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UNC Perinatal Psychiatry – live chat with Dr. Meltzer-Brody

Originally published September 19, 2012.

As I sat at my computer at lunch hour, a wonderful email popped into my inbox!

To my surprise, Wendy Newhouse Davis posted a link on Postpartum Support International’s Facebook page regarding a Live Chat with Samantha Meltzer-Brody, M.D Director of the University of North Carolina at Chapel Hill School of Medicine Perinatal Psychiatry Unit. The UNC Perinatal Psychiatry Inpatient Unit (PPIU) is the first in the US. It was modeled after the mother-baby units (MBU’s) in Europe. I dream of the day when there are mother-baby units in all of the states in the US. If only there had been such a place for Andrea Yates to rest.

The live chat was held on the platform. I had an hour until my next client, so I popped on over, not knowing what to expect! I was able to login easily using Twitter (CoverItLive asked for Facebook or Twitter, I usually link to other social media platforms with my Twitter handle), so no need to set up yet another id on yet another piece of software!

To my pleasure, I found some of my gr8 tweeps there with whom I talk fairly regularly!

Hi there Lauren Hale of #PPDCHAT , Amber Koter-Puline of Beyond Postpartum and of course, Katherine Stone!

I can say it was an absolutely wonderful experience! I learned a lot on this call!

To me, as a clinician, one of the most salient topics were Dr. Meltzer-Brody’s personal and educated take on the differential diagnosis of perinatal mood disorders. As clinicians, we know mood disorder symptomology overlaps. Depression, anxiety and anger are often co-mingled in the same individual and these symptoms ebb and flow.

I was happy to hear her educated opinion about the intermingled nature of mood disorders, and how these are not truly separate, but co-mingled, and present uniquely in each woman. Of course then I wanted to ask some questions about bipolar disorder, but the topic was unipolar postpartum depression, so I didn’t want to be rude.

I am hoping Dr. Meltzer-Brody will present another chat on perinatal bipolar disorder.

From a clinical standpoint, the other salient topic was how to manage breastfeeding in a women with a maternal mood disorder. Dr. Meltzer-Brody had some practical, clinical suggestions regarding night-time feeding. She said that she and her team work to tailor an individual plan that fits the individual family structure.

For instance, because sleep is so important to a woman with a history of mood disorders, she may mandate a block of sleep for that woman as part of her treatment plan. She cited one clinical case where she “implemented sleeping from midnight to 6am. The mom would go into another room and sleep during this time but would do the midnight nursing session, and her husband would do the 3am feeding.”

I let her know that one of my secret wishes was that her team would develop an evidence-based and clinically-oriented CEU class with practical solutions regarding sleep, breastfeeding and perinatal mood disorders for professionals working with moms with perinatal mental illness.

As clinicians, we need to honor all women in all safe infant-care choices, and also have ways to talk about and support individualized choices in a way that helps mom and baby.

I was thrilled when she suggested they may put together a webinar! I’ll be waiting! Dr. Meltzer-Brody mentioned her colleague, Alison Stuebe, MD, might be a good fit for that topic!

Dr. Meltzer-Brody also discussed the need for clinicians to address maternal-infant bonding when a maternal mood is treated. She says this is part of the UNC treatment plan.

All in all, an enjoyable way to spend a lunch hour!

The only thing that peeved me a bit was that there was too much of a delay between my typing a response and then the response getting into the feed, so the comments seemed out of line with the discussion.

As always, the Postpartum Support International website is a wonderful resource for finding skilled providers.

You are not alone. Pick up the phone.

Call PSI’s Warmline at 800-944-4773


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