Baby Blues vs Postnatal Depression
| Feature | Baby Blues | Postnatal Depression |
|---|---|---|
| Onset | Days 3–5 after birth | Usually 2–8 weeks after birth |
| Duration | Resolves within 2 weeks | Persists >2 weeks |
| Severity | Mild — tearfulness, mood swings | Moderate–severe — impacts functioning |
| Suicidal thoughts | No | Can occur — always take seriously |
| Treatment needed | Reassurance and support | Yes — therapy and/or medication |
Blood Tests to Check
Postnatal depression can be triggered or worsened by physical factors — always check:
| Test | Why |
|---|---|
| TSH / T4 (thyroid) | Postpartum thyroiditis affects 5–7% of new mothers — causes depression or anxiety |
| FBC (haemoglobin) | Iron-deficiency anaemia is extremely common postpartum |
| Ferritin | Iron stores — depleted by pregnancy and blood loss in delivery |
| Vitamin D | Deficiency common in new mothers — linked to depression |
| Vitamin B12 | Deficiency if breastfeeding on vegan diet without supplements |
Postpartum PsychosisPostpartum psychosis is a rare (1 in 1000) but psychiatric emergency: rapid onset within days of birth, hallucinations, delusions, confusion, manic behaviour. Requires immediate hospitalisation. Call 999 immediately.
Edinburgh Postnatal Depression ScaleThe EPDS is a 10-question questionnaire used by midwives and health visitors to screen for PND at 6–8 weeks. A score of ≥13 suggests depression. If you score ≥12, speak to your GP immediately.
Treatment Options Safe While Breastfeeding
| Treatment | Breastfeeding Safety | Notes |
|---|---|---|
| Sertraline (SSRI) | Preferred option | Low transfer to breast milk |
| Paroxetine (SSRI) | Generally acceptable | More evidence than others |
| Antidepressants generally | Discuss risk/benefit | Small amount in breast milk; usually much safer than untreated depression |
| CBT / psychological therapy | Fully safe | First-line for mild–moderate PND |
| Peer support groups | Fully safe | Valuable addition to formal treatment |
Will I always feel this way?
No. With treatment, most women with postnatal depression recover fully. The sooner treatment starts, the faster the recovery.
What if I have thoughts of harming myself or my baby?
Contact your GP, midwife or mental health crisis team immediately. Intrusive thoughts about harm are a symptom of PND and are different from plans or intentions. Help is available 24/7.
Does PND affect my baby?
Untreated PND can affect bonding and infant development. However, mothers who seek treatment generally have babies who develop normally. Getting help is the best thing you can do for both of you.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.