Credits: Canva
By now, we all must be aware of how a mother's body changes during and even after pregnancy. What comes next is a challenging phase, called postpartum. However, it is not just the mothers, but dads too go through postpartum depression. As per the UT Southwestern Medical Center, 1 in 10 dads struggle with postpartum depression (PPD) and anxiety. According to a 2019 study published in Innovations in Clinical Neuroscience, a peer reviewed journal providing evidence-based information, titled Postpartum Depression in Men by Jonathan R Scarff defines postpartum depression as an episode of major depressive disorder occurring soon after the birth of a child. While it is frequently reported in mothers, but can also occur in father. However, there is no established criteria for this in men, although it could present over the course of a year, with symptoms of irritability restrict emotions, and depression.
Fathers can also experience postpartum depression (PPD) due to various factors, including a history of depression, relationship conflicts, financial stress, and maternal depression. Sleep deprivation and disrupted circadian rhythms, known to affect maternal mental health, may also contribute to PPD in men. Additionally, hormonal changes during and after pregnancy play a role. Studies suggest that lower testosterone levels in new fathers reduce aggression and enhance responsiveness to a baby’s cries, while increased estrogen levels promote more engaged parenting. However, these hormonal shifts can also increase vulnerability to depression. Low testosterone is directly linked to depressive symptoms, and imbalances in estrogen, prolactin, vasopressin, and cortisol may hinder father-infant bonding, further exacerbating PPD symptoms.
In fact the study also goes on to note that fathers can experience prenatal depression like mothers too. While it depends on the kind of environment they are in, here are some of the common reasons why dads feel this way:
Hormonal Changes: As per a 2014 study published in the American Journal of Human Biology, titled Prenatal hormones in first-time expectant parents: Longitudinal changes and within-couple correlations, showed that fathers experience hormonal changes during and after their partner's pregnancy. The main reason is the decline in testosterone.
Feeling Disconnected: While dads also want to be part of the newborn experience, the baby usually spends most of the time with the mother. It may make them feel like they are on the "outside".
Other reasons include the pressure that a father feels. Parenting is not easy, it adds on to financial pressure, and this thought could also lead to depression. Especially, if depression runs in father's family, he is more likely to feel depressed with these changes around him. Most new parents underestimate the role lack of sleep plays in their lives. Staying up all night trying to get your baby to eat or sleep can leave you feeling sleep deprived, which could be one of the reasons why the father too may feel tired and depressed.
The American Academy of Pediatrics recommended that postpartum depression screenings not be solely the responsibility of obstetrician, and it must be done by pediatricians too to incorporate maternal health. However, fathers too should go for such screenings. In fact, in 2020, an editorial in the Journal of the American Academy of Pediatrics called on pediatricians to assess the mental health of all new parents regardless of gender.
The ray of hope here is that more and more people are talking about it and are able to recognize the depression dads also go through. The change is not just for moms, but also for dads, thus it is important that they also are taken care of.
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The UK today began the first phase of its flu vaccination program, offering jabs to millions of children and pregnant women ahead of winter.
Nearly 19 million people received their flu jab in England last year, helping prevent an estimated 104,000 hospitalizations.
Flu season typically peaks in December and January. Starting vaccinations earlier for children and pregnant women aims to protect those most vulnerable to serious illness and limit the spread of the virus before it circulates more widely.
Starting vaccination in September gives children and pregnant women time to build protection before flu begins circulating more widely. As per the NHS, the children’s flu vaccine can take up to 14 days to work.
Children and pregnant women are among the first groups offered vaccination because they are more vulnerable to serious illness from flu.
Most school-aged children will receive their vaccine, via nasal spray, at school.
Parents of two- and three-year-olds, as well as children in clinical risk groups, will be invited to arrange vaccination through their GP practice.
Pregnant women can receive the flu jab at any stage of pregnancy through their maternity team, GP practice or participating pharmacy.
NHS teams are also taking vaccines into local communities, including through high street pharmacies and mobile vans.
Why Are Young Children and Pregnant Women More Vulnerable?
Flu can be much more serious than a bad cold. Every winter, thousands of children require hospital care because of the virus, while pregnant women also face a higher risk of serious illness.
Flu can spread quickly among younger age groups, which means vaccinating children can also help limit transmission to people who may be more vulnerable, including babies, grandparents and pregnant women.
Vaccinating pregnant women can also help protect their newborn babies in their first weeks.
“Flu can really knock you for six, and for some children and pregnant women it can mean becoming seriously ill or ending up in hospital. Getting vaccinated only takes a few minutes, but it can make a real difference – helping protect you and the people around you from getting seriously unwell,” said Dr Amanda Doyle, National Director for Primary Care and Community Services at NHS England.
From 1 October, flu vaccinations will be offered to other eligible groups, including:
Parents of two- and three-year-olds will also be able to book appointments at participating community pharmacies through the National Booking Service from October.
The NHS’s year-round RSV vaccination program is also expanding from today to include people aged 65 to 74 with a weakened immune system or certain long-term lung conditions.
RSV can make babies and adults with long-term lung conditions seriously unwell and increase their risk of hospitalisation.
Eligible people can receive the vaccine through their GP practice or, in some areas, a participating pharmacy. Those eligible should expect an invitation from their GP.
Pregnant women can also receive RSV, whooping cough and flu vaccines to help protect their newborn babies in their first weeks.
“Vaccinations play a vital role in protecting those most at risk from flu and they are also crucial for relieving pressures on our NHS over the winter months,” Secretary of State for Health and Social Care Yvette Cooper said.
“Everyone who is eligible for a free vaccination will be notified through their phone or in the post,” Cooper added.
Credit: Kaiser Permanente South Bay Medical
A US woman has naturally conceived and given birth to a healthy set of triplets, a rare pregnancy that medical professionals described as an uncommon occurrence.
Nyla Craft from South Bay region in Los Angeles, already a mother of two — a daughter and a son — gave birth to three boys: two identical twins and a third who is their fraternal sibling, said chief of neonatology Dr Rohit Passi at Kaiser Permanente South Bay Medical Center, as reported by the Los Angeles Times.
“This is a very rare pregnancy and a rare outcome,” Passi said.
The triplets were conceived naturally, Passi said, which happens in only about one in 10,000 pregnancies.
They were carried for 36 weeks, which is considered a good gestational period for triplets. All three were born at a healthy weight, with a combined weight of about 19 pounds — around three pounds short of the reported world record total weight for triplets, according to the Guinness Book of World Records.
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Craft said she first learned she was expecting triplets during a doctor’s appointment earlier this year.
“Earlier this year, I went to the doctor and I saw like two different sets,” she said. “I was like, oh my goodness, I’m having twins. And she was like, no, there are three. And I was like, oh my gosh, triplets.”
Craft said the physical demands of carrying the triplets were unlike anything she had experienced before.
When she learned the three babies weighed a combined 19 pounds at birth, the figure put her difficult pregnancy into perspective, ABC7.com reported.
Quynh Vo-Hanser of Kaiser Permanente South Bay said the pregnancy was especially unusual.
“This is a really rare event,” Vo-Hanser said. “This is what we would refer to as a mixed triplet. This is a spontaneous pregnancy, which meant that it was achieved naturally. And within this triplet set, there’s an identical twin set, and then the fraternal sibling.”
Vo-Hanser emphasized the rarity of the birth. “Within the United States, there are 3.5 million deliveries and about 2,400 are triplets,” she said.
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The rare delivery on August 18 required a larger-than-usual medical team to care for both the mother and the three babies.
There were three NICU nurses, one for each baby, along with two doctors caring for the babies and additional doctors and nurses looking after Craft. “There were about 15 people in the delivery room when we normally have about five,” Passi said.
The trio’s combined birth weight of about 19 pounds also put them close to the reported world record for the heaviest set of triplets at birth, which stands at 22.7 pounds.
The combination of a naturally conceived triplet pregnancy, an identical twin pair and a fraternal sibling, all born at 36 weeks and of the same sex, made the delivery particularly unusual, according to the medical team.
Credit: AI
A fever in an infant or young child is often dismissed as a routine infection. However, recurrent or unexplained fever could sometimes point to a urinary tract infection (UTI), which, when associated with an underlying abnormality, may put the kidneys at risk. Identifying UTIs early is particularly important in infants and toddlers who cannot communicate their symptoms.
Unlike older children, infants and toddlers cannot explain symptoms such as pain or burning while urinating. A UTI may therefore present only as fever, poor feeding, reduced milk intake or irritability.
Whenever a child has a febrile UTI, we should look for an underlying cause. One such condition is vesicoureteral reflux (VUR), where urine flows backwards from the bladder towards the kidneys.
When bacteria are present in the bladder, this backward flow can carry infection towards the kidneys. Repeated kidney infections can cause renal scarring, particularly in young children.
Repeated scarring can affect kidney growth and function and, in severe cases, contribute to chronic kidney disease later in life. This makes timely evaluation and management important.
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After a documented febrile UTI has been treated, children may require evaluation for an underlying cause based on their age, history and clinical findings. If VUR is identified, treatment depends on its severity. Not every child with reflux needs an operation. Management depends on the grade of reflux and the child’s clinical condition.
VUR is graded from 1 to 5. Low-grade reflux, particularly Grades 1 and 2, can often be managed through monitoring and, in selected cases, antibiotic prophylaxis. Many children may outgrow the condition as the urinary system matures.
Higher-grade reflux, especially when associated with recurrent infections or renal scarring, may require intervention. Options include minimally invasive Deflux injection or laparoscopic and robotic-assisted surgery in selected cases.
Constipation, bowel and bladder dysfunction, and improper toilet habits, which can contribute to recurrent UTIs, should also be given attention. Encouraging children to void regularly and managing constipation can help reduce infections.
In the present era, urinary abnormalities may be suspected during an antenatal ultrasound (TIFFA scan) allowing early postnatal evaluation and monitoring.
The message for parents is simple: recurrent fever in a young child should not always be dismissed as a routine infection. Identifying a UTI and investigating an underlying problem such as VUR at the right time can help prevent recurrent infections, reduce renal scarring and protect kidney health in the long run.
By Dr. G. Ravindra Varma, Managing Director and Senior Consultant Urologist, Andrologist, Uro-Oncologist, Laparoscopic and Robotic Surgeon, AINU, Visakhapatnam
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