Clinician Note: Updated information and references for nonpharmacologic intervention for postpartum depressive symptoms:

1) Estrogen may improve mood, but studies show most of the women with postpartum depression were also receiving antidepressants so results are inconclusive
[Gregoire AJ, Kumar R, Everitt B, et al. Transdermal oestrogen for treatment of severe postnatal depression. Lancet 1996;347:930-3]

2) There is no evidence that the postpartum administration of progesterone improves mood.
[Abreu AC, Stuart S. Pharmacologic and hormonal treatments for postpartum depression. Psychiatr Ann 2005;35:568-76]

3) Omega-3 fatty acids continue to show promise.
[Parker G, Gibson NA, Brotchie H, et al. Omega-3 fatty acids and mood disorders. Am J Psychiatry 2006;163:969-78]
[Sontrop J, Campbell MK. Omega-3 polyunsaturated fatty acids and depression: a review of the evidence and a methodological critique. Prev Med 2006;42:4-13]

4) Light therapy also shows promise.
[Corral M, Kuan A, Kostaras D. Bright light therapy’s effect on postpartum depression. Am J Psychiatry 2000;157:303-4]

5) Infant massage good for baby and mother…. who can argue with that?
[Onozawa K, Glover V, Adams D, et al. Infant massage improves mother-infant interaction for mothers with postnatal depression, J Affect Disord 2001;63:201-7]

6) For problematic infant sleep patterns, interventions have also proven to benefit both baby and mother.
[Hiscock H, Wake M. Randomised controlled trial of behavioural infant sleep intervention to improve infant sleep and maternal mood. BMJ 2002;324:1062-5]

7) Exercise. There is still strong evidence that exercise will help improve mood. It’s hard to do when you’re feeling badly, but it can really help.
[Armstrong K, Edwards H. The effectiveness of a pram-walking exercise programme in reducing depressive symptomatology forpostnatal women. Int J Nurs Pract 2004;10:177-94]
[Da Costa D. Exercise as a nonpharmacologic option for women with PPD. Prim Psychiatry 2006;13:18]
[Daley AJ, MacArthur C, Winter H. The role of exercise in treating postpartum depression: a review of the literature. J Midwifery Womens Health 2007;52:56-62]

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