The impact of postnatal depression on mother-infant interaction and infants’ communication skills
: A video-based analysis

  • Vasiliki Eirinaki

Student thesis: Doctoral Thesis


Background: Postnatal depression (PND) is the most common complication observed in women following delivery, affecting approximately 17% of mothers. Research shows that mothers with PND are less involved in playful and stimulating interactions with their babies, such as face-to-face contact, play and maternal singing. These deficits in mother-child interactions have been found to negatively affect the child’s development, with infants of mothers with PND being at increased risk of poor developmental outcomes. However, there is limited research focused on infants’ verbal and non-verbal communication skills during interactive activities with mothers with PND, especially in the context of an inpatient MotherBaby Unit (MBU).
Aim: To examine the effect of maternal PND on both mother-infant interaction and infant development, with special focus on infants’ verbal and non-verbal communication skills, in the context of mothers with severe PND who have been hospitalised with their infants in an inpatient MBU.
Research questions:
1) Are there any differences in the quality of mother-infant interaction between mothers with and without PND and their babies?
2) Do infants of mothers with PND differ in their non-verbal communication skills when compared to infants of mothers without PND?
3) Do infants of mothers with PND differ in terms of the ways in which they use a toy during a play interaction with their mothers when compared to infants of mothers without PND?
4) What is the impact of PND on maternal vocal behaviour and, consequently, on infants’ verbal communication skills?
Method: A total of 52 videos that contain footage of 104 participants (52 mother- infant pairs) were analysed and compared. In particular, the clinical group consists of 22 inpatient mothers with PND interacting with their infants (aged 3-12 months); their interaction has been videorecorded for intervention purposes in the clinical context of an MBU. A comparison group of 230 mothers without PND was recruited from several Children’s Centres in London, and their play interaction with their infants (aged 3-12 months) was also video-recorded. Video-recordings of mother-infant interactions of the two groups (n=52) were compared and analysed using the Infant CARE-Index (Crittenden, 2005) and the Global Rating Scale (Murray & Karpf, 2000). Additionally, a micro-analytic approach was employed to evaluate the infants’ communication skills, as well as to assure the detailed examination of complex and extremely rapid behaviours that occur during mother-infant interaction.
Results: Significant group differences were found in the quality of the mother- infant interaction, with the presence of PND playing a crucial role. In the communicative domains of facial affect, vocal behaviour, touch and gaze, the behaviours of the dyads from the clinical group diverged from the respective behaviours of the comparison group. Mother-infant pairs from the clinical group (vs the comparison group) showed less engagement in a mutually enjoyable play interaction and differences in the use of a toy as part of their play interaction. Overall, infants of mothers with PND showed neurodiversity in their verbal and non-verbal communication skills in comparison with the infants of mothers without PND.
Conclusion: The findings of the present study call for paying more attention to mothers with severe PND and their infants, in order to reinforce maternal abilities and simultaneously address their challenges, so as to create an optimal developmental milieu for their infants. These findings could contribute to the improvement of treatment options focused on enhancing the mother-child relationship among mothers with PND through play, maternal speaking/singing and face-to-face contact, thereby promoting a better quality of life for this population. Another practical implication of the findings of this study could be to further inform guidelines and strategies for intensive educational programmes especially designed for pre-schoolers of mothers with depression – who are at high risk for cognitive and language difficulties – in order to support young children to develop their verbal and non-verbal communication skills more effectively.
Date of Award22 May 2022
Original languageEnglish
Awarding Institution
  • University of Roehampton
SponsorsThe Froebel Trust
SupervisorCecilia Essau (Director of Studies) & Olympia Palikara (Co-Supervisor)


  • Postnatal depression
  • Microanalysis
  • Mother-Baby Unit
  • Infant development
  • Mother-infant interaction
  • Communication skills

Cite this