emerge. Given that mothers who are already feeling anxious and miserable might be drawn to these books as a solution, the potential for things to be made worse is concerning. </p>
<h2>Unhelpful advice</h2>
<p>So why don’t these books seem to work for most parents? Most likely because the suggestion that you can encourage a baby into a parent-led routine goes against a lot of what we know about young babies’ needs. Babies need to feed often because <a href="http://birthingandbreastfeeding.blogspot.co.uk/2017/02/breastfeeding-truths-come-under-attack.html">their tummy is small</a>. Breast milk in particular is <a href="http://pediatrics.aappublications.org/content/80/3/434.short">really easily digested</a> so they need to feed lots – which also helps build a good milk supply. </p>
<p><a href="http://onlinelibrary.wiley.com/doi/10.1002/ajpa.20736/full">Waking at night</a> is normal too. After all, lots of adults wake up at night but can attend to their own needs such as pulling a cover back over them or getting a drink. Babies need help doing this. Finally, <a href="http://www.sciencedirect.com/science/article/pii/S0022347679805405">human infants are really quite vulnerable</a> compared to many other mammals. They can’t even hold their heads up let alone walk and feed themselves shortly after birth. This means that they are programmed to want to keep their caregiver close. </p>
<p>Trying to persuade babies that they want to feed less often, sleep through the night and lie contentedly on their own flies in the face of normal developmental infant needs. Although some parents may be lucky enough to find it works for them, many others will find it instead creates other issues. For example, trying to limit how much a baby feeds can reduce milk supply, making them distressed, and increasing the <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-277X.2010.01145.x/full">likelihood of breastfeeding difficulties</a>. Not responding to an infant’s cries at night is <a href="http://www.sciencedirect.com/science/article/pii/S014976340900075X">stressful for their developing brains</a> too. Meanwhile, sleeping close to their mother at night promotes a <a href="https://academic.oup.com/sleep/article/27/3/507/2707994/Mother-Infant-Bedsharing-is-Associated-with-an">steadier temperature, heart rate and breathing</a>. </p>
<h2>Miracle cure</h2>
<p>Saying all of this, you can fully understand why parents are drawn to books that promise that routines will work. <a href="http://journals.lww.com/jpnnjournal/Abstract/2007/04000/Patterns_of_Sleep_Disruption_and_Depressive.12.aspx">Motherhood is exhausting</a> and many new mothers are now <a href="http://familiesinsocietyjournal.org/doi/abs/10.1606/1044-3894.3684?code=afcf-site">isolated from family</a>, which can increase the risk of depression. Many may need to return to work while still dealing with sleepless nights. </p>
<p>It’s normal for parents to worry about whether they are doing it “right”. But they should remember that a baby having frequent needs and wanting to be kept close is normal. In fact, responding to babies’ needs helps the new-born to <a href="http://psycnet.apa.org/record/2006-08097-003">learn that the world is a good place</a>. </p>
<p>Books and “expert” advice may seem like a good idea but the fact of the matter is that little ones respond to biology, and haven’t been reading the same advice as mum or dad.</p><img src="https://counter.theconversation.com/content/83992/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Brown has previously received funding from the ESRC and NIHR. She is the author of 'Breastfeeding Uncovered: Who really decides how we feed our babies' and 'Why starting solids matters' both published by Pinter and Martin publishers.
</span></em></p>Parental well-being is being adversely affected by baby advice which isn’t backed by evidence.Amy Brown, Associate Professor of Child Public Health, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/813102017-08-25T01:24:34Z2017-08-25T01:24:34ZPostpartum depression can affect dads – and their hormones may be to blame<figure><img src="https://images.theconversation.com/files/182492/original/file-20170817-10986-dh8jpe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New fathers can feel low, too.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/lorix/6318744499">loriZ</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>Postpartum depression has become more visible as celebrity moms including <a href="http://www.hachettebookgroup.com/titles/brooke-shields/down-came-the-rain/9781401308469/">Brooke Shields</a>, <a href="http://celebritybabies.people.com/2015/10/21/drew-barrymore-postpartum-depression-people-cover/">Drew Barrymore</a> and <a href="https://www.glamour.com/story/chrissy-teigen-postpartum-depression">Chrissy Teigen</a> have publicly shared their struggles with feeling sad and hopeless after birth. But when a father – Adam Busby, from reality TV show “OutDaughtered” – opened up about <a href="http://people.com/tv/outdaughtered-quintuplets-dad-adam-busby-suffering-postpartum-depression/">his own postpartum depression</a> in 2017, he <a href="http://www.intouchweekly.com/posts/adam-busby-depression-137710">received instant backlash</a>, including comments telling him to “man up.”</p>
<p>Despite the skepticism, postpartum depression in fathers is very real, with estimates that <a href="https://doi.org/10.1001/jama.2010.605">around 10 percent of men report symptoms</a> of depression following the birth of a child, about double the typical rate of depression in males. Postpartum depression <a href="https://doi.org/10.1146/annurev-clinpsy-101414-020426">in women has been linked with hormonal shifts</a>, but the role of hormones in men’s postpartum depression has been unknown.</p>
<p>In an attempt to solve this mystery, my colleagues and I recently tested whether men’s <a href="https://www.ncbi.nlm.nih.gov/pubmed/28757312">levels of the hormone testosterone are related to their postpartum depression risk</a> during early parenthood. We found that men’s testosterone levels might predict not only their own postpartum depression risk, but their partner’s depression risk as well. </p>
<h2>Testosterone levels in flux through life changes</h2>
<p><a href="https://en.wikipedia.org/wiki/Testosterone">Testosterone is an androgen hormone</a>, responsible for the development and maintenance of male secondary sex characteristics. It promotes muscle mass and body hair growth, and motivates sexual arousal and competitive behavior.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/183037/original/file-20170822-1055-18mzeuu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/183037/original/file-20170822-1055-18mzeuu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/183037/original/file-20170822-1055-18mzeuu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=728&fit=crop&dpr=1 600w, https://images.theconversation.com/files/183037/original/file-20170822-1055-18mzeuu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=728&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/183037/original/file-20170822-1055-18mzeuu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=728&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/183037/original/file-20170822-1055-18mzeuu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=915&fit=crop&dpr=1 754w, https://images.theconversation.com/files/183037/original/file-20170822-1055-18mzeuu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=915&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/183037/original/file-20170822-1055-18mzeuu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=915&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Cotton top tamarin babies get care from both parents.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ekilby/26123804612">Eric Kilby</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
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<p>Many studies have found that testosterone dips in new fathers across the animal kingdom. Among animals that engage in the biparental care of offspring – Mongolian gerbils, Djungarian hamsters, California mice and cotton-top tamarins – males show <a href="https://doi.org/10.1111/jne.12176">lower testosterone levels following the birth of pups</a>.</p>
<p>Human males also often show declines in testosterone around the birth of their infants. In one of the <a href="https://doi.org/10.1073/pnas.1105403108">largest studies of testosterone and fatherhood</a>, <a href="http://anthropology.nd.edu/faculty-and-staff/faculty-by-alpha/lee-gettler/">anthropologist Lee Gettler</a> and his colleagues followed over 600 single men in the Philippines for about five years. If men became partnered fathers during that time, their testosterone levels decreased more than the men who stayed single. Gettler also found that fathers who spent more time with their children showed lower testosterone, suggesting that testosterone may be suppressed by paternal caregiving. </p>
<p>Along similar lines, <a href="http://edelsteinlab.psych.lsa.umich.edu/">psychologist Robin Edelstein</a> and I found that men assessed repeatedly over their partner’s pregnancy showed <a href="https://doi.org/10.1016/j.yhbeh.2016.07.005">declining testosterone levels from early to late pregnancy</a>. Men whose testosterone dropped more dramatically were more likely to report postpartum commitment and investment in their romantic relationships with their partners.</p>
<p>Researchers still haven’t identified exactly what causes men’s testosterone to change over the transition to parenthood. Possible suspects include proximity to the partner or infant, increased stress or disrupted sleep and exercise routines.</p>
<h2>Lower testosterone, higher depression</h2>
<p>Previous research has <a href="https://doi.org/10.1210/jcem.84.2.5495">linked testosterone with men’s depression levels</a> in general. Low testosterone may contribute to the feelings of lethargy and disinterest in normally pleasurable activities that characterize depression. In fact, some psychiatrists have even suggested prescribing <a href="https://doi.org/10.1176/appi.ajp.160.1.105">testosterone supplements to treat depression in men</a>. However, no studies had specifically looked at the potential role of testosterone in fathers’ postpartum depression.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/183201/original/file-20170823-6594-vm7cf3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/183201/original/file-20170823-6594-vm7cf3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/183201/original/file-20170823-6594-vm7cf3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/183201/original/file-20170823-6594-vm7cf3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/183201/original/file-20170823-6594-vm7cf3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/183201/original/file-20170823-6594-vm7cf3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/183201/original/file-20170823-6594-vm7cf3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/183201/original/file-20170823-6594-vm7cf3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">How does the birth of a baby affect a father’s testosterone and his mental health?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/tired-daddy-naughty-baby-boy-asian-193271417">szefei/Shutterstock.com</a></span>
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<p>My colleagues and I analyzed data from the <a href="https://www.nichd.nih.gov/research/supported/Pages/cchn.aspx">Community Child Health Research Network</a>, a National Institutes of Health-funded study of new parents’ health and well-being. The study recruited moms after the birth of an infant and followed them for several years, along with their partners. At one of the study sites, in Lake County, Illinois, men also provided saliva samples for testosterone analysis when their infants were around nine months old. Both moms and dads reported on their symptoms of depression several times across the first few years of parenthood.</p>
<p>We found that dads with lower testosterone reported feeling more depressed. This fits with other research into how testosterone and depression work together. But ours is the first study to observe this relationship specifically in fathers of infants. Given that many men show drops in testosterone over the transition to parenthood, this finding may help explain why the postpartum period is such a high-risk time for depression in men.</p>
<h2>An unexpected side effect – for the moms</h2>
<p>We were surprised when we examined links between men’s testosterone and their partners’ depression. Yes, low testosterone seemed to put men at higher risk for depressive symptoms. But men’s levels had the opposite effect for their partners: Women with lower-testosterone partners actually reported fewer symptoms of depression. Why would that be?</p>
<p>We tested one possible explanation by looking at how women rated their relationships. It turned out that moms paired with low-testosterone men reported higher relationship satisfaction, and their higher relationship satisfaction predicted lower rates of depressive symptoms.</p>
<p>In other words, having a low-testosterone mate might make for a better-quality relationship, in turn reducing the likelihood that women will become depressed. We know <a href="http://dx.doi.org/10.1037/0022-3514.65.6.1243">social support from a partner</a> can protect women against developing postpartum depression, so our finding fits with that research. Lower-testosterone men may be <a href="https://doi.org/10.1016/j.yhbeh.2016.07.005">more dedicated to their relationships</a> or <a href="https://doi.org/10.1073/pnas.1105403108">spend more time with children</a>, helping to relieve some of the pressure on moms. </p>
<p>At around 15 months postpartum, we also checked moms’ ratings of whether their partners hurt, threatened, yelled at or insulted them. If men had higher testosterone, moms reported higher levels of intimate partner aggression about six months later. Testosterone is associated with <a href="https://doi.org/10.1016/j.neubiorev.2004.12.007">more aggressive and competitive behavior</a>. Our finding shows a potential dark side to high testosterone in the postpartum period.</p>
<p>Dads also told us about their parenting stress at 15 months postpartum, reporting on emotions such as feeling trapped by parenting responsibilities, believing their children made too many demands on them and lacking warm feelings toward their children. At first, we didn’t find a link between men’s testosterone levels and their parenting stress. But after we statistically controlled for the relationship between low testosterone and depression, we saw that higher testosterone put men at greater risk of experiencing problems in the parenting relationship. This result suggests that, once you adjust for their potentially lower risk of depression, high-testosterone men may find parenting to be more stressful.</p>
<h2>A happy medium for testosterone?</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/28757312">Our results suggest</a> that fathers of infants might be at risk at both sides of the postpartum testosterone spectrum. At low levels, they might be more vulnerable to depression. But at high levels, they might have less satisfying and more aggressive relationships, less happy partners and more parenting stress. In terms of resilience to depression and stress, men with average levels of postpartum testosterone seemed to fare best.</p>
<p>Our findings reveal that men’s postpartum testosterone has a complex relationship with family health. From an evolutionary perspective, lower testosterone during the transition to parenthood may help motivate men to invest in their family. In the animal kingdom, lower-testosterone males <a href="https://doi.org/10.1111/jne.12176">spend more time with infant pups</a> and show less aggression toward them. So it makes sense that human males would show shifts in testosterone as they adapt to parenthood.</p>
<p>But these shifts may make men more vulnerable to mood disorder symptoms. Perhaps this is because lower-testosterone men are taking a more hands-on role in the family and helping more with infant care. Their contributions are great news from the family’s perspective, but may put men at heightened risk of some of the same depressive symptoms that <a href="http://www.salon.com/2013/02/25/is_motherhood_causing_my_depression/">many new mothers face</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/183030/original/file-20170822-30494-12wv57l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/183030/original/file-20170822-30494-12wv57l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/183030/original/file-20170822-30494-12wv57l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/183030/original/file-20170822-30494-12wv57l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/183030/original/file-20170822-30494-12wv57l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/183030/original/file-20170822-30494-12wv57l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/183030/original/file-20170822-30494-12wv57l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/183030/original/file-20170822-30494-12wv57l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">New parenthood is hard, whether you’re a man or a woman.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/nataliebroach/3478461504">Natalie Broach</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>After all, caring for infants is hard, draining work. In modern industrialized societies like the United States, many new parents lack the extended family support networks that can help lighten the burden of childcare. And in the U.S., <a href="http://www.slate.com/blogs/xx_factor/2017/06/15/most_major_u_s_employers_fail_on_paid_paternity_leave_the_aclu_says_that.html">paternity leave is a rarity</a>, and many dads struggle with family-unfriendly work arrangements that drain time and energy. Just as new moms can feel overwhelmed and isolated after spending long hours tending to their babies, so too can dads.</p>
<p>If new dads (or moms) are experiencing depressed moods after the birth of their infants, they can take some comfort in the fact that these feelings are normal – and may even be rooted in our evolutionary biology. There’s <a href="http://postpartummen.com">no shame in seeking help</a>, whether it’s talking to a friend, prioritizing sleep and exercise, or visiting a therapist. <a href="http://www.parents.com/parenting/dads/sad-dads/">Postpartum depression affects the whole family</a> and should be taken seriously.</p><img src="https://counter.theconversation.com/content/81310/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Darby Saxbe receives funding from the National Science Foundation. </span></em></p>Having a newborn can be rough, whether you’re a mom or a dad. New research ties men’s testosterone to their postpartum depression – with some surprising upsides for their partners.Darby Saxbe, Assistant Professor of Psychology, USC Dornsife College of Letters, Arts and SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/816402017-08-16T15:01:17Z2017-08-16T15:01:17ZHere’s looking at you, kid: how webcams help parents bond with premature babies<figure><img src="https://images.theconversation.com/files/182229/original/file-20170816-32632-11b9aq5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/newborn-premature-baby-swaddles-purple-wrap-580721896">Shutterstock</a></span></figcaption></figure><p>During pregnancy, most parents prepare for the baby’s arrival and look forward to introducing a healthy baby to family and friends soon after the birth. But an <a href="http://www.rcpch.ac.uk/system/files/protected/page/Your%20baby%E2%80%99s%20care%20-%20A%20guide%20to%20the%20National%20Neonatal%20Audit%20Programme%202015%20Annual%20Report.pdf">increasing number of parents</a> (8-12%) find that things do not progress as planned and their hoped-for healthy baby is sick or premature and needs expert neonatal care.</p>
<p>When this happens, joy is replaced by concern about the baby’s immediate and longer-term health and development, and a period of stress and anxiety for the parents often follows. Admission to a neonatal unit also means the parents are separated from their baby for lengthy periods just when they should be establishing bonds. </p>
<p>While the survival and long-term future of babies is improved in a neonatal unit, the separation of parents and children limits opportunities for early bonding. Parents are encouraged to visit the neonatal unit as much as possible; however, there is a need to develop and evaluate interventions to help parents feel closer to their babies when they are physically separated from them. <a href="http://www.explainthatstuff.com/webcams.html">Webcam</a> technology presents a potential solution.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/182238/original/file-20170816-32661-1wxub6m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/182238/original/file-20170816-32661-1wxub6m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/182238/original/file-20170816-32661-1wxub6m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/182238/original/file-20170816-32661-1wxub6m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/182238/original/file-20170816-32661-1wxub6m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/182238/original/file-20170816-32661-1wxub6m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/182238/original/file-20170816-32661-1wxub6m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Admission to a neonatal unit separates parents from their baby just when they should be establishing close bonds.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/premature-baby-incubator-machine-229937416">Shutterstock</a></span>
</figcaption>
</figure>
<p>Published recently in <a href="https://bmcpediatr.biomedcentral.com/about">BMC Pediatrics</a>, our <a href="http://rdcu.be/t6Al">study</a> is one of a few world-wide to have evaluated the use of webcam technology in neonatal units. This UK-based study represents the first in-depth analysis of parent and professional views on whether webcams can assist the early bonding process.</p>
<p>We interviewed 30 mothers and fathers and 18 professionals, including nurses, midwives, nursery nurses and doctors, in a Scottish hospital over a six-month period.</p>
<h2>The comfort of technology</h2>
<p>Each webcam was placed over an individual cot/incubator in the neonatal unit and transmitted real-time images of the baby, wirelessly and securely, to a linked tablet computer kept by recovering mothers in the postnatal area in the hospital. The camera was switched off when medical/nursing procedures were undertaken to avoid any potential distress on the part of parents, but otherwise it was in constant operation, allowing parents to see their baby whenever they wished.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/BFQqDui8mI8?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">YouTube.</span></figcaption>
</figure>
<p>Parent and professional views of the webcam technology were overwhelmingly positive. One of the issues discussed by a number of the parents was that the technology allowed them to “feel that they were with their baby” even during periods of separation. It also meant they were able to be more responsive to their babies’ needs – for example, seeing their baby, helped mothers to produce breast milk. One mother of an eight-week premature baby said: </p>
<blockquote>
<p>When I had my little boy [also admitted to a neonatal unit] I couldn’t see him straightaway, whereas this time having the camera means I can see her constantly, she’s right beside my bed, really. Also, with things like expressing milk, I’ve found that a lot easier.</p>
</blockquote>
<p>Parents also discussed how webcam technology had helped them to “keep more stable emotionally” in the days following the delivery. The mother of a six-week premature baby described the comfort the webcam brought her:</p>
<blockquote>
<p>If I didn’t have the camera, I think I would have cracked up. I’d been waking up during the night and being able to see that she was there and that she was sleeping meant I was able to fall back to asleep again.</p>
</blockquote>
<p>Use of the technology also helped the mothers to “recover physically” following the birth, with issues such as rest, nourishment and the reduction of pain being discussed. One mother stated she would “definitely have got less sleep if I hadn’t been able to see her on the tablet”.</p>
<p>Parents also discussed the benefits that the webcam technology afforded in allowing them to share “real-time” pictures of the baby with their wider family and friends. The mother of a five-week premature baby told us:</p>
<blockquote>
<p>My partner loves it, just being able to see her all the time. And my mum and dad thought it was a fantastic idea. Because our baby’s in neonatal they couldn’t visit her, so it meant they didn’t have to wait to see her.</p>
</blockquote>
<p>Finally, staff in the neonatal care unit stressed the almost “gift-like” quality of webcam technology. A neonatal nurse said:</p>
<blockquote>
<p>You get such a great reaction the minute the baby’s stable. If I took a tablet round, the mum was just so happy. She thought she wasn’t going to see her baby for maybe another 12 hours, and then I appear and say, “Here she is, now you can watch her.”</p>
</blockquote>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/182230/original/file-20170816-32614-1fkgr9m.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/182230/original/file-20170816-32614-1fkgr9m.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=408&fit=crop&dpr=1 600w, https://images.theconversation.com/files/182230/original/file-20170816-32614-1fkgr9m.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=408&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/182230/original/file-20170816-32614-1fkgr9m.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=408&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/182230/original/file-20170816-32614-1fkgr9m.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=513&fit=crop&dpr=1 754w, https://images.theconversation.com/files/182230/original/file-20170816-32614-1fkgr9m.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=513&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/182230/original/file-20170816-32614-1fkgr9m.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=513&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Neonatal professionals have described the comfort webcams bring parents separated from their newborn babies.</span>
<span class="attribution"><a class="source" href="http://www.basildonandthurrock.nhs.uk/wards/childrens-and-maternity/817-neonatal-intensive-care-unit-nicu-2">BUH NICU</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<h2>Parental anxieties</h2>
<p>But for a <a href="http://rdcu.be/t6Al">small minority</a> of parents in our study, the ability to see their baby 24/7 appeared to increase rather than decrease their anxiety. Areas of concern included interpreting what was being seen on the screen of the tablet and wondering if it was something to be concerned about. The father of a six-week premature baby said:</p>
<blockquote>
<p>It’s a double-edged sword using the webcam, I would say. You can see what’s happening but you don’t always know what’s happening.</p>
</blockquote>
<p>Another mother of a ten-week premature baby said she got deeply anxious if the camera was not switched on:</p>
<blockquote>
<p>Sometimes they turned the camera off and they’d forget to turn it on again and I had a sense of anxiousness when I couldn’t see him. I didn’t want to make a fuss and be a neurotic mother but I would ask, “Please can you turn it on so I can see he’s okay?”</p>
</blockquote>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/182232/original/file-20170816-32632-bky3bs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/182232/original/file-20170816-32632-bky3bs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/182232/original/file-20170816-32632-bky3bs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/182232/original/file-20170816-32632-bky3bs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/182232/original/file-20170816-32632-bky3bs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/182232/original/file-20170816-32632-bky3bs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/182232/original/file-20170816-32632-bky3bs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Being able to see their baby at any time gives most parents peace of mind, but for some it made them more anxious.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/premature-newborn-baby-girl-hospital-incubator-396467245">Shutterstock</a></span>
</figcaption>
</figure>
<p>With a <a href="http://who.int/pmnch/media/news/2012/preterm_birth_report/en/">current global increase</a> in premature births, webcam technology can offer an important solution to periods of enforced parent-child separation in the early postnatal period. For the majority of parents these benefits meant increased feelings of closeness; enhanced emotional well-being; assisted the mother’s physical recovery, and facilitated the involvement of family and friends.</p>
<p>These benefits appeared to encourage the early bonding process between parents and their babies. Further work is required to assess the cost-effectiveness of webcam technology and also to evaluate its use in the family home following the mother’s discharge from hospital; currently it is only available in the hospital.</p>
<p>While mothers are commonly discharged after a few days, their premature baby may remain in neonatal care for weeks or even months. Webcam access at home could mean the difference between stressful anxiety and peace of mind for new parents.</p><img src="https://counter.theconversation.com/content/81640/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Susan Kerr receives funding from the Digital Health & Care Institute, the National Institute for Health Research (NIHR), the Medical Research Council (MRC), the Chief Scientist Office (Scottish Government), NHS Greater Glasgow & Clyde.
Susan Kerr would like to acknowledge the contribution of her co-authors: Dr Caroline King, School of Health & Life Sciences, Glasgow Caledonian University; Dr Rhona Hogg, formerly NHS Greater Glasgow & Clyde; Dr Kerri McPherson, School of Health & Life Sciences, Glasgow Caledonian University; Dr Janet Hanley, School of Health and Social Care, Edinburgh Napier University; Dr Maggie Brierton, formerly Clinical Psychology Department, Child and Families Speciality, NHS Fife;
Dr Sean Ainsworth, Victoria Hospital, NHS Fife.
The technology (named mylittleone) was developed by Integrated Care 24, England, UK, a not for profit ‘gold’ social enterprise. The setting up, use and evaluation of the technology were facilitated by the Digital Health & Care Institute (DHI), Scotland. The views expressed in the article are those of the authors and do not necessarily reflect those of the funding body.
</span></em></p>Watching their babies via webcams eases parents’ anxiety and helps them connect in the absence of physical contactSusan Kerr, Reader/Lead, Healthy Lives & Relationships Research Group, Glasgow Caledonian UniversityLicensed as Creative Commons – attribution, no derivatives.