Baby Swim As an Intervention for Depressive Symptoms and Lacking Attachment During the Postpartum Period (BIDAP)

BIDAP - Baby Swim As an Intervention for Depressive Symptoms and Lacking Attachment During the Postpartum Period

Mental health issues are very common during and after pregnancy, and studies from around the world indicate that 10-15% of all pregnant and postpartum women experience depression. Risk factors for developing depression include a history of depression, low levels of social support, and stressful life events. The symptoms are the same as for depression during other periods of life, but often include feelings of inadequacy regarding motherhood, along with associated feelings of shame or guilt. Obsessive thoughts directed toward the baby may also be part of the symptomatology. Such thoughts are typically experienced as frightening by the mother but, in the vast majority of cases, do not pose any risk to the child. Maternal depression can also affect a mother's ability to bond with her baby, and difficulties in forming an attachment can, in turn, increase and perpetuate depressive symptoms. In the long term, insecure attachment between mother and child can lead to behavioral problems in the child, such as aggression and avoidance, anxiety and depression in adolescence, negative effects on cognitive development, and trust issues in close relationships.

Baby swimming is a structured form of interaction that takes place in 34-degree Celsius water in a calm environment, aiming to teach the baby vital skills while stimulating social, intellectual, and motor development. At least one parent actively participates and is encouraged to perform various exercises. These activities strengthen the bond between the baby and the parent and contribute to making time in the water a safe and enjoyable experience. Previous studies have shown that baby swimming can improve attachment between parent and child.

In the present project, the aim is to investigate whether baby swimming can be used as an intervention for depressive symptoms in new mothers and whether this intervention can reduce depressive symptoms while also strengthening the bond between mother and child.

Study Overview

• Status: Recruiting
• Conditions: Postpartum; Attachment; Depression - Major Depressive Disorder
• Intervention / Treatment: Behavioral: Baby swimming

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Alkistis Skalkidou, PhD, MD; Phone Number: +46 6110000; Email: alkistis.skalkidou@kbh.uu.se
• Study Contact Backup: Name: Sara Sylvén, PhD, MD; Phone Number: +46706110451; Email: sara.sylven@neuro.uu.se

Study Locations

• Sweden
  • Uppsala, Sweden
    • Recruiting
    • Uppsala University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Women who have

• given birth at full term
• are 18 years or older
• have a baby aged 3-7 months at the time of inclusion
• exhibit depressive symptoms according to the EPDS scale.

Exclusion Criteria:

• Multiple pregnancy (twins, triplets)
• Known psychotic disorder or bipolar disorder
• Inability to communicate adequately in Swedish or English, or inability to read and complete digital questionnaires in Swedish or English.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Waiting list; After completing the baseline questionnaire at T0, participants will be randomized into two groups: half will receive the intervention immediately (the treatment group), while the other half will receive it after seven months (the waitlist control group).	Behavioral: Baby swimming; Participants in the treatment group will be contacted by a researcher and invited to an introductory meeting at the swimming facility, where they will receive information about the baby swimming course from the instructor. The course will take place twice a week for five weeks, totaling 10 sessions of 30 minutes each. During the sessions, mothers will be encouraged to engage in physical contact, maintain eye contact, and respond to their baby's signals. The course will also include water safety exercises.
Active Comparator: Intervention; Participants in the treatment group will be contacted by a researcher and invited to an introductory meeting at the swimming facility, where they will receive information about the baby swimming course from the instructor. The course will take place twice a week for five weeks, totaling 10 sessions of 30 minutes each. During the sessions, mothers will be encouraged to engage in physical contact, maintain eye contact, and respond to their baby's signals. The course will also include water safety exercises.	Behavioral: Baby swimming; Participants in the treatment group will be contacted by a researcher and invited to an introductory meeting at the swimming facility, where they will receive information about the baby swimming course from the instructor. The course will take place twice a week for five weeks, totaling 10 sessions of 30 minutes each. During the sessions, mothers will be encouraged to engage in physical contact, maintain eye contact, and respond to their baby's signals. The course will also include water safety exercises.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depressive symptoms	Self-reported depressive symptoms measured by the Edinburgh Postnatal Depression Scale	Seven months follow up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Attachment	Measured by the Postpartum Bonding Questionnaire	Seven months follow up

Collaborators and Investigators

• Sponsor: Uppsala University

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2024
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): August 1, 2027

Study Registration Dates

• First Submitted: January 29, 2025
• First Submitted That Met QC Criteria: January 29, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 29, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Keywords: depression; postpartum; attachment; baby swimming
• Additional Relevant MeSH Terms: Mental Disorders; Behavioral Symptoms; Mood Disorders; Depression; Depressive Disorder; Depressive Disorder, Major
• Other Study ID Numbers: BIDAP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No