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.

Why Do Dads Experience PPD?

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.

What Can Be Done?

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.

A new study published in The Lancet Obstetrics, Gynaecology, & Women's Health has revealed an alarming rise in infertility rates among women aged 35 years and older.

The analysis, based on the Global Burden of Disease Study 2023, found that global female infertility could affect nearly 80 million women aged 35–49 by 2036 if current trends continue.

In 2023, an estimated 53.60 million women aged 35–49 were affected by infertility. Nearly 54 million women in this age group sought fertility care, including fertility testing and assisted reproductive technologies such as in vitro fertilization (IVF).

Asia Bears Highest Burden

According to the study, Asia has the highest need for fertility care particularly East Asia reported the highest regional burden, while Australasia has the lowest. At country level, the Central African Republic had the highest reported burden, while Nepal had the lowest.

Although disparities between low- and high-income regions have narrowed, the burden is shifting toward high-income settings, where women are more likely to delay pregnancy and seek fertility testing and treatment.

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The researchers said, "This shift reflects broader social and economic changes, including delayed family planning and greater access to fertility services in some affluent regions".

"Advanced-age female infertility represents a growing global health challenge. Despite improved regional equity, low-SDI countries continue to face significant burdens. This necessitates implementing tailored public health strategies and prioritizing resource allocation to mitigate future burdens," said the researchers from China, Hong Kong, and Singapore in the paper.

To address the rising demand, the authors called for

• expanding and integrating fertility services into primary health care, reducing financial barriers to treatment,
• using innovative delivery methods,
• mobile health tools,
• improve equitable access to fertility care.

Infertility A Growing Global Health Concern

The World Health Organization defines infertility as the failure to achieve a clinical pregnancy after 12 months of regular unprotected intercourse.

Approximately 8–12 per cent of reproductive-aged couples worldwide experience infertility, with the burden disproportionately affecting women aged 35–49 years.

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The study noted that this higher risk is largely biological, driven by age-related declines in ovarian reserve and oocyte quality, which reduce natural fertility, increase miscarriage risk, and lower the success rates of assisted reproductive technologies (ART).

As populations age and socioeconomic transitions continue, the number of women exposed to advanced-age infertility risk is increasing, making it an increasingly important public health issue.

How Was The Study Conducted?

The researchers analyzed data from the Global Burden of Disease (GBD) 2023 study to provide what they describe as the first comprehensive assessment of infertility among women aged 35–49 across 204 countries and territories.

Since 1990, both the age-standardized prevalence rate and disability-adjusted life years (DALYs) attributable to infertility have risen steadily, by 0.45 per cent and 0.47 per cent every year, respectively.

The study projects that infertility cases in women aged 35–49 will continue to rise, reaching nearly 80 million by 2036 in the absence of targeted interventions.

The researchers also found a 23.10% reduction in the relative disparity in infertility-related DALYs between low- and high-Socio-demographic Index (SDI) regions since 1990, indicating progress in equity while highlighting persistent structural gaps in access to care.

A 20-month-old toddler from West Bengal who suffered from recurring urinary tract infections (UTIs) for six months was eventually diagnosed with cystinuria, a rare inherited metabolic disorder that causes recurrent kidney stone formation.

About The Case

The diagnosis came after the toddler experienced persistent UTIs over a period of six months. After multiple episodes of infection couldn’t be solved despite treatment, the doctors discovered the rare condition.

Initially, the doctors believed that it could be vesicoureteral reflux, a condition in which urine flows backward from the bladder towards the kidneys.

However, more investigations revealed an unusual kidney stone caused by cystinuria, an inherited disorder that leads to excessive amounts of the amino acid cystine in urine.

As cystine dissolves poorly in urine, it can crystallise and form stones, which may block urine flow, trigger recurrent UTIs, and damage the kidneys if left untreated for a long time. Doctors at a Bengaluru hospital treated the child using a minimally invasive procedure to remove the stone.

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What Is Cystinuria?

Usually, the kidneys reabsorb cystine after filtering blood. In individuals with cystinuria, this process does not work well.

Large amounts of cystine pass into the urine. As cystine does not dissolve in urine, it forms crystals and eventually stones in the kidneys.

The condition is caused when the child inherits one faulty gene from each parent. Parents who carry one altered gene usually have no symptoms themselves.

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Symptoms & Treatment

Unlike most kidney stones, which are more common in adults, cystinuria presents during childhood or adolescence. Parents must look out for the following symptoms in their children:

• Recurrent urinary tract infections

• Pain while passing urine

• Blood in urine

• Abdominal or flank pain

• Kidney stones at an unusually young age

• Difficulty passing urine if stones obstruct the urinary tract

Although cystinuria has no cure, effective treatment and management can reduce stone formation and protect kidney function. It includes:

• Drinking large amounts of water to dilute urine and reduce the formation of stones

• Reducing salt intake

• Limiting consumption of excessive animal protein

• Medications that make urine less acidic (urine alkalinisation)

• Drugs that reduce cystine stone formation in severe cases

• Surgical or minimally invasive procedures to remove stones when necessary

Parents must seek medical attention when the child faces the following:

• Two or more UTIs within six months or repeated infections over a year

• Recurrent fever without an obvious cause

• Intense pain during urination

• Blood in the urine

• Difficulty in gaining weight

• Persistent irritability

• Recurrent abdominal or back pain

While most recurrent UTIs are caused by common anatomical or behavioural factors, persistent or unusual infections can occasionally point to rare inherited disorders like cystinuria that warrant medical attention.

Early diagnosis and timely treatment can help prevent permanent kidney damage and significantly reduce the frequency of stone formations.

Hypertension or high blood pressure is an increasingly common problem among children and adolescents; many children may not have any obvious signs or symptoms in the early phase. It is said that hypertension in children is a “silent condition,” and therefore, it is of paramount importance that doctors, parents, and teachers are aware of it to detect the condition early.

Symptoms Of High Blood Pressure In Children

While some kids might not have any symptoms at all, there are some signs that shouldn't be overlooked. Recurrent headaches or morning headaches, especially headaches in the back of the head, may occasionally be a sign of high blood pressure. Symptoms can be dizziness, blurred vision, flashers, loss of energy for no known reason, nausea, vomiting, difficulty breathing during exercise, chest pain, palpitations, or frequent nosebleeds for no obvious reason.

There can also be changes in a child's behaviour or physical appearance in the school environment that teachers might observe. Children with high blood pressure often experience headaches, frequent visits to the sick room for weak or dizzy spells and ask to go out of class to rest. Sometimes, symptoms such as difficulty in concentration, sudden drop in school performance, irritability, changes in mood or appearing unusually withdrawn are associated with underlying health problems, such as hypertension.

Some children may be more tired, winded or unwell from sports or physical activity than others and avoid it. These symptoms can be missed and dismissed as stress, poor sleep or lack of interest in studies or sports. Such symptoms may be overlooked and blamed on stress, sleep deprivation or low interest in studies or sports.

Leading Causes & Prevention

Doctors think obesity, poor diet, excessive salt intake, poor sleep, low exercise, and watching too much screen time are all factors that are driving up hypertension rates in kids and teens. Other kidney disease, heart disease, hormone imbalances, or family history can also contribute in some children.

Regular blood pressure checks on children's routine visits are very significant because many children with hypertension may be asymptomatic, experts say. Prompt diagnosis and treatment can prevent complications with the heart, kidneys, brain and eyes in the long term.

It is important that parents and teachers do not shrug off repeated complaints of headaches, fatigue, dizziness or vision problems as insignificant. Early medical assessment can be important in safeguarding a child's long-term health.

By Dr Vaibhav Meshram, Paediatrician, Ruby Hall Clinic