Postnatal Depression and Its Effect on Infant Care Practices and Early Child Development in Cross River State, South South Nigeria

Postnatal depression (PND) is a significant yet underdiagnosed condition that affects not only maternal wellbeing but also infant care quality and early child development. In Nigeria, few studies have examined the bidirectional relationship between maternal mental health and infant outcomes in the south-southern region. This prospective cohort study examines the prevalence of PND and its effect on infant care practices and developmental outcomes in Cross River State, South South Nigeria. A total of 340 mother-infant dyads were recruited at six to eight weeks postpartum from postnatal clinics in Calabar. PND was assessed using the Edinburgh Postnatal Depression Scale (EPDS), with a cut-off of 13 or above. Infant care practices, breastfeeding, immunisation, healthcare utilisation, and stimulation behaviours were assessed at two and six months. Developmental outcomes were measured at six months using the WHO Motor Development Milestones and the Ages and Stages Questionnaire-3 (ASQ-3). PND prevalence was 22.1%. Mothers with PND were significantly less likely to breastfeed exclusively at two months (OR 0.38) and more likely to miss scheduled immunisation visits (OR 2.9). Infants of depressed mothers showed lower developmental scores at six months across motor, communication, and personal-social domains. Socioeconomic hardship and lack of partner support were the strongest PND predictors. The study calls for routine postnatal depression screening, integration of maternal mental health services into child welfare clinics, and partner-inclusive postnatal support programmes. Keywords: postnatal depression, infant care, child development, Cross River State, South South Nigeria.