title: Can Postpartum Depression Be Managed in Pediatric Primary Care?
abstract: BACKGROUND
  Postpartum depression is prevalent among women who have had a baby within the last 12 months. Depression can compromise parenting practices, child development, and family stability. Effective treatments are available, but access to mental healthcare is challenging. Routine infant healthcare visits represent the most regular contact mothers have with the healthcare system, making pediatric primary care (PPC) an ideal venue for managing postpartum depression.
  
  
  METHODS
  We conducted a review of the published literature on postpartum depression programs. This was augmented with a Google search of major organizations' websites to identify relevant programs. Programs were included if they focused on clinical care practices, for at-risk or depressed women during the first year postpartum, which were delivered within the primary care setting.
  
  
  RESULTS
  We found that 18 programs focused on depression care for mothers of infants; 12 were developed for PPC. All programs used a screening tool. Psychosocial risk assessments were commonly used to guide care strategies, which included brief counseling, motivating help seeking, engaging social supports, and facilitating referrals. Available outcome data suggest the importance of addressing postpartum depression within primary care and providing staff training and support. The evidence is strongest in family practices and community-based health settings. More outcome data are needed in pediatric practices.
  
  
  CONCLUSIONS
  Postpartum depression can be managed within PPC. Psychosocial strategies can be integrated as part of anticipatory guidance. Critical supports for primary care clinicians, especially in pediatric practices, are needed to improve access to timely nonstigmatizing care.
authors.affiliation: 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York.
authors.forename: Su-Chin Serene
authors.initials: SC
authors.lastname: Olin
authors.affiliation: 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Kerker
authors.affiliation: 2 Albert Einstein College of Medicine/Children's Hospital at Montefiore , Bronx, New York.
authors.forename: Ruth E K
authors.initials: RE
authors.lastname: Stein
authors.affiliation: 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York.
authors.forename: Dara
authors.initials: D
authors.lastname: Weiss
authors.affiliation: 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York.
authors.forename: Emma D
authors.initials: ED
authors.lastname: Whitmyre
authors.affiliation: 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Hoagwood
authors.affiliation: 1 Department of Child and Adolescent Psychiatry, New York University School of Medicine , New York, New York.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Horwitz
mesh_terms: D000293:Adolescent; D002648:Child; D003153:Community Health Services; D003376:Counseling; D003863:Depression / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D019052:Depression, Postpartum / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D009035:Mothers / Q000523:psychology*; D016487:Parenting; D010372:Pediatrics; D011181:Postnatal Care; D011247:Pregnancy; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation