Most women with real postpartum depression are never diagnosed. Even though postpartum depression is very common, and even though identifying it can help both the baby and the mother, most cases slip through the cracks. A simple new 3-question test has proven very reliable at detecting postpartum depression.

Perhaps surprisingly, none of the questions were about feeling sad, feeling happy, laughing, crying, feeling hopeful or hopeless, or being able to sleep. Nevertheless, the brief 3-question test was able to identify accurately 95 percent of the depressed women in a September 2008 study. It was about as reliable as more involved questionnaires, and much more practical because of its brevity.

The likelihood of postpartum depression usually peaks when the baby is about 12 weeks old, give or take a couple of weeks. I understand that pediatric offices are very busy these days, but I would love to see this 3-question test (or a more extensive one) for moms at every well-baby visit in the first 6-months. Too many moms and babies go through this without the support they deserve.

What are the 3 questions? They focus on a unique and important part of postpartum depression: excess anxiety. Some anxiety for new parents, of course, goes with the territory. Parenthood is, after all, a new adventure into the unknown. You love a new person so much, it’s normal to feel fear and anxiety. But when anxiety or fear predominate your daily experience with a new baby, it can be a sign of postpartum depression.

Here is the test:
As you have recently had a baby, we would like to know how you are feeling. Please underline the answer that comes closest to what you have felt IN THE PAST 7 DAYS, not just how you feel today.

1. I have blamed myself unnecessarily when things went wrong.
• a. Yes, most of the time — 3
• b. Yes, some of the time — 2
• c. Not very often — 1
• d. No, never — 0

2. I have been anxious or worried for no good reason.
• a. No, not at all — 0
• b. Hardly ever — 1
• c. Yes, sometimes — 2
• d. Yes, very often — 3

3. I have felt scared or panicky for no very good reason.
• a. Yes, quite a lot — 3
• b. Yes, sometimes — 2
• c. No, not much — 1
• d. No, not at all — 0

The way I have presented it here, the maximum possible score is 9. Women with a score of 3 or more may or may not be depressed, but deserve further evaluation to be sure. 1If a cutoff score of 4 or even higher were used, the results would more likely indicate depression, but some depressed women would be missed. The purpose of a screening test is to find those who would benefit from more evaluation. This test has only been validated as a screening tool for moms. Depressed dads are also important to identify, but they may have very different symptoms.

Each day I see parents trying their best to do what’s right for their families, but no one has the perfect guidebook that tells parents what to do. Here are the top eight solvable problems that I advise parents to remedy today.

1. Do… Have confidence in your parenting style.
Don’t … Worry about what your parents or the neighbors or your child’s teacher thinks about your parenting style.
Create a parenting style that makes you comfortable and relax.

2. Do… Create an exercise program for yourself.
Don’t … Skip it because you don’t have the time.
Kids follow our example. If we’re not exercising, they won’t learn to either. So take care of yourself and teach your kids to do the same.

3. Do… Take the time to create healthy love foods for your family.
Don’t … settle routinely for food that isn’t helping them build a strong body and mind.
What children eat is vitally important and the foods they learn to love when young will often be their favorites as adults. You can create healthy love foods for them by what you feed them now and give them a life-long gift.

4. Do… Give your kids a good multi-vitamin each day.
Don’t … Trust our food sources to provide all the nutrients kids need.
Most kids don’t eat 5 servings of fruits and veggies a day. Even if they did (and I do encourage at least that many) our food’s nutrient density has gone down. Kids need a good multi-vitamin each day to round out their nutritional needs.

5. Do… Stay consistent with your rules.
Don’t … Let whining wear you down.
If you want a child to sleep in her own bed, then letting her sleep in your bed “just this once” is going to make it much harder later.

6. Do… Think about the things that matter.
Don’t … Pick the wrong things to worry about.
You need to pay close attention to some things, like your kids’ safety. But don’t sweat the small stuff even if it means your kids sleep in their street clothes instead of pajamas.

7. Do… Take advantage of today.
Don’t … Wait until tomorrow to build life-long memories.
Time flies. Plan something every season that your kids will look forward to year after year.

8. Do… Pay attention to both your perspective and your child’s.
Don’t … Lose sight of your needs or theirs.
If we focus too much on whatever children want, or too much on what we want, they miss out on learning both to give and receive.

For such a little person, a baby sure goes through a lot of laundry: diapers, bibs, sleepers, undershirts, blankets, sheets, socks, pants . . . and of course all the items the baby spits up on that also need to be cleaned—often.

That’s why having a baby in the house turns the mundane washer and dryer into wonder machines of incredible convenience. This increase in laundry loads is also a good reason for you to focus your green efforts on the laundry room.

If you’re buying a new washer, remember to look for Energy Star models. Traditional top-loading washing machines use about forty gallons of water per load, whereas Energy Star washers use only about twenty-five gallons per load. That’s a 40 percent savings in water, which translates into an energy cost savings of almost 50 percent.

Make that new machine a front-loader. Front-loading machines work on a horizontal axis that saves both water and energy. A top-loading machine must be filled with water in order to keep the clothing wet and then an agitator swirls the water around, but a front-loading machine uses less water because the tub does not need to be filled completely; the tub itself rotates, making the clothes tumble in the water.

These machines also reduce the energy needed for drying clothes because they spin clothes faster than top-loading machines, which reduces the moisture level before the clothes even enter the dryer. As an extra green bonus, front-loading washers are kinder to your clothing, so your clothes last longer. In comparison to top-loading washing machines, the front-loaders use 50 percent less energy and a third less water. With those savings, it will pay for itself in six years and should last for ten. In addition, a front-loading Energy Star washer will save enough energy annually to light your entire home for a month and a half, and it saves as much water in a year as the average person drinks in a lifetime.

Laundry Detergent
While you’re looking for ways to go green in the laundry room, don’t overlook your detergent. You’ll find that it’s easy to make the switch to green detergents that are plant based (corn, palm kernel, or coconut oil) and to non-chlorine-bleach products made from sodium percarbonate or sodium perborate. For those laundry tasks that require special attention, think simple and homemade.

• For stains, try soaking fabrics in water mixed with one of the following:
Borax, lemon juice, hydrogen peroxide, or white vinegar.
• For fabric softening, add a quarter cup of baking soda to the wash cycle.
• For static cling, add a quarter cup of white vinegar to the wash water.
• To soften water, use a soap-based, rather than detergent-based, cleaner.
• Buy laundry products in containers that are recyclable.

There are very good reasons for making the switch to a green product. Most conventional laundry detergents are made from petroleum— a nonrenewable resource. They don’t readily biodegrade, and they threaten wildlife after they go down the drain. Many also contain chemical fragrances and phosphates (which build up in streams and lakes, upset the natural balance, and starve fish of the oxygen they need to survive). They also contain chemicals linked to cancer and reproductive problems. That’s just plain bad for the earth and for your family.

Chlorine bleach should also be banned from your laundry room. This popular whitener and disinfectant is highly caustic; when it goes from your drain into the natural world, it can create organochlorines, which are suspected carcinogens as well as reproductive, neurological, and immune system toxins. They also damage the earth’s ozone layer.

Washing and Drying Tips to Try Today
• When you have several loads to wash, do them back-to-back so you can use the residual heat in the dryer.

• Run the washing machine only when you have a full load.

• Wash with cold water to save 80 to 90 percent of the energy costs of washing.

• To prevent static cling, add one cup white vinegar to the rinse cycle, using your washing machine’s dispenser. Static cling, by the way, is caused by using synthetic fabrics, so you could also switch to cotton. The vinegar also kills bacteria and prevents the buildup of detergent residue. Remove the laundry before it’s overdried.

• Clean out the dryer’s lint trap after every load to improve circulation and reduce energy use.

• Air dry whenever possible using indoor racks or an outdoor line. This conserves energy—and your clothes. They will not wear out or fade as quickly. (You’ll also save about seven hundred pounds of carbon dioxide over six months of warm weather.)

• Remove clothing from the dryer before the cycle ends and line dry to finish. This conserves energy and increases the life span of the clothing.

• Avoid using dryer sheets to soften fabrics. They often contain harsh chemicals that can irritate sensitive skin. Soften fabric with baking soda in the wash cycle. Try a commercial green fabric softener like Natural Choices Home Safe Products’ Safe ’n Soft, Ecover’s Natural Fabric Softener, or Sun & Earth’s Ultra Fabric Softener.

More than four million acres of American farmland have already been dedicated to organic farming, helping our health and our future. That’s four million acres farmed without the use of toxic pesticides or other toxic chemicals; four million acres nurtured with both ancient and modern techniques that are in balance with nature, helping to reduce the production of greenhouse gasses and reduce the threat of global warming.

Growing our foods organically has proven to be one of the hottest, fastest-growing movements of the twenty-first century. When Congress passed the Organic Foods Production Act in 1990, there were fewer than one million acres of organic farmland. In just twelve years, by 2002, that figure had doubled. Then the pace of progress picked up. Within just three more years, the amount of organic farmland doubled again. In 2005, we saw, for the first time, certified organic farmland in all fifty states. There has been exceptional progress, but we need to do more.

If organic cropland continues to double—and it can!—we can expect to see a revitalization and renewal of our streams and our soil as we build a smart, sustainable future. I can remember drinking stream water in our national parks when I was a child. I can remember catching and eating fish from our local streams. Today, all of the streams surveyed by the U.S. Geological Survey and more than 90 percent of fish tested in farming regions are polluted with pesticides.

By eating strategically we can reclaim our streams, our food, and our future. Here’s my take on the top five organic food choices a pregnant woman can make for the sake of her baby and the health of the planet:

Beef. If you eat beef during pregnancy, I strongly suggest choosing organic beef. The meat from grass-fed, organically raised cattle tends to be leaner overall and has about five times the omega-3s of its conventional counterpart. In contrast, a 2007 study published in the Oxford journal Human Reproduction linked mothers who ate beef from conventionally raised cattle during pregnancy with lower sperm counts years later in their adult sons. The men in the study whose mothers ate conventional beef most frequently had sperm counts that averaged 24 percent lower than their counterparts, and they were three times more likely to be infertile. The authors of the study believe the added hormones were the culprit.

Milk. If you drink milk, opt for organic. Milk from organic, pasturefed cows is produced without antibiotics, artificial hormones, and pesticides, and can also provide extra omega-3s and beta-carotene. I find that when women start making organic choices for themselves and for their families, they often intuitively start at the top of the food chain with organic milk. They understand that the foods they eat and the medicines they take will often get into their breast milk, so they easily make the connection that the medicines and foods given to dairy cows may affect their family’s health. They prefer avoiding the routine use of antibiotics, artificial hormones, pesticides, and genetically modified feed. And I agree. Recent USDA monitoring data found that 27 percent of the conventional milk samples contained synthetic pyrethroid pesticides. By contrast, lower levels of the pesticide showed up in just 5 percent of the organic samples.

Potatoes. When making the switch to organic vegetables, be sure to put potatoes on your shopping list. As the number one consumed vegetable in the United States, conventionally farmed white potatoes also have one of the highest levels of pesticide contamination. So by switching to organic, you can make a big difference in two important ways: by lowering your own exposure to chemical pesticides and by using your consumer clout to create a bigger market for the organic version of this popular veggie. And be sure to eat the peels! That way you will get all the available nutrients, including high levels of potassium and Vitamin C.

Apples. Among fruits, I would start with apples. Based on head-to-head, controlled studies, organic apples tend to have higher nutrient levels and taste better than the conventional variety. And sadly, conventionally grown apples are one of the most pesticide-contaminated fruits tested by the USDA. They are a major source of exposure to organophosphate pesticide, a chemical linked to decreased intelligence and increased attention problems in kids and hormone problems in adults.

Soy. Products made from organic whole soy beans can be a wonderfully nutritious food. Unfortunately only a tiny fraction of the nation’s soy crop is currently organic. And to make matters worse, 87 percent of the conventionally grown soy I the United States is genetically modified-and most of the domestic crop. What’s more, in recent years, soy has been the domestic crop most contaminated with organophosphate pesticides. Yes it’s hard to avoid soy- it’s found in virtually any processed food you eat these days, from soup to nuts. The only way out of this situation is to make sure that the processed foods you purchase are organic. That way you’ll know that any soy you’re eating wasn’t genetically altered, and wasn’t grown with pesticides. So be sure to check the label before you buy.

When decorating or remodeling any room of your home, “green” means using products and materials that include the following characteristics:

1. Are locally manufactured. Buying products manufactured nearby cuts down on the waste of fuel and the emissions that result from transporting goods long distances, and also supports your local economy.

2. Conserve natural resources. These include products that are made from rapidly renewable materials generally produced from agricultural crops, such as organic cotton, wool, sisal, cork, and bamboo, and products made from wood derived from certified well-managed forests. Examples include cork and bamboo flooring.

3. Are salvaged. Some construction and decorating components can be reused or rescued, thus reducing the consumption of new products made from raw materials. Examples include period hardware and millwork.

4. Contain recycled content. These include products made of materials that have been diverted from the landfill and put into the production of new products. An example is flooring made of reclaimed wood.

5. Are made to last. Green products don’t need frequent replacement. Well-made items constructed from quality materials stay out of landfills and incinerators and save the production costs of replacement products.

6. Avoid toxic emissions. Green products minimize toxic industrial chemicals and contribute to a healthy home environment. Examples include zero- or low-VOC paints, caulks, and adhesives.

With these criteria in mind, let’s start the green nursery makeover with an empty room, then furnish, decorate, and stock it with products that are safe for both the baby and the environment.

Remember, every change you make in the green direction is a positive step. So whether you make one small change or redo the entire room “green,” you’re contributing to the green movement and giving your child a healthier home in which to have her sweet dreams. It’s a good feeling knowing you are doing something that’s right for your family and the planet—and at the same time creating a beautiful living space

There are certain microscopic bacteria that can pose special health risks to pregnant women and to their babies. Although most people can safely eat food containing a type of bacteria called Listeria, pregnant women are ten times more likely to get sick if they eat those same foods. And if they do get sick, the infection can be devastating for the baby. The tricky thing about Listeria is that, unlike many bacteria, they can thrive at refrigerator temperatures. To be sure, ensure your partner avoids the following:

• Soft cheeses such as Brie, Camembert, feta, and Mexican queso fresco, or any cheeses with blue veins. Most hard cheeses are fine, as are pasteurized cream cheese, cottage cheese, cheese spreads, sliced cheese and yogurt.

• Foods from deli counters (prepared salads, meats, and cheeses), unless they are heated to steaming right before eating.

• Hot dogs, packaged cold cuts, meat spreads, pate, smoked seafood, and leftovers, unless they are heated to steaming right before eating. Canned or shelf-stable products are generally fine.

• Raw or unpasteurized milk during pregnancy, including goat’s milk, and foods that contain unpasteurized milk. Raw and partially cooked eggs, meat, and poultry can harbor other unwanted visitors. In addition to Listeria, be cautious about E. coli, salmonella, and Toxoplasma by doing the following:

• Cook ground beef until no pink is visible, and be sure pork and lamb are well done. For turkey or other poultry, cook thoroughly to 180° F (with a thermometer).

• Cook eggs until both the whites and the yolks are firm. Soft scrambled eggs aren’t a pregnancy treat.

• Remember hidden sources of raw or partially cooked eggs, such as cookie dough, unpasteurized eggnog and Hollandaise sauce.

• You’ve heard not to change kitty litter during pregnancy to avoid Toxoplasma. This is good advice, but pregnant women can also pick up Toxoplasma from unpasteurized milk and undercooked meats. Be sure milk is pasteurized and meats are cooked to at least 150 degrees F.

• Even if cooked food is safe, microorganisms can still live on hands or utensils while cooking. Wash before and after handling raw foods. Always wash cutting boards, kitchen surfaces and utensils after use.

You know that it is wise to back up your computer’s hard drive; I recommend backing up your child’s food drive with a daily multivitamin/mineral supplement. This simple habit could improve your child’s health and even intelligence. I’ll explain briefly why I feel strongly about this:

For young babies, breast milk provides an ideal food.
The match between their complex nutritional needs and the milk that moms make is spectacular. In their dance of supply and demand, babies are designed with a drive to enjoy just the right amount and moms are designed to make just the right amount. Even so, I do suggest that many breastfed babies take 200 IU of vitamin D daily, as the American Academy of Pediatrics recommends – but not because of any lack in breast milk. We are built to get vitamin D from sun exposure. Because of the amount of time babies spend indoors, and the depleted-ozone-caused need for sunscreen when babies spend much time outdoors, many babies need an extra boost of this important vitamin, linked not just to building strong bones, but also to preventing breast cancer, colon cancer and Parkinson’s disease.

I used to think that when breast feeding was over, so was the age of perfect foods. Now I understand that children are perfectly designed to thrive on a balanced variety of whole foods: fresh fruits, various veggies, whole grains, beans, nuts, and lean sources of protein and calcium. They are even designed to enjoy just the right amounts of these ideal foods, as long as their food drives aren’t tricked by empty calories, added fats, sweetened drinks, etc. Children should be able to get all of the vitamins, minerals, and other micronutrients they need for optimum development by eating the right combinations and right amounts of healthful foods.

But the reality is that most kids today do NOT get the micronutrients they need from what they eat. Not by a long shot. By some estimates, only 2% of kids regularly eat the recommended number of servings of different food groups. The result is that, even though the typical American child eats too many calories, the typical child is getting suboptimal levels of many key nutrients, including thousands of food components (phytonutrients) we are just beginning to learn about.

And there are 13 major, named micronutrients, “the Greene 13”, that concern me the most: calcium, fiber, folic acid, iron, magnesium, omega 3 fatty acids (especially DHA), phosphorous (except for kids who drink carbonated beverages and get too much phosphorus), potassium, vitamin A, vitamin C, vitamin D, vitamin E, and zinc. Most kids don’t get enough of at least one of these. One in six girls get iron at levels low enough to affect their test scores. Seven out of ten boys and nine out of ten girls don’t get enough calcium at key times of growth. A daily multivitamin is more than just a safety net for occasional nutritional accidents. It is also like spackle to fill in the small nutritional holes, gaps, and cracks that many children develop every day. One could compare it to defragging the nutrients, or to a patch for their operating system. And beyond this, it can help a child thrive the way we all want.

A June 2001 study published in Neuroscience and Biobehavioral Reviews compared the results of 13 double-blind placebo-controlled trials of multivitamins and their effect on the intelligence of children. Ten of the studies analyzed were able to measure a boost in non-verbal intelligence in those children who got a daily multivitamin. I’m not surprised. We know these nutrients affect our intelligence, our growth, our behavior, and our immune systems, and that typical American children do not get enough.

I recommend starting the supplement spackle at the first birthday, unless the child is on a toddler formula that already has the extras added. The body and brain are growing especially fast up to age 3, when many kids are notoriously picky eaters (with French fries the most popular vegetable, apple juice the most popular fruit, and white flour the most popular grain).

Not all vitamins are created equal.
One extremely popular kids brand contains hydrogenated vegetable oil, the chemical dyes FD&C Blue #2 Lake, FD&C Red #40 Aluminum Lake, FD&C Yellow #6 Aluminum Lake, artificial flavors, aspartame, sugar, butylated hydroxytoluene (this preservative is a suspected carcinogen banned in all foods in Japan and Australia, and in baby foods in the U.S.), carrageenan, gelatin, and pregelatinized starch.

So what should you look for in a multivitamin?

Depending on how your child eats, you probably want to supplement with 50% to 100% of the age-appropriate recommended doses of at least “the Greene 13” (listed above). You may not find all of these in one place. In fact, it can be a great idea to look for other sources of calcium, fiber, and omega 3’s (DHA), either in foods or in supplements.

Most children probably do not need or benefit from extra-large supplemental doses of vitamins or minerals, and especially not vitamin A or iron. Most children certainly do not benefit from artificial colors or preservatives, or from extra helpings of sugars or artificial sweeteners found in some children’s vitamins.

Look for vitamins with low-sugar, or healthy sweetener options.
I suggest not starting with gummy or candy vitamins, because daily candy is not a lesson kids need to learn, and it can be a hard habit to break. Where possible, food sources of the vitamins and minerals in the supplements may contain many more nutrients than named on the label. Don’t settle for pop-culture standards. A healthy food store is a great place to ask for help selecting the best vitamins for your child.

But whatever vitamin you choose, the simple habit of a daily multivitamin/mineral can be an important back-up to your child’s food drive, a smart idea in a culture that seems bent on enticing children with foods that undermine their body’s wisdom.

As a father and pediatrician, I’ve changed many diapers—enough to teach me that diapers are a daily reminder that as humans we deplete resources as we consume, and we make messes with our waste.

Those landfill diapers that are so easily tossed into the trash are clearly a major ecological issue. But what about the energy, water, and often chlorine involved in laundering cloth diapers? Comparing the environmental impact of different types of diapers has been the subject of a number of studies—with differing results often linked to the vested interests of those behind the study.

The largest and most objective study to date was carried out by the Environment Agency, the public body responsible for protecting the environment in England and Wales. The panel compared disposable diapers to home-laundered cloth diapers and commercially laundered cotton diapers in terms of global warming, ozone depletion, smog formation, depletion of nonrenewable resources, water pollution, acidification, human toxicity, and land pollution. The study did not include what I call hybrid diapers—the reusable diapers equipped with flushable, biodegradable liners.

This study found that overall environmental impact is about the same for all three options they did consider; the biggest impact is on global warming, resource depletion, and acidification. For disposable diapers, the most significant impact comes during manufacture; for home-laundered diapers, the primary impact comes from the electricity used in washing and drying; for commercially laundered diapers, the biggest impact comes from use of fuels and electricity.

Thus, according to the Environment Agency, if you choose cloth diapers, the first focus should be on reducing the energy used during washing and drying and reducing fuels and emissions during transportation (see Chapter Seven for more information about laundry). If you choose disposable diapers, focus first on greener manufacturing, such as used by the Eco-Diapers mentioned previously.

Although the Environment Agency report is more thorough than other analyses to date, it is still quite incomplete. For instance, it looked only at the major brands used—not the greener alternatives. It didn’t look at making choices back at the very beginning of the manufacturing process: at the oil rigs where the plastic liners of landfill diapers begin, at the forests where the wood pulp starts as trees, and in the cotton fields long before cotton is a cloth. There is a big difference between cotton grown drenched in toxic chemicals and cotton organically grown, between sustainable forestry and irresponsible logging, between dioxin-producing chlorine gas in pulp mills and bleach-free diapers.

Whatever we choose for diapers, we have an unavoidable impact on the environment. But whatever we choose, we can make those diapers a little greener.

Editor’s Note: Pictured above: reusable cloth diapers from Kushies Online.