Leukemia - Part III

Today, we will wrap up our discussion of leukemia by talking about the treatment options. As you might expect, because there are several different types of leukemia, there are also several treatment options.

What factors determine the treatment of leukemia?

There are several things that influence what treatment is best for you. These factors include:

• Your age
• The type of leukemia
• Your overall health status
• How widespread your leukemia is

What are the treatments for leukemia?

Some chronic leukemias do not need treatment for many years. If you have chronic leukemia that does not need treatment yet, your doctor will want to see you regularly to monitor your condition, including:

• Regular blood work to keep track of your blood cell counts,
• Monitoring your symptoms,
• Doing regular physical exams to look for signs that your chronic leukemia may need treatment.

If you have an acute leukemia, or a chronic leukemia that has progressed to the need for treatment, here are some of the common treatments used to fight leukemia:

• Chemotherapy – Chemicals used to kill the leukemia cells. Your leukemia may need a single drug or a combination of drugs. Some of these drugs are given in an IV and some come in a pill form.
• Targeted therapy – Targeted drug treatments are designed to focus on blocking specific abnormalities in the cancer cells that are found on the specialized testing done on the bone marrow test. If your leukemia has certain specific abnormalities found, you may benefit from targeted therapy. More targeted drugs are being developed to try to fight more types of leukemia cells.
• Radiation therapy – Radiation uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. The radiation is directed to precise points on your body where there are collections of leukemia cells. Radiation therapy can also be used to prepare you for a bone marrow transplant.
• Bone marrow transplant – Also called a stem cell transplant, this helps to reestablish healthy stem cells by replacing the leukemic bone marrow with stem cells that are free of leukemia. These stem cells then regenerate normal bone marrow. Sometimes you can use your own stem cells, but often a stem cell donor is needed.
• Immunotherapy –Cancer cells have the ability to hide from your immune system. Immunotherapy breaks down their ability to hide. If your immune system can see cancer better, it will fight against it.
• CAR-T cell therapy – This process takes your own T cells (germ fighting white blood cells) and engineers them to fight cancer cells, then infuses them back into your blood. This is an option for certain types of leukemia.
• Clinical trials – These are experiments to test new cancer treatments or new ways of using existing treatments. Before joining a clinical trial, you should discuss the benefits and risks of the particular trial in your very particular situation.

I hope that this series about leukemia has been informative for you.

If you have any questions about leukemia, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Leukemia – Part II

Last week, we started a discussion about leukemia, which is a type of blood cancer that starts in white blood cells. Today, we will continue that discussion to include the typical signs and symptoms, as well as how leukemia is diagnosed.

What are the symptoms and signs of leukemia?

Symptoms can vary depending on the type of leukemia. Chronic leukemias may cause milder symptoms than acute leukemias. Here are some of the common signs and symptoms:

• Fatigue and/or weakness
• Weight loss that is unintentional
• Fever
• Repeated infections, or recurrent mouth sores
• Swollen lymph nodes
• Enlarged liver and/or spleen
• Easy bruising or bleeding, including recurrent nosebleeds
• Excessive sweating, including night sweats
• Tiny red or purple spots in your skin, especially where clothing fits more closely
• Other types of skin changes, including chronic itching
• Bone pain or tenderness

What are the risk factors that increase your risk of developing some types of leukemia?

Many people with leukemia have no known risk factors, and most people with known risk factors don't get leukemia, but here are some factors that can increase your risk of developing leukemia:

• Previous cancer treatment – Some types of chemotherapy and radiation treatment can increase your risk of developing certain types of leukemia.
• Genetic conditions – Certain genetic conditions, including Down syndrome, are associated with an increased risk of leukemia.
• Chemical exposure – Exposure to some chemicals, such as benzene, increases risk.
• Smoking – Cigarette smoking increases the risk of acute myelogenous leukemia.
• Family history of leukemia

How is leukemia diagnosed?

As I mentioned last week, chronic leukemia often has few if any symptoms in the early stages. It may be found on routine blood tests done on a yearly physical exam or for other reasons. If you have some of the signs or symptoms of leukemia, or your routine blood work results are concerning for leukemia, your doctor will do a physical exam to look for signs of leukemia, such as swollen lymph nodes, pale skin or mucous membranes, or an enlarged liver or spleen.

Blood tests are the next thing after the physical exam to look for leukemia. A complete blood count (CBC) tells us the levels of white blood cells, red blood cells, and platelets in the blood, along with some other things like the size of the cells. An extra test can be added to the CBC, where a pathologist looks at the blood cells under the microscope to count the different types of white blood cells, and to look for abnormal leukemia cells (although leukemia cells may not be in the blood sample even when leukemia is present).

The next test would be a bone marrow test. Your doctor will use a long, thin needle to remove a small sample of bone marrow from your hip bone. This sample is sent to the lab for several tests to look for leukemia cells. If leukemia cells are present, other tests will be done to look for characteristics to classify the leukemia and to determine the best treatment options for your particular leukemia.

Next week, we will wrap up our discussion of leukemia by talking about the different treatment options.

If you have any questions about Leukemia, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Leukemia

Leukemia is the most common type of blood cancer. Most people have heard of leukemia and have an idea about how scary the diagnosis might be. It may surprise you to know that some leukemias are not as scary as others. Leukemia is a big subject, so we will talk about it this week and next. Let's get started.

What is leukemia?

Leukemia is a type of blood cancer that starts in white blood cells. The name leukemia comes from the word leukocyte, which is another name for white blood cells (WBCs). Leukocytes grow in the bone marrow from stem cells. Stem cells in the bone marrow can develop into red blood cells, white blood cells (leukocytes), or platelets. They each have a specific function within the blood. WBCs help to fight infections. Once they are formed from the stem cells, WBCs don't usually divide and make more cells on their own. They wait in the bone marrow until they are needed, then are released into the circulation. Most WBCs live for a short time, hours to days.

Leukemia happens when the genetic material inside the cell, called DNA, is damaged or altered in some way. The damaged DNA tells the cells to continue growing and dividing and keeps them from maturing properly. As they multiply, they overwhelm the bone marrow. This slows down and eventually stops the production of normal WBCs, red blood cells, and platelets.

How are leukemias classified?

Leukemias are put into categories based on two things:

How fast the condition is developing:

• Acute leukemia - In acute leukemia, the abnormal WBCs are very immature. They can't carry out any normal function, and they multiply quite rapidly. The disease progresses quickly. These leukemias require aggressive and timely treatment.
• Chronic leukemia - These abnormal cells are more mature. They can perform some of their functions for a period of time. They multiply and accumulate more slowly. Some forms of chronic leukemia can go unnoticed or undiagnosed for years. They are often discovered by accident when a patient comes in for another issue that requires blood work, sometimes a wellness exam.

Which type of white blood cell is involved:

• Lymphocytes - Lymphocytic leukemia affects the lymphocytes, which include T cells and B cells, and natural killer cells. Each of these cell types has a specialized role in the immune system. Some produce antibodies. Some directly fight infections (or direct other cells to fight). They are the best fighters against viruses.
• Myeloid cells - Myelogenous leukemia affects the cells that give rise to white blood cells called granulocytes and monocytes. These make up most of the white blood cells circulating in the blood. They carry enzymes to fight infections or actually swallow up bacteria and fungi.

What are the different types of leukemia?

The major types of leukemia are:

• Acute lymphocytic leukemia (ALL) - The most common type of leukemia in young children but can also occur in adults.
• Acute myelogenous leukemia (AML) - A common type of leukemia, which occurs in children and adults. AML is the most common type of acute leukemia in adults.
• Chronic lymphocytic leukemia (CLL) - The most common chronic adult leukemia. Someone with CLL may feel well for years without needing treatment.
• Chronic myelogenous leukemia (CML) - Mainly affects adults. A person with CML may have few or no symptoms for months or years before entering a phase in which the leukemia cells grow more quickly.
• Other types - Other, rarer types of leukemia exist, including hairy cell leukemia, myelodysplastic syndromes and myeloproliferative disorders.

Next week, we will continue our discussion of leukemia.

If you have any questions about Leukemia, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Child Passenger Safety Week

It's Child Passenger Safety Week. Car crashes are a leading cause of death in children. When the right car seat is used and installed correctly, car seats can significantly reduce the risk of injury in children. Unfortunately, many children are not riding in the right seat and when they are, up to half of them are not installed correctly. Let's talk about how you can make sure you child's seat is installed correctly.

Why is this so important?

The U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA) just released statistics for 2021. According to the NHSTA, while riding in passenger vehicles in 2021:

• 710 children under 13 were killed.
• More than 100,000 children under 13 were injured.
• More than a third (36%) of the children who died were unrestrained.

Data shows:

• Car seat use reduces the risk for injury in crashes by 71-82% for children, compared to seat belt use alone.
• Booster seat use reduces the risk of serious injury by 45% for children ages 4-8 compared with seat belt use alone.
• Seat belt use reduces the risk for death and serious injury by about half for older children and adults.

How do you choose the correct seat?

The recommended seat for your child depends on their age, weight, and height. All children ages 12 and younger should be buckled properly in the back seat. Here are the stages:

Rear-facing car seat - Use from birth until ages 2-4.

• Infants and toddlers should be buckled in a rear-facing car seat with a harness, in the back seat.
• Check the car seat manual and labels for weight and height limits for the seat. When your child reaches the limits for this seat, they should move to a new seat.
• NEVER place a rear-facing car seat in the front seat of your vehicle. Front passenger air bags can injure or kill young children in a crash!

Forward-facing car seat - Use until at least age 5, depending on your child's size.

• Once children outgrow their rear-facing car seat, they should be buckled in a forward-facing seat with a harness and a top tether, in the back seat. The tether is an adjustable strap with hook used to connect to one of your vehicle's tether anchors.
• Use this car seat until your child reaches the maximum weight or height limit for this seat, which can be found in the manual and labels on the seat.

Booster seat - Use after outgrowing the forward-facing car seat, until the seat belt fits properly.

• Use a belt-positioning booster seat.
• If the booster seat does not position the seat belt properly, your child should still be in a forward-facing car seat.
• A seat belt fits properly when the lap belt is across the upper thighs, not the stomach, and the shoulder belt is across the center of the shoulder and chest. It should not be across the neck or face, and not off the shoulder.
• Seat belt fit can vary by vehicle. Check the fit in each vehicle they may ride in to make sure they don't need a booster seat. Sometimes they need a booster seat in one vehicle but not in a different vehicle.

Seat belt use - When the seat belt fits properly without a booster seat.

• Use a seat belt every time you are in the car.
• Proper seat belt fit usually occurs between ages 9 and 12, depending on size.
• Children 12 years old and younger should ride in the back seat, even after the seat belt fits properly, for the best protection from injury.

How do you know if the car seat is installed properly?

The annual Child Passenger Safety Week will end with National Seat Check Saturday. This year, certified child passenger safety technicians will be offering free car safety seat checks and education nationwide on Saturday, September 23. Use this link to find a car seat inspection station near you:

Car Seat & Booster Seat Safety, Ratings, Guidelines | NHTSA.

Using the same link, if you scroll up from the section on car seat inspection, you will also find a section on car seat installation with an explanation of car seat parts and vehicle parts that are used to install car seats, as well as instructions for installing various kinds of rear and forward-facing car seats, and booster seats.

For more child safety information for parents and caregivers, use this link:

Parents and Caregivers | NHTSA

If you have any questions about child car safety, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Healthy Aging

September is Healthy Aging Awareness Month. It is an opportunity to promote ways that people can stay healthy as they age. There are many factors that influence healthy aging. Let's talk more about what we know about healthy aging.

What is healthy aging?

The Pan American Health Organization defines healthy aging as a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course.

A simple way to think about it is that healthy living equates to healthy aging. The healthy living habits that you develop and maintain throughout your life contribute to the ability to thrive later in life. They contribute to greater resilience relating to illness and hardships in life.

What influences healthy aging? What can we do about these factors?

There are many factors that influence healthy aging, including:

Genetic factors -

• We can't do much about genetic factors, although knowing your family history and sharing that information with your doctor is an important aspect of healthy aging.
• Regular exercise and maintaining an active lifestyle -
• Get at least 150 minutes of moderate aerobic activity per week. Or get at least 75 minutes of vigorous aerobic activity per week. Do this throughout life.
• Do strength training exercises for all major muscle groups at least two times a week, throughout life. One set of each exercise is enough for health and fitness benefits.
• Continue to participate in activities throughout life that maintain flexibility, such as sitting on the floor, squatting, bending, stretching, Yoga, gardening, etc.

Healthy food choices -

• Most of each meal should be vegetables and fruits - They should take up half of your plate.
• Choose whole grains to take up one fourth of your plate.
• Choose healthy proteins for one fourth of your plate, such as fish, poultry, beans, and nuts. Limit red meat and avoid processed meats.
• Limit salt intake.

Healthy sleep habits -

• Get between 7 and 9 hours of sleep per night.
• Sleep quality matters - Follow this link to learn more about how to get better sleep: A Good Night's Sleep | National Institute on Aging (nih.gov)

Regular medical check-ups -

• See your doctor regularly and follow recommended medical screening guidelines, such as cancer screenings.

Take care of your mental health -

• Mental wellness is essential to your overall health and quality of life.
• Stay connected with friends and family and continue to meet new people.
• Find ways to manage stress, such as meditation, physical activity, keeping a journal, etc.
• Exercise your brain regularly by learning new skills, such as learning a new game, a musical instrument, or a new craft or hobby such as quilting, or maybe new computer software.
• Be aware of symptoms that might indicate depression and seek treatment. Follow this link to learn more about depression and its symptoms: Depression and Older Adults | National Institute on Aging (nih.gov)

Quit smoking -

• It doesn't matter how old you are or how long you've been smoking, quitting smoking will improve your health.

Avoid alcohol and other substances -

• Alcohol use is associated with multiple health problems.
• Other substances can be both illicit drugs as well as misuse of prescription drugs.

If you have any questions about healthy aging, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Can Outdoor Play Prevent Nearsightedness? - Part II

Last week, we talked about myopia, or nearsightedness, including the increasing incidence of it around the world. We also talked a little bit about how exposure to outdoor light can help to prevent myopia. Today, we'll continue the conversation.

Why is preventing myopia important?

Nearsightedness is associated with a variety of complications. Last week I talked about the long-term complications associated with high (severe) myopia. Here are some complications of unrecognized or uncorrected myopia:

• Poor school performance - Delays in reading or other academic skills
• Difficulty with social interactions
• Eyestrain
• Headaches
• Impaired safety - Not being able to see hazards adequately

What does the research tell us about the link between outdoor play and myopia?

As we discussed last week, myopia is caused by a mix of genetic factors and environmental factors. We can't change the genetic factors, but we do have some control over the environmental factors.

Researchers from all around the world agree that time spent outdoors reduces the likelihood that a child will become nearsighted. The data supports the idea that the primary reason for this is the bright outdoor light. The strong link between exposure to sunlight and myopia is especially true in families where the parents also had myopia.

How much outdoor time helps to prevent myopia?

• The current recommendation is for 2 hours per day outside. This is based on multiple research studies done around the world.
• There are studies showing benefit from less time outside, just not as much benefit. Even adding one additional hour outside in a week can decrease the risk of myopia to some degree.
• Here's a rhyme to remember: Go outside and play, two hours a day, to keep myopia away!
• This outdoor time is also beneficial for teenagers, to lessen the risk of developing myopia and decrease or maybe eliminate the progression of myopia that is already present.

What about the dangers of sun exposure? Didn't I just tell you a few weeks ago to avoid too much sun exposure due to the associated risks?

There is a fine line we need to walk between healthy sun exposure and damaging our health. I did talk about the dangers of sun exposure in recent Health Tips, including eye damage from UV radiation. So, what should you do so your kids get this benefit from the outdoor light?

• Go outside (or have the kids go outside) without sunglasses for about 20 minutes a day, preferably in the morning. The rest of the day, particularly between 10am and 2pm, wear good sunglasses with UV protection. Even with sunglasses on, there is benefit. The sunglasses are not blocking all of the bright light.
• Use sunscreen for outdoor play time. You still get the eye benefits with sunscreen on.
• You can also have the kids play in the shade on a sunny day, they still get much brighter light in the shade on a clear day than they do indoors.

Can that bright light be recreated indoors?

There are currently some experiments with the idea of glass cube walls to help add light to classrooms. But from the research to date, the amount of light that you need to get the goodness of time outdoors, really has to come from outdoor light.

Light can be measured in different ways, such as lumens, lux, foot candles. Lux is the unit of illuminance, indicating the actual brightness received on the ground. Just for comparison, here are some average illuminance values:

• A bright sunny day - Around 100,000 lux.
• Shade illuminated by an entirely clear sky on a bright sunny day - 20,000 lux
• Indoor classroom light - On average 500 lux

As you can see, there is no real comparison. Outdoor light wins for brightness!

How do you know if your child has myopia?

Make sure they get regular vision screenings, which can be done at their yearly well exam.

• At least once between ages 3 and 5
• Before/during kindergarten, usually age 5-6
• Annually through the end of high school

Also, watch for the symptoms we talked about last week.

If there is a problem on the screening test, or you notice symptoms, they need a complete eye exam with an optometrist or ophthalmologist.

If you have any questions about myopia, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Can Outdoor Play Prevent Nearsightedness?

The prevalence of myopia, otherwise known as nearsightedness, is increasing dramatically in the US and around the world. Also on the rise is the prevalence of severe or high myopia. While simple myopia is correctable with glasses, high myopia increases the risk of multiple serious eye conditions. There is a way to help prevent myopia in our children, which is as simple as having them play outdoors.

What is myopia?

Myopia, or nearsightedness, occurs when the eye grows too long from the front to the back. The lens of the eye functions to focus light onto the retina at the back of the eye. If the back of the eye is too far away from the lens of the eye, as it is in myopia, the images are focused at a point in front of the retina. As a result, people with myopia have blurry vision. Their near vision is ok, but they have very poor distance vision.

How much has the incidence of myopia increased?

In the early 1970s, about 25% of the population in the US had myopia. Today, that number has increased to 42%. This is a trend that is happening in many other parts of the world. The World Health Organization (WHO) estimates that half the world's population may be nearsighted by 2050.

Why is this important?

Being nearsighted, particularly having high myopia, increases the risk of conditions that can cause vision loss and blindness later in life. These conditions include:

• Glaucoma
• Retinal detachment
• Early development of cataracts

What causes myopia?

• Myopia is caused by a mix of genetic or hereditary factors and environmental factors.
• According to several research studies, the amount of time a child spends outside in the daylight plays a significant role in the development of myopia.

What are the signs and symptoms of myopia?

• Blurry distance vision
• Sitting very close to the TV or computer screen
• Holding books very close to the eyes
• Squinting when doing activities that require distance vision

How does outdoor play affect myopia?

Several studies have shown that outdoor time, in sunlight, can prevent or lower the chance of developing myopia, or lower the severity of myopia if it does develop. There are a few things that could contribute to this.

Sunlight -

One of the biggest reasons is exposure to the bright light of the sun. Research has shown that the sun's rays cause a release of dopamine, which impacts the development of the retina and may slow the elongation of the eye as children grow.

Relaxed focus -

Another thing that can provide benefit is allowing the eyes to relax by allowing a child's eyes to change focus from nearby to distant objects randomly, over and over again. Excessive near focus, such as staring at a digital screen could be a significant contributor to the development of myopia.

Vitamin D -

Another possible contributor is that more time spent in the sun allows for greater Vitamin D production. There has been research showing that nearsighted people have lower levels of Vitamin D than people with normal eyesight. We need more research to know how much Vitamin D affects the development of myopia.

Next week, we will talk more about myopia and things you can do to help prevent or lessen the severity of this condition in children.

If you have any questions about myopia, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Postpartum Depression - Part II

Last week, we started our discussion about postpartum depression (PPD), which is a serious complication of childbirth. Today we will talk about the possible complications of PPD along with the diagnosis and treatment.

What are the complications of PPD?

PPD can have a ripple effect, causing emotional strain for everyone close to a new baby. If not treated, PPD can have several complications for mothers, children, and for the other parent. These complications include:

For mothers -

• Untreated PPD can last for months or longer and sometimes becomes an ongoing depressive disorder.
• Mothers may stop breastfeeding
• Problems bonding with and/or caring for their baby
• Higher risk of suicide
• Increased risk of future episodes of major depression

For children -

• Higher risk of emotional and behavioral problems
• Higher risk of sleeping difficulties
• Higher risk of eating difficulties
• Delays in language development or other developmental milestones

For the other parent -

• Increased risk of depression
• Job difficulties due to additional or unexpected time taken off work

Can PPD be prevented?

The risk for PPD can be decreased by addressing some of the risk factors. This can include making sure that women have support from others during pregnancy and after bringing the baby home, providing breastfeeding support before and after leaving the hospital with the new baby, etc.

Women should also tell their healthcare provider if they have a personal or family history of depression, or other risk factors for PPD. If you are at higher risk, your provider can monitor you closely for symptoms during pregnancy and may recommend early postpartum checkups to screen you for symptoms. If caught early, treatment can start earlier when symptoms may not be as severe. If you have a history of PPD with a prior pregnancy, your provider might recommend treatment with talk therapy or an antidepressant medication immediately after delivery. Most antidepressants are safe to take while breastfeeding.

How is PPD diagnosed?

Your healthcare provider will talk with you about your symptoms to help determine if you have PPD. It is important for you to be honest and open about how you're feeling so that they can make an accurate assessment of your condition.

You may be asked to fill out a questionnaire about your feelings, thoughts, and other symptoms.

Blood tests may be done to rule out other causes for your symptoms, such as thyroid problems.

How is PPD treated?

Treatment for PPD is tailored to the type and severity of your symptoms. Treatment of PPD can include:

• Antidepressant medicines - Including the recently FDA-approved medication called zuranolone (brand name Zurzuvae). This is the first approved pill specifically for postpartum depression. Clinical trial research shows that this pill improves symptoms of PPD much faster than other antidepressants.
• Anti-anxiety medicines - If you are experiencing significant anxiety.
• Psychotherapy - It can help to talk through your feelings and concerns with a mental health professional. They can help you find ways to cope with your feelings and solve problems.
• Support groups - Everyone could use more support!

What things can you do at home to help with baby blues or PPD?

• Get adequate rest
• Accept help from family and friends
• Make time to take care of yourself
• Connect with other new moms
• Avoid alcohol and recreational drugs
• If you are having trouble with breastfeeding, ask your provider about getting help from a professional lactation consultant.

If you or a loved one have symptoms of PPD, contact your healthcare provider. If you have any questions about postpartum depression, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Postpartum Depression

The FDA recently approved the first pill specifically for postpartum depression. Postpartum depression is a type of depression that happens after having a baby. It affects an estimated one in seven mothers in the US. It is a serious and potentially life-threatening complication of childbirth. Today we'll talk more about this condition, including how to recognize it in yourself or your loved ones.

What is postpartum depression?

Postpartum refers to the time after childbirth. Postpartum depression (PPD) is a type of depression that happens after someone gives birth. Sometimes it can even start during pregnancy and continue after childbirth. Symptoms range from mild to severe and may appear within a week of delivery or may develop gradually, even up to a year after delivery. If it is not treated, PPD can last many months or longer.

What are the symptoms of postpartum depression?

It can be normal to feel somewhat overwhelmed when a new baby comes home, even for experienced mothers. If you have any of the following symptoms that last for more than 2 weeks, contact your health care provider:

• Depressed mood or severe mood swings
• Frequent crying
• Anxiety, panic attacks, or restlessness
• Irritability or intense anger
• Fatigue, sometimes overwhelming
• Feelings of guilt or fear that you're not a good mother
• Difficulty bonding with your baby
• Feelings of hopelessness
• Thoughts of harming yourself or your baby
• Recurring thoughts of death or suicide

How is PPD different from the baby blues?

Up to 75% of new moms experience baby blues after delivery. This can start within the first 2-3 days after delivery and may last from a few days up to 2 weeks. Baby blues resolves without treatment. Symptoms are much milder than PPD, and can include feelings of sadness, anxiety, crying, feeling overwhelmed, or trouble sleeping. PPD may be mistaken for baby blues at first, but the symptoms of PPD are more intense and last longer. Baby blues should not interfere with your ability to care for your baby or handle your normal daily tasks.

Why is PPD sometimes not recognized or treated?

Sometimes it is not recognized because no one asks a new mom how she is feeling. Some women may feel embarrassed or guilty about their symptoms.

In addition, many mothers are hesitant to reveal their symptoms to family members or health care providers. They often fear they will be judged on their parenting or think that people will think they are a bad mother.

Anyone can develop postpartum depression. It absolutely does not mean you are a bad mom!

Are some women at higher risk of developing PPD?

Although anyone can develop PPD, there are some factors that may increase your risk. They include:

• Personal or family history of depression or bipolar disorder
• Having depression during pregnancy
• Having little or no support from family and friends
• Problems with a previous pregnancy or birth
• Current relationship or money problems
• Age younger than 20
• Having alcoholism or other substance abuse issues
• Having a baby with special needs
• Having difficulty breastfeeding
• Pregnancy was unplanned or unwanted

What is postpartum psychosis?

Postpartum psychosis is a rare condition that usually develops within the first week after delivery. The symptoms are quite severe. Symptoms include:

• Feeling confused or lost
• Having obsessive thoughts about your baby
• Hallucinating or having delusions
• Sleep problems
• Having too much energy
• Feeling paranoid
• Making attempts to harm yourself or your baby

Next week we will continue our discussion about PPD, including talking about the complications of PPD and how it is diagnosed and treated.

If you have any questions about postpartum depression, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor