"SINCE YOUR NEW BABY WAS BORN, HOW OFTEN HAVE YOU FELT HOPELESS"

“Since your new baby was born, how often have you felt hopeless?”

By Andrew Malekoff©

Care to venture a guess as to what grade level of student has the highest rate of expulsion from school because of problematic behavior? Let’s see how you did.

According to a research study at Yale University, led by Dr. Walter Gilliam, the rate of expulsion in pre-kindergarten programs serving three- and four-year-olds is more than three times that of children in grades K through 12. According to Dr. Gilliam the study did not explore reasons why the children were expelled, "We weren't measuring behavioral problems, we were measuring the decisions teachers make." So, we are left to speculate and to study the risks that pre-school children face that contribute to this astounding statistic.

Early childhood mental health expert Jane Knitzer offers a clue when she tells us that “research indicates that babies whose mothers are depressed…may ‘act out’ in early childhood programs, and sometimes be ejected from them.” At the Marks Family Right from the Start 0-3+ Center (RFTS), a division of North Shore Child and Family Guidance Center, we know that the emotional health of a parent influences a child’s development. In a survey we found that over 60% of families of 147 recent admissions reported serious behavior problems in children as young as 2 years of age. A review of the histories of these families found between 50 and 75% of the children were living with a depressed parent, most often a mom with a history of depression.

Sandra Radzanower Wolkoff, RFTS director, advises that we need to pay attention not only to maternal depression, but to the mood disorders that accompany childbirth and that are often an unexpected complication of pregnancy. Although we are not always sure of the causes for onset, what we do know according Wolkoff, is that “danger lies in how they incapacitate mothers, frighten fathers, and embroil infants.”

One young mother who is recovering from post-partum depression at RFTS recently told a rapt audience at a North Shore Child and Family Guidance Center event at the Glen Head Country Club, about how she could barely lift her head off of her pillow, let alone lift and hold and cuddle and care for her baby.

The Center for Disease Control (CDC) reports that postpartum depression affects up to 20% of mothers within the first year after giving birth. The rate of depression for mothers living in poverty is close to a staggering 50%. Mental health experts agree that constancy of relationship from early childhood is the single best predictor of positive outcomes in later life. Promoting safe and warm relationships with parents and other caregivers is key to young children’s healthy development and later success in school and beyond. Maternal depression, left untreated, may be a key factor leading to the expulsion of pre-schoolers.

According to Wolkoff, “Depressed mothers tend to perceive their children as being more difficult, frequently viewing their children more negatively. Mothers who are suffering from depression can respond with too little emotion or energy, or overreact with aggression and irritability. The origin of this inconsistency in parenting is not a lack of desire. Rather, it is consequence of utter exhaustion.”

The Center on Disease Control in Atlanta administered a surveillance project aimed at identifying maternal depression early on. Two questions that they asked moms are: 1) Since your new baby was born, how often have you felt down, depressed, or hopeless? and 2) Since your new baby was born, how often have you had little interest or little pleasure in doing things? The women who answered "often" or "always" to either question were classified as experiencing self-reported post-partum depressive symptoms. Detecting the problem is the first step in getting moms and their families the help they need.

We must encourage primary care physicians and other health professionals to incorporate these questions into their encounters with pregnant women and mothers of infants. If you are reading this clip it, highlight these two questions and pass it along it to your local pediatrician, obstetrician and gynecologist or pediatric hospital unit. Add a personal note. Who knows, maybe it will keep one more child from being expelled.

Children grow best when they feel safe and are safe. Healthy attachments are not about children getting what they want, but getting what they need—the assurance that an adult caregiver is by their side, looking out for them, teaching them how to manage their own feelings, and learning about the give and take of relationships. All children deserve this. Let’s take a small step to make sure they get it.

Originally published in the Anton Newspapers, Long Island, New York, July 2008