E tūtaki ana ngā kapua o te rangi, kei runga, kei runga te Mangoroa e kōpae pū ana || The clouds in the sky close over, but above them spreads the milky way


Many mothers worry that their depression or anxiety will affect their baby.

Can depression or anxiety affect the baby?

This is a complex issue as many factors influence the characteristics, nature and development of a baby. A mother’s depression or anxiety is only one of many factors. Many mothers with depression or anxiety can and do respond appropriately to their baby – you do not need to be perfect.

One respected psychiatrist said “mothers cannot always be sensitive and responsive to their infants. Intermittent failures will happen spontaneously. This is a necessary part of a baby learning its separateness from its mother. What is important is the overall balance of sensitivity and responsiveness.” He called this “good enough mothering”. This is the best any of us can hope to achieve

“Even though I felt exhausted and flat I managed to look after my baby. The only time I could smile was when he looked at me. He was so gorgeous. I was so pleased he was here – I couldn’t understand why I was depressed.”


What will have an impact on the baby?

These are as, or more, important than the effects from depression and anxiety

  1. Mothers ability to be ‘emotionally present’ for the baby (this is affected by many factors). This means to be aware of the emotional and physical needs of the baby and to be able to respond to them without your own concerns/issues/problems getting in the way.
  2. The presence of violence or aggression in the home.
  3. The availability and quality of other caregivers.
  4. The availability of practical support.
  5. The presence of stresses, eg financial, housing.
  6. Drug and Alcohol misuse in the home.
  7. The duration of any mental illness (the longer the more effect).
  8. The presence of mental illness in the father.
  9. The presence of siblings (this can be a protective factor or can add to the risk).
  10. The consistency of care.

“I don’t feel connected to my baby”

Some mothers don’t feel bonded to their baby and this can make them feel ashamed and worried. They will usually try and hide these feelings from other people. They may feel very concerned that the baby is well cared for and safe but they have difficulty feeling that the baby is ‘their baby’. They may feel that the baby would be better cared for by someone else.

Anything that is making a person feel numb or frightened can cause them to have difficulty relating to their others, including their baby.

Possible causes of not feeling connected to your baby:


  1. Often part of depression.
  2. May result from a traumatic or complicated birth experience.
  3. Past traumatic experiences.
  4. Can happen if you are under severe stress.
  5. Can occur if your baby is/has been unwell.
  6. Can occur if you have been separated from your baby through hospital admission or NICU (neonatal intensive care)


  1. Feelings can change.
  2. Connected and positive feelings can and do develop.
  3. Relationships develop over time.

Rose gave birth by caesarean section under epidural anaesthetic (she was awake when the baby was born). Four weeks later she said:

“When the baby was born, I didn’t feel anything. I looked at her, this little baby, white and messy, but she didn’t feel like mine. I still have trouble feeling she is my baby. I was so busy I felt I didn’t have time for my baby. It was a horrible time. My husband was working long hours. Looking back on it now I wish I had asked for more help- from everyone, but no not me – I was too proud. I worry that it was the baby who suffered most but she seems a happy wee button now.”


Bowlby J. A Secure Base. Clinical applications of attachment theory. London: Routledge, 1988.

Grossman K, Grossman K, Waters E, eds. Attachment from Infancy to Childhood. The major longitudinal studies. New York: The Guilford Press, 2005.

Karen R. Becoming Attached. Oxford: Oxford University Press, 1998.

NICHD Early Child Care Research Network..Child Care and Child Development. Results from the NICHD Study of Early Child Care and Youth Development. New York: The Guilford Press, 2005.

Sunderland M. The Science of Parenting. New York: Penguin Group, DK Publishing, 2006.

Winnicott DW. Maturational Processes and the Facilitating Environment – 3rd Edition. London: Hogarth Press, 1976.

World Association of Infant Mental Health (WAIMH). WAIMH position statements and newsletters, 2003-2007.

Zeanah CH, Jnr. ed. Handbook of Infant Mental Health – 2nd Edition. New York: The Guilford Press, 2000.

Other recommended authors include Alicia Leiberman, Stanley Greenspan, Terry B. Brazelton, Arietta Slade.

See also an excellent New Zealand website on babies and children, www.raisingchildren.org.nz

Engaging cues

These say “I want to interact” or “I’m interested”

Shown by baby as:

  1. Smiling.
  2. Looking at caregivers face.
  3. Smooth movements of arms and legs (usually to the caregiver).
  4. Eyes wide, bright and focused.
  5. Bright face.

Disengaging cues

These say “I need a break” or “I’ve had enough”

Shown by baby as:

  1. A sad face
  2. Lower lip quivers
  3. Frown
  4. Fussiness (low pitched vocalisation- not rhythmical)
  5. Pushing away hands
  6. Pulling body away creating a distance from caregiver or object
  7. Dull looking eyes and face
  8. Fast breathing
  9. Hand behind head & hand to ear
  10. Hiccoughs
  11. Looking away from caregiver or object

Hunger cues

These say “I’m hungry, can I have some food please”

Shown by baby as:

  1. Clenched fingers and fists over chest and tummy.
  2. Bending arms and legs up.
  3. Mouthing.
  4. Rooting.

Satiation cues

These say “I’m full” or “I’ve had enough food or drink”

Shown by baby as:

  1. Extended arms and legs.
  2. Arms straightened along sides.
  3. Finger(s) straight.
  4. Pushing away the object.

Soothing a Baby

Each baby is different so try to work out what works best for your baby. Here are some methods to try to help soothe your baby:

  1. Use one action at a time and repeat over and over.
  2. If what you have tried is not working try another soothing action and repeat over and over.
  3. Show your baby your face.
  4. Gently hold both of baby’s arms close to his or her body.
  5. Rock, walk, or take baby for a ride in pram or car.
  6. Talk to baby in a steady, soft voice.
  7. Pick up and hold baby close.
  8. “Windy” babies may be more comfortable in a more upright position
  9. Sing, hum or croon to your baby.
  10. Wrap baby snugly.
  11. Stroke one area of the baby’s body such as head, foot or back (don’t do it too lightly but also don’t press too hard).


Babies can calm down by themselves by

  1. Sucking on their fingers, fist or tongue,
  2. Bringing hands to mouth.
  3. Changing position of lying.
  4. Looking and listening to faces or noises.

The following is a guideline to the different states that babies can be in.

Babies behave in certain ways in each state. By recognising what state your baby is in it is easier to work out what to do with them.

This can make being with them feel like less work and more fun.

There are two sleep states:

  1. Quiet asleep
  2. Active asleep


Three awake states:

  1. Quiet Alert
  2. Active Alert
  3. Crying


And one in between state:

  1. Drowsy (falling asleep or waking)

Quiet sleep

What baby does What you can do
Lies still. Baby is hard to wake up. No face or eye movements. This is not a good time to feed.
Smooth, regular breathing, generally unresponsive. May twitch, occasionally startles. Good time for the carer to take a rest or if you want to do something a bit noisy, baby will probably stay asleep.

Active sleep

What baby does What you can do
More body activity. Irregular breathing. Movements of face – may smile. Eyes move under lids. More responsive. More likely to wake up. Don’t rush to interact with your baby, they may go back to sleep. Best not to feed your baby in this state. Fussy/crying sound does not mean your baby is hungry. Wait until your baby is fully awake to feed or do anything very active with them.


What baby does What you can do
Smooth body movements. Mild startles. This state comes before waking. As your eyes may open and close baby’s eyes may open and close. You may think they are awake.
They are heavy lidded, dull and glazed. They may have facial movements. Wait and see if they will wake or stay asleep.
To wake your baby give them something to see, hear or suck.

Quiet alert

What baby does What you can do
Minimal body activity. Regular respirations. Face has a bright shiny look. Good time to feed, talk, look at, or hold your baby.
Eyes are wide and bright. Most attentive to stimuli. Will focus on voice, face or moving objects. Baby will learn and respond best in this state. Giving your baby something to see, hear or suck will keep your baby in an alert state.
Baby may look away indicating that they need a break or a rest. When put down to rest the key is to go slowly and follow a sequence that your baby can learn. This will allow for your baby’s need for rest

Active alert

What baby does What you can do
Much body movement. Baby needs a change of pace.
May fuss. Eyes open – less bright. Try feeding if it is time for your baby to feed. Try giving your baby something to suck on like hands.
More sensitive to noise and being hungry. You may need to slow down or stop what you are doing with your baby.


What baby does What you can do
Cry, grimace, move a lot Crying tells you your baby has had enough. You need to stop whatever you are doing. You may need to help soothe your baby. Doing one soothing action like rocking, over and over, works best. Singing calmly or quietly repeating sounds or words may reassure them.