The blues may have several causes, some biological and some emotional. When a baby is born, there are very sudden changes in the mother's hormone levels. Some, required during pregnancy, drop rapidly, while others like those which start the production of milk, rise. These rapid changes may act to trigger the blues.

Many mothers are unprepared for the extreme weariness which often follows a birth. The weariness is usually due to a combination of factors. In many cases the mother will have been anticipating the birth with some apprehension. This, as well as the physical exertion of the birth itself, can make mothers feel exhausted. To add to this discomfort could be sore stitches, sore breasts and muscular ache.

Rest and quiet are most important after a birth. Few mothers get either, as they are busy responding to the needs of the baby, or, when they might be able to rest, they are disturbed by hospital or home routines or by visitors who may stay too long.

Sometimes the baby may have a slight health problem such as jaundice or feeding difficulties in the early days. These problems are very common with new babies, but they cause mothers great anxiety. The problems do settle down as the baby gets older and mothers should try to talk to medical staff and allow themselves to be reassured that the baby will thrive. A new mother may feel that she will be unable to cope when at home alone with the baby. This is especially the case with first time mothers. Often the promise of practical help from family and friends can ease the situation, and as the mother learns how to cope at home her feelings of depression lift.

If the mother is worrying about her ability to support the baby financially she can get advice from the social worker in hospital or from her health visitor when she returns home from the hospital. Many mothers are unaware of the range of benefits to which they are entitled once they have had a baby. Another reason could include the feeling of anti-climax after the birth of the baby.

* mild depression

* being very emotional and upset

* tearfulness for no apparent reason

* being tense and anxious

* difficulty sleeping

* constant worry about minor problems

* some mothers have pains for which there is no medical cause

* being unwell generally with no apparent cause and symptoms

* impossible to cheer up

* most mothers who have the blues feel very tired and lethargic most of the time

Mothers who have the blues should be allowed to cry if they want to and allowed to express their fluctuating emotions. If they feel miserable they should not be told to pull themselves together. It can be a great help to a mother if someone listens to her and reassures her that her worries and misery will not last and she will soon feel better.

A mother who has the blues must have as much rest as possible. It may also help the mother is she is told that the blues are very common and that they usually pass quickly. Affected mothers are often over-sensitive about what is said to them by relatives and medical staff. So tact and empathy from the staff can be very beneficial at this time. Make sure that people around the mother know that she is going through a bad patch. A sympathetic ear, a reassuring hug is all it takes to snap out of the baby blues. The community midwife may also be able to provide useful advice.

Generally baby blues fade away in a couple of days and soon the mother will start enjoying her baby. In some cases, however, baby blues may worsen and develop into post-natal depression.