Mean duration of postpartum amenorrhea Mean duration of postpartum amenorrhea
1010 ((±± 4) months 4) months (n = 122(n = 122))
!Kung-like nursing intensity
US-like nutritional status
Lactational Lactational Amenorrhea in TobaAmenorrhea in Toba
•• Mean = 10.3 monthsMean = 10.3 months
Valeggia & Ellison
Lactational Lactational Amenorrhea in TobaAmenorrhea in Toba
•• Mean = 10.3 monthsMean = 10.3 months
•• High nutritional status and high nursing High nutritional status and high nursing
intensity intensity —— leads to short periods of leads to short periods of
lactational lactational amenorrheaamenorrhea
Valeggia & Ellison
99
Lactational Lactational Amenorrhea in TobaAmenorrhea in Toba
•• Mean = 10.3 monthsMean = 10.3 months
•• High nutritional status and high nursing High nutritional status and high nursing
intensity intensity —— leads to short periods of leads to short periods of
lactational lactational amenorrheaamenorrhea
•• Thus, nursingThus, nursing intensity alone is insufficient intensity alone is insufficient
explanationexplanation
Valeggia & Ellison
Lactational Lactational Amenorrhea in TobaAmenorrhea in Toba
•• Mean = 10.3 monthsMean = 10.3 months
•• High nutritional status and high nursing High nutritional status and high nursing intensity intensity —— leads to short periods of leads to short periods of lactational lactational amenorrheaamenorrhea
•• Thus, nursingThus, nursing intensity alone is insufficient intensity alone is insufficient explanationexplanation
•• Interaction between nursing intensity and Interaction between nursing intensity and nutritional statusnutritional status
Valeggia & Ellison
Why do we respond to babies?Why do we respond to babies?Why do we respond to babies?Why do we respond to babies?
The Evolution of Mickey Mouse:The Evolution of Mickey Mouse:
•• Sons can have multiple Sons can have multiple wiveswives
•• Sons had very high Sons had very high reproductive successreproductive success
In highest social groups:In highest social groups:
Sex Biased Investment in IndiaSex Biased Investment in India
•• Result:Result:
•• Sons had multiple wives Sons had multiple wives from from ‘‘lowerlower’’ social group social group each of whom would each of whom would bring a dowry to the bring a dowry to the familyfamily
•• Thus Thus
•• Investment in sonsInvestment in sons
•• Female infanticideFemale infanticide
In highest social groups:In highest social groups:
Opposite pattern (preference for daughters) on bottomOpposite pattern (preference for daughters) on bottom
Gabbra (northern Kenya, southern Ethiopia) are typical of patrilineal groups in Africa:
pastoralists
patrilocal residence
brideprice and resource holding polygyny
male-biased wealth inheritance
divorce is not recognised
insist on virginity at marriage
Chewa (Malawi, Zambia) are typical matrilneal group:farmers, matrilocal residence, have no brideprice, female-biased wealth inheritance, high divorce rates and hate virginity
“Many girls have love affairs with young boys before
they reach puberty, and at one time children build play-
houses, after the manner of the Cewa, where they
pretended to be adults playing at cooking and
copulation. The Cewa encouraged this among their
own children and at puberty Cewa girls, if not already
deflowered, had their hymen forcibly ruptured in a
prescribed manner. We have seen that the [patrilineal]
Ngoni formerly expected girls to be chaste before
marriage. Whilst the Cewa believed that if a girl did
not copulate at puberty she would die.”
Source ‘ Marriage in a changing society’ J A Barnes
1950. (re the Ngoni moving into a Chewa area) p.33
women whose children are all of one sexwomen whose children are all of one sex
Sex of children
All daughtersAll sons
Percent
70
60
50
40
30
20
10
0
Chew a
Gabbra
(Ruth Mace)
PostPartum PostPartum DepressionDepression
Postpartum DepressionPostpartum Depression
(Hagen 1999)
40-80% of women experience postpartum mood changes - Elation or Depression Postpartum Psychiatric DisordersPostpartum Psychiatric Disorders
•• Maternity Blues: mild Maternity Blues: mild mood disturbance that mood disturbance that resolves within a few hours resolves within a few hours to a few days; 1 in 2 birthsto a few days; 1 in 2 births
•• Postpartum Psychosis: 1 in Postpartum Psychosis: 1 in 1000 births1000 births
(Brockington, 2004)
Clinical Definition of PPDClinical Definition of PPD•• No different clinically from other forms of depression except foNo different clinically from other forms of depression except for its r its ““postpartum onsetpostpartum onset”” (from immediately after birth to 4 weeks after (from immediately after birth to 4 weeks after birth)birth)
•• For a diagnosis of PPD, 5 of the following symptoms must be For a diagnosis of PPD, 5 of the following symptoms must be present for 2 weeks and represent a change from previous levels present for 2 weeks and represent a change from previous levels of of functioning (at least 1 of the symptoms must be either depressedfunctioning (at least 1 of the symptoms must be either depressedmood or diminished interest or pleasure):mood or diminished interest or pleasure):•• Depressed mood, nearly every day during most of the dayDepressed mood, nearly every day during most of the day
•• Marked diminished interest or pleasure in almost all activities Marked diminished interest or pleasure in almost all activities
•• Significant weight loss (when not dieting), weight gain, or a chSignificant weight loss (when not dieting), weight gain, or a change in appetite ange in appetite
•• Insomnia or Insomnia or hypersomnia hypersomnia (excess sleep)(excess sleep)
•• Psychomotor agitation or psychomotor retardationPsychomotor agitation or psychomotor retardation
•• Fatigue or loss of energyFatigue or loss of energy
•• Feelings of worthlessness or inappropriate guiltFeelings of worthlessness or inappropriate guilt
•• Impaired ability to concentrate or indecisiveness Impaired ability to concentrate or indecisiveness
•• Recurrent thoughts of death, recurrent suicidal ideation withoutRecurrent thoughts of death, recurrent suicidal ideation without a specific plan, a specific plan, or a suicide attempt or a specific plan for committing suicideor a suicide attempt or a specific plan for committing suicide
CrossCross--Cultural IncidenceCultural Incidence
•• PPD was once thought to be a culturePPD was once thought to be a culture--bound bound illness found only in Western countries because of illness found only in Western countries because of the absence of a social support structure (Stern and the absence of a social support structure (Stern and KruckmanKruckman, 1983), 1983)
•• However, mounting evidence suggests that women However, mounting evidence suggests that women around the world experience PPD, with prevalence around the world experience PPD, with prevalence rates ranging from 0% to 40%rates ranging from 0% to 40%
1414
PPD Risk Factors in Sample PPD Risk Factors in Sample
•• Sadness about infantSadness about infant’’s s gendergender
PPD Protective FactorsPPD Protective Factors
•• Maternal EducationMaternal Education
•• Paternal EmploymentPaternal Employment
Hypotheses explaining PPDHypotheses explaining PPD• Dysregulation of mechanisms underlying normal mood variation
• “Psychological Pain” Hypothesis: negative affect is associated with social circumstances that were reproductively costly in ancestral environments; mothers will take actions to reduce their levels of psychological pain
• Accounts for minor depression, but not most debilitating symptoms of depression
• Social Navigation Hypothesis: depression induces cognitive changes that focus and enhance capacities for accurate analysis and solution of key social problems=social rumination function; costs associated with depression can persuade social partners to provide help=social motivation function
FatheringFathering
Hormonal Changes in FathersHormonal Changes in Fathers
•• Study Design:Study Design:
•• 34 couples34 couples
•• watched 5 min. video of breastfeedingwatched 5 min. video of breastfeeding
•• Held a doll in Held a doll in ‘‘usedused’’ blanketblanket
•• Listened to tape of distressed newbornListened to tape of distressed newborn
•• Postnatal group fathers held own Postnatal group fathers held own
•• Of 186 nonOf 186 non--industrial industrial cultures cultures —— 100% of babies 100% of babies sleep in same place as their sleep in same place as their mothers at least until 1 year mothers at least until 1 year of ageof age
•• Of 172 societies, all infants Of 172 societies, all infants slept with mothers at least slept with mothers at least part of the nightpart of the night
•• The US stands out in that The US stands out in that babies are normally placed in babies are normally placed in other roomsother rooms
American Pediatricians American Pediatricians
RecommendationsRecommendations
0102030405060708090
RegularBed time
RitualizedBed time
Babyshouldsleep inanotherroom
No parentalcontact in
night
CoCo--Sleeping in English ParentsSleeping in English Parents
0
10
20
30
40
50
60
70
80
90
100
3 Months Breast feeders
What is SIDS?What is SIDS?
•• Sudden Infant Death SyndromeSudden Infant Death Syndrome
•• No characteristics to detect it No characteristics to detect it ---- babies stop babies stop
breathingbreathing
•• In U.S. 1.5/1000 live birthsIn U.S. 1.5/1000 live births
•• Hong Kong: 0.4/1000 live birthsHong Kong: 0.4/1000 live births
1919
Does CoDoes Co--sleeping Protect against sleeping Protect against
SIDS?SIDS?
•• Cultures in which mothers sleep with babies have Cultures in which mothers sleep with babies have
lower SIDS ratelower SIDS rate
Does CoDoes Co--sleeping Protect against sleeping Protect against
SIDS?SIDS?
•• Cultures in which mothers sleep with babies have Cultures in which mothers sleep with babies have
lower SIDS ratelower SIDS rate
•• Position of the baby Position of the baby ---- prone positionprone position
Does CoDoes Co--sleeping Protect against sleeping Protect against
SIDS?SIDS?
•• Cultures in which mothers Cultures in which mothers
sleep with babies have sleep with babies have
lower SIDS ratelower SIDS rate
•• Position of the baby Position of the baby ----
prone positionprone position
•• MotherMother’’s breath (CO2) s breath (CO2)
stimulates breathingstimulates breathing
Does CoDoes Co--sleeping Protect against sleeping Protect against
SIDS?SIDS?
•• Cultures in which mothers Cultures in which mothers
sleep with babies have lower sleep with babies have lower
SIDS rateSIDS rate
•• Position of the baby Position of the baby ---- prone prone
positionposition
•• MotherMother’’s breath (CO2) s breath (CO2)
stimulates breathingstimulates breathing
•• SkinSkin--toto--skin contact skin contact
increases skin temperatureincreases skin temperature
Does CoDoes Co--sleeping Protect against sleeping Protect against
SIDS?SIDS?
•• Cultures in which mothers Cultures in which mothers sleep with babies have lower sleep with babies have lower SIDS rateSIDS rate
•• Position of the baby Position of the baby ---- prone prone positionposition
•• MotherMother’’s breath (CO2) s breath (CO2) stimulates breathingstimulates breathing
•• SkinSkin--toto--skin contact skin contact increases skin temperatureincreases skin temperature
•• Wake up more frequently, avoid Wake up more frequently, avoid deep sleep stagesdeep sleep stages
2020
Does CoDoes Co--sleeping Protect against SIDS?sleeping Protect against SIDS?•• Cultures in which mothers sleep Cultures in which mothers sleep with babies have lower SIDS with babies have lower SIDS raterate
•• Position of the baby Position of the baby ---- prone prone positionposition
•• MotherMother’’s breath (CO2) s breath (CO2) stimulates breathingstimulates breathing
•• SkinSkin--toto--skin contact increases skin contact increases skin temperatureskin temperature
