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Kathryn Taaffe McLearn, PhD; Cynthia S. Minkovitz, MD, MPP; Donna M. Strobino, PhD; Elisabeth Marks, MPH; William Hou, MS

Arch Pediatr Adolesc Med. 2006;160:279-284.

Objective  To determine whether maternal depressive symptoms, reported when infants are 2 to 4 months old, are associated with mothers' early parenting practices.

Design  Secondary data analyses collected from the National Evaluation of Healthy Steps for Young Children. Data sources included newborn enrollment questionnaires and parent interviews when infants were 2 to 4 months old. Maternal depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale.

Setting  Twenty-four pediatric practices across the United States.

Participants  A total of 5565 families enrolled in Healthy Steps; 4874 mothers (88%) completed 2- to 4-month interviews and provided Center for Epidemiologic Studies Depression Scale data; 17.8% of mothers reported having depressive symptoms.

Main Outcome Measures  Ten parenting practices assessed in 3 domains: safety (sleep position and lowering water temperature), feeding (cereal, water, or juice; continuing breastfeeding), and practices to promote child development (showing books, playing with infant, talking to infant, and following 2 or more routines).

Results  Mothers with and without depressive symptoms reported similar uses of safety and feeding practices. Mothers with depressive symptoms had reduced odds of continuing breastfeeding (adjusted odds ratio [AOR], 0.73; 95% confidence interval [CI], 0.61-0.88), showing books (AOR, 0.81; 95% CI, 0.68-0.97), playing with the infant (AOR, 0.70; 95% CI, 0.54-0.90), talking to the infant (AOR, 0.74; 95% CI, 0.63-0.86), and following routines (AOR, 0.61; 95% CI, 0.52-0.72).

Conclusion  Maternal depressive symptoms are common in early infancy and contribute to unfavorable parenting practices.

Author Affiliations: National Center for Children in Poverty, Mailman School of Public Health, Columbia University, New York, NY (Dr McLearn and Ms Marks); and Department of Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md (Drs Minkovitz and Strobino and Mr Hou). Dr McLearn is currently with Center for Children's Healthcare Improvement, Department of Pediatrics, University of North Carolina, Chapel Hill. Ms Marks is currently with Population Health Division, Research Centre of the University of Montreal Hospital Centre, Montreal, Quebec.

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