WA News Guest Opinion / Editorial Iatrogenic Perinatal Anxiety
Iatrogenic Perinatal Anxiety
Written by Dr Leon Levitt
Tuesday, 29 August 2017

25082017-anxious-stress-mother-babyThere is an epidemic of anxiety among younger generations especially new parents, expecting to be ‘the best parent’, who believe normal is a calm compliant baby. They want something to fix their baby, stop crying, fix wind, enable sleep, and stop noises or curling up legs or vomiting. Their child has silent reflux, milk allergy, colic, tongue tie or any other condition that the parent implores us to fix. They have done research and know there is something wrong.

Generally, the child is thriving and the behaviour will settle as the child moves out of this developmental stage.

Health professionals often feel a need to fix this ‘problem’. We are trained to look for conditions and seek solutions just like parents. The more that we look for causes and solutions, the more we encourage fearful thoughts in parents. Our desire to fix, not miss anything and show concern causes perinatal anxiety to flourish exacerbating the problem. Our suggestion of tongue tie, leads to surgery; cow’s milk allergy leads to guilt and an extreme diet; reflux leads to medications that are not without their complications. All our suggestions cause anxiety.

How can we help?

Know what is normal. If you gather a group of 5-10 babies together and observe, they feed differently, cry differently, sleep less or more, etc. There is a natural variation in behaviour not requiring a diagnosis or treatment.

Distinguish between a sick child and a healthy child whose parents have a problem. This is usually a diagnosis that can be made from a metre away. Is the baby thin, pale, unusually agitated or lethargic?

Begin with the assumption that the child is OK, before assuming the worst. This is exactly what we need to encourage the parents to do also. Don’t catastrophise on the first sign of something different. Babies are naturally healthy. Significant illness is rare. In order to reduce anxiety in parents, we need to encourage them to take a variation in behaviour as normal first, and only if it is very much out of the ordinary and persistent to seek an opinion.

Spend time with the parents, educate them, reassure them, weigh the child and confirm good weight gain, and help them to let go of their frustrations. The more they try to fix a problem that is not abnormal, or one that cannot be fixed, the greater the frustration and anxiety. 

Teaching them to let go and deal with their anxiety may be the most important advice we give them for their entire parenting lives.

Consider referral to an experienced practitioner (psychologist, psychiatrist, mental health trained Child Health Nurse or GP experienced in perinatal medicine) if this is not your area.

By Dr Leon Levitt

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