There is so much excitement for the arrival of a new baby, both for expectant mothers and loved ones. Still, after having the baby, some people can experience sadness, fatigue, and a general sense of letdown [6] instead of the happiness they were expecting, leaving them feeling confused and disappointed about themselves.

There isn't a particular cause. Physical and emotional factors such as decreasing hormonal levels contribute to baby blues. [6] Baby blues usually occurs between two to four days after birth and usually resolves within two weeks. [6]

Symptoms of the baby blues

Baby blues, or "postpartum blues," occurs in roughly 50% to 85% of all mothers. [6] Symptoms of baby blues can vary from person to person, but common symptoms include the following: 

  • Crying that isn't prompted by something [6]
  • Emotional emptiness or letdown [6]
  • Physical discomfort [6]
  • Fatigue or confusion [7]
  • Uncertainty about their role as a mother [6]
  • Feeling overwhelmed or anxious [6]
  • Feeling irritated or sensitive [6]
  • Decreased sleep and concentration [2]
  • Changes in appetite [2]

First-time mothers are more likely to experience severe baby blues symptoms because they may have unrealistic expectations of themselves as mothers. [6]

What causes the baby blues?

The causes of baby blues are mainly unknown, but women undergo many hormonal, physical, emotional, and mental changes during pregnancy. Hormonal changes, including drastic decreases in estradiol, progesterone, and prolactin time following delivery, contribute to the baby blues. [2]

Studies have shown the following may contribute to baby blues:

  • Higher levels of depressive symptoms during pregnancy[2]
  • At least one prior episode of diagnosed depression[2]
  • A history of premenstrual depression or other menstrual-related mood changes[2]
  • A history of major depression or dysthymia[2]Have had multiple pregnancies in their lifetime [2]
  • Family history of postpartum depression[2]
  • Low-income status[2]
  • Planned vs. unplanned pregnancy[2]
  • Unexpected pregnancy[2]
  • Family history of mood disorders[2]
  • History of postpartum depression in the past[2]
  • Low self-esteem[5]
  • Increase in stress related to caring for the baby[5]

Other studies suggest significant risk factors that may predispose a woman to the onset of baby blues include higher monoamine oxidase levels or decreased serotoninergic activity immediately following childbirth. [2] 

Monoamine oxidase is an enzyme that naturally occurs in the body and some foods. It plays a role in moods, depression, and stress. [4] Abnormal levels of monoamine contribute to anxiety. [1]

Serotonin is a neurotransmitter responsible for regulating many functions in the body. Still, it plays a significant role in the brain and with mood, memory, appetite, aggression, fear, perception, stress responses, and sleep rhythms. [3]

Baby blues vs postpartum depression

Roughly one in seven women can develop postpartum depression (PPD). [7] The baby blues usually last up to two weeks following childbirth. [7] Postpartum depression lasts longer and most commonly occurs within six weeks after delivery and occurs in 6.5%-20% of women. [7]

Postpartum depression is 4-11 times more common in women who have the baby blues. [2] According to DSM-5, the symptoms must last longer than two weeks. [2] 

Baby blues symptoms are milder and last less than two weeks, and do not generally require medical treatment. Postpartum depression is more severe, causes significant distress, and significantly impairs daily life in women who suffer from it. [2]

Baby blues occur around 2-5 days after delivery and usually resolve 10-14 days, and it does not affect the functioning or the ability to care for the baby. [7]

Do I need to see a doctor?

If you experience baby blues for longer than two weeks and symptoms worsen or interfere with your ability to function, you should see your doctor. You may have postpartum depression, and you should see your doctor if you experience the following symptoms for at least two weeks: [7]

  • Low or depressed mood present for most of the day
  • Loss of enjoyment or interest in activities you usually enjoy
  • Trouble sleeping or sleeping too much
  • Slowing of movements or agitation
  • Fatigue or low energy
  • Suicidal feelings or behaviors or thoughts of death
  • Thoughts or feelings of
  • Trouble focusing, concentrating, or indecisiveness
  • Weight or appetite changes (weight changes of 5% over one month)[7]

Postpartum psychosis can happen to some women and is a psychiatric emergency that can pose risks of suicide or harm or death to the infant. If you or someone is experiencing hallucinations, isn't sleeping for several nights, is agitated, or showing unusual behavior or delusions (beliefs not based on reality), you should seek immediate medical attention. [7]

Treating the baby blues

Although baby blues, by definition, resolves within two weeks, self-care can help minimize symptoms. The following can be helpful: 

  • Sleeping when your baby sleeps: when we are sleep-deprived, everything can feel worse. Rest can help you recharge and feel better equipped to handle your new role as a mom.
  • Proper diet: Like other times in life, if we don't eat well, we may not feel well. Eating nutritious food can help you feel your best.
  • Talk to a trusted friend or family member:  Talking to someone can help you feel like you are not alone, and it can help get something that is bothering you off your chest. It can also be good to talk and laugh with a friend, which can make you feel better and improve your mood.
  • Exercise: Getting out of the house and walking with the baby can go a long way to making you feel better. Exercise improves circulation and can boost chemicals in the brain, improving your self-esteem, decreasing stress levels, improving your overall sense of well-being, and decreasing anxiety. [1] Exercise can also act as a distraction away from something that is bothering you and help you to refocus on something that will help you feel better. [1]

Resources:

  1. Anderson, E., & Shivakumar, G. (2013). Effects of exercise and physical activity on anxiety. Frontiers in Psychiatry, 4, 27. https://doi.org/10.3389/fpsyt.2013.00027
  2. Balaram K, Marwaha R. Postpartum Blues. [Updated 2022 Jun 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554546/
  3. Berger, M., Gray, J. A., & Roth, B. L. (2009). The expanded biology of serotonin. Annual Review of Medicine, 60, 355–366. https://doi.org/10.1146/annurev.med.60.042307.110802
  4. Herraiz, T., & Guillén, H. (2018). Monoamine Oxidase-A Inhibition and Associated Antioxidant Activity in Plant Extracts with Potential Antidepressant Actions. BioMed Research International, 2018, 4810394. https://doi.org/10.1155/2018/4810394
  5. M'baïlara, K., Swendsen, J., Glatigny-Dallay, E., Dallay, D., Roux, D., Sutter, A. L., Demotes-Mainard, J., & Henry, C. (2005). Le baby blues: caractérisation clinique et influence de variables psycho-sociales [Baby blues: characterization and influence of psycho-social factors]. L'Encephale, 31(3), 331–336. https://doi.org/10.1016/s0013-7006(05)82398-x\
  6. McKelvey, M.; Espelin, J. (2018). Postpartum depression.Nursing Made Incredibly Easy!, –––16(3), 28-35. https://doi.org/10.1097/01.nme.0000531872.48283.ab
  7. Mughal, S., Azhar, Y., & Siddiqui, W. (2022). Postpartum Depression. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554546/