Post-Partum Depression and Early Childhood Development

The bond between a mother and child is special. Because that connection is so profound, wellbeing for an infant is largely determined by the physical and mental health of their mother. According to the American College of Obstetricians and Gynecologists (ACOG), Post-Partum Depression (PPD) is one of the most common threats to maternal mental health, affecting approximately 600,000 women a year. It is estimated that 14% to 23% of mothers will experience depression at some point during pregnancy and 5%-25% experience PPD. All women who give birth are potentially at risk. Despite that fact, many mothers with PPD struggle with guilt or shame. While PPD is highly treatable, fear of being labeled a bad mother can make it hard for women to discuss the issue or reach out for the help they need.

Symptoms of PPD include feelings of anger, crying more often than usual, withdrawing from loved ones, feeling distant from the baby, worrying or feeling overtly anxious, thinking about hurting yourself or the baby, and doubting one’s ability to care for the baby. These feelings of being unable to connect to the baby can be particularly unsettling for new mothers and particularly disruptive to the attachment and responsiveness which underlies health child development. Because the first three years of life are so foundational, untreated PPD can have lifelong consequences for children.

Simple acts of care such as hugs, smiles, and lullabies create new brain pathways for infants which develop their capacity to form memories, relationships, and logic. Post-partum depression can weaken the mother-child bond, stunting cognitive and linguistic development. A number of other negative outcomes have been linked to PPD, such as higher rates of behavioral problems and lower grades. If essential neural pathways are not formed during early childhood, they may never develop. This means that treatment is especially time sensitive; early treatment allows moms to fully bond with their children as soon as possible and to optimize their child’s early developmental period. TexProtects advocates for improving post-partum mental health and other issues which impact a child’s crucial development period through our Prenatal to Three Policy Agenda.

Destigmatizing PPD and supporting mothers with mental healthcare will help ensure every child in Texas has a strong start. Last legislative session, HB 253 mandated the creation of a five-year strategic plan to raise public awareness around PPD and to improve access to mental health screening, referral, treatment, and support services. The Texas Health and Human Services Commission (HHSC) recently released their initial draft of the Post-Partum Depression Strategic Plan for public comment. TexProtects submitted comments on that draft plan that included the following key recommendations:

  1. Texas should continue strong investments in programs overseen by the Department of Family and Protective Services’ (DFPS) Prevention and Early Intervention (PEI) Division – such as Texas Home Visiting, Project HOPES, Project HIP, and Texas Nurse-Family Partnership – to reach more families. These voluntary programs are proven to improve maternal and infant health, strengthen referrals and connections, and promote positive parenting.
  2. Texas should increase investments in Texas Family Connects, a short-term evidence-based nurse home visiting program that links nurses to moms with newborns. To encourage scale-up into more Texas regions, Texas should explore additional financing strategies, including Medicaid coverage for maternal mental health screenings, case management, and nurse visits delivered through Family Connects.
  3. Texas should expand Help Me Grow, a referral line and centralized access point that helps parents with young kids to get connected to community-based resources. Department of State Health Services (DSHS) Title V has recently become a statewide hub for Help Me Grow, a national model that works to create a “Centralized Access Point” for parents with young children. Included in this work is strategic integration with statewide 2-1-1 so that families have both an effective “front door” when looking to access services and a warm handoff to regional hubs where parent navigation can ensure families get access to the right program and supports at the right time.

Increasing healthy beginnings and supporting young families are critical components of our Prenatal to Three Policy Agenda. Learn more about our work to ensure infants and toddlers (and their families) have what they need to be safe and well and maximize the potential of the early years of development.



Maternal and Child Health Inequities Emerge Even Before Birth (Child Trends)

Highlighting findings from the State of Babies Yearbook: 2020, this brief focuses on the evident disparities in maternal health and birth outcomes among babies and families of color: “To have a healthy pregnancy and positive birth outcomes, women and their infants require access to appropriate health care services, before, during, and after birth.”

TexProtects’ Takeaway:  Black and Indigenous babies have a much higher risk of birth complications, low birthweight, and death within their first year of life in comparison to white babies. To achieve the strongest possible outcomes for all, we must meaningfully address health disparities in our communities, beginning with the earliest days of each child’s life.

Tracking COVID-19’s Effects by Race and Ethnicity (Urban Institute)

To work toward an equitable recovery for all U.S. citizens, policymakers and practitioners should pursue solutions that acknowledge and account for COVID-19’s disparate impact on communities of color. “To design these race-conscious policies, policymakers need data to gauge how the pandemic may be affecting people’s health, housing, and livelihoods. This tool uses the near-real-time Household Pulse Survey data to track a set of measures for US households as the pandemic and recovery unfold.”

TexProtects’ Takeaway: The onset of this health crisis has further exposed how systemic racism is creating harmful disparities between white communities and communities of color. The Texas Health and Human Services Commission (HHSC) is taking the first step and has recently announced that it is seeking to remedy the lack of information about how Black and Latinx/Hispanic communities are affected by the virus. All labs that test for COVID-19 are now required to collect information on race, ethnicity, and other factors.

Start with Equity: From the Early Years to the Early Grades (Bipartisan Policy Center & The Children’s Equity Project at Arizona State University)

“Millions of young children are disproportionately underserved, over-punished, and barred from high-quality education in American schools…. The Children’s Equity Project and the Bipartisan Policy Center have come together to create an actionable policy roadmap for states and the federal government—as well as for candidates at all levels of government vying for office—to take meaningful steps to remedy these inequities in early learning and education systems.”

TexProtects’ Takeaway: More than half of the children in the United States are children of color. COVID-19 is exacerbating the inequitable distribution of opportunity in our education system. This policy agenda supports fully funding programs like Head Start, requiring states to report plans on who they will work to make learning systems more equitable, supporting and funding equitable educator training, and ensuring all education legislation prioritizes racial, ethnic, linguistic, socioeconomic, and ability-based integration.

Health Care Access for Infants and Toddlers in Rural Areas  (Child Trends)

“While many public reports provide indicator data on rural health care access at the national level, this brief uses data from the State of Babies Yearbook: 2020 to examine state-level differences in how infants and toddlers living in rural areas are faring. Equipped with these data, state policymakers can explore strategies to support the needs of very young children and their families.”

TexProtects’ Takeaway:  Only 0.5% of infants and toddlers in Texas who could benefit from evidence-based home visiting (HV) programs are receiving those services. This upcoming legislative session, policymakers in Texas must identify why there are gaps in how existing HV programs serve rural children and families.

As schools reopen, addressing COVID-19-related trauma and mental health issues will take more than mental health services (Child Trends)

To address COVID-19 related trauma and mental health concerns amongst students, Child Trends recommends that decision-makers in education take a comprehensive approach that extends beyond offering school-based mental health services. Such an approach includes (but is not limited to) educating all school staff about trauma and mental health; acknowledging that not every community has experienced the pandemic in the same way; and ensuring that school staff know how to connect students to community-based mental health resources.

TexProtects’ Takeaway: Through the passage of HB 18, the Texas Legislature took a step last session to ensure that all school staff are adequately trained to understand the impact of trauma on students, implement strategies to minimize the negative impacts, and maximize academic opportunities in an environment of safety and connection, making referrals when needed and with parental consent. Policymakers and organizations like TexProtects must hold school districts accountable and ensure that these mandatory trainings are taking place in a timely fashion.

To support infant development, states can encourage parents to read, sing, and tell stories with their children (Child Trends)

“Here’s an easy, evidence-based, and low-cost investment for early childhood leaders and policymakers to promote young children’s development, empower parents, and strengthen families: Encourage parents and other caregivers to read, sing, and tell stories to their children. It’s that simple.”

TexProtects’ Takeaway: Building the caregiver-child bond through singing, reading, and telling stories contributes to strengthening resiliency and encouraging literacy skills and cognitive and socioemotional intelligence in young children.


Different brain profiles in children with prenatal alcohol exposure with or without early adverse exposures (Andre, Q., McMorris, C., Kar, P., Ritter, C., Gibbard, B. Tortorelli, C., & Lebel, C.)

“Prenatal alcohol exposure (PAE) has been linked with widespread brain abnormalities including reduced brain volume, altered cortical thickness, and altered white matter connectivity. Fetal alcohol spectrum disorder (FASD), the neurodevelopmental disorder associated with PAE, is the most common cause of preventable developmental disabilities in children… The goal of this study was to determine how PAE in the presence or absence of postnatal adverse exposures is associated with brain structure and mental health symptoms in children.”

TexProtects’ Takeaway: This research contributes to a long line of research on adverse childhood experiences (ACEs) and how they shape the physical and mental brain health of children. TexProtects is working with policymakers on legislation that would create a framework in Texas on how to mitigate and treat ACEs on a statewide level to ensure the health of every child.

Father-child play: A systematic review of its frequency, characteristics and potential impact on children’s development (Amodia-Bidakowska, A., Laverty, C., & Ramchandani, P.)

This paper reflects a systematic literature review of publications in psychological and educational databases (until the year 2018) to “characterize the nature and potential impact of father-child play” for children ages 0-3. Given their findings, the authors suggest that father-child play can substantially benefit children’s development, which “provides a clear imperative for policy makers and practitioners to facilitate and support fathers, as well as mothers, in developing more positive and playful interactions with their infants.”

TexProtects’ Takeaway: Fathers matter! Encouraging strong father-child relationships is part of building protective factors for resiliency in children. This report enforces that early father-infant play is linked to positive social, emotional, and cognitive outcomes.


African American, American Indian, and Alaska Native children are all more likely to live in grandfamilies – “families in which grandparents, other adult family members or close family friends are raising children with no parents in the home” – than other racial or ethnic groups. The following two reports by Generations United are intended to support child welfare or other government agencies, as well as nonprofits, to better serve the grandfamilies with which they work:

TexProtects’ Takeaway: Children of color are dramatically overrepresented in kinship care both within and without the formal foster care system. Historically, there has been a severe lack of support and services for these families – especially those that are culturally appropriate.

Road to Resilience: Raising Healthy Kids (Mayo Clinic Health System)

“This six-week virtual program will help you and the youth in your life combat the effects of Adverse Childhood Experiences (ACEs). There are a variety of resources in linked pages on this site that you and your youth should review at your own pace. You can read content, watch videos or do activities.”

TexProtects’ Takeaway: Adverse childhood experiences (ACEs) can lead to negative mental and physical health effects later in life. This tool is a great way to help build resiliency against these potential negative outcomes so that ACES do not dictate a child’s future.

Using Media Effectively with Young Children and Virtual Visitation (Youth Law Center & Quality Parenting Initiative)

“While in-person visitation is the best way to support families, it isn’t always possible during this emergency. Now more than ever, it is critically important that birth and foster parents partner together to ensure that children experience continuity of relationships and can maintain contact with the people they love.” This brief shares research and practical suggestions from Dr. Rachel Barr, an expert in media and young children, to help parents navigate and make the best of virtual visitation with their young children.

TexProtects’ Takeaway:  Virtual visitation can be used to maintain and strengthen relationships for young children. Learn how to navigate difficulty holding a child’s attention, problems with eye contact and sharing attention, loss of physical contact, technical problems, and toddler independence.

Early Childhood Matters: Recommendations for Messaging and Policy for Early Childhood Brain Development

Critical data on policymakers’ knowledge and prioritization of early childhood brain development.

View the Report.

The Story of Early Childhood

Children that experience chronic adversity and trauma can affect their neurological and hormonal development.

View the Report.