Assessing the impact of a postnatal singing intervention on mental health, well-being measures and mother–infant interaction: results from the SHAPER-PND trial

BACKGROUND: Loneliness and a lack of social support are prominent risk factors in the development of postnatal depression (PND), affecting 24% of new mothers in the UK. Breathe Melodies for Mums (M4M), a 10-week group singing intervention, is effective at reducing depressive symptoms in PND; however, its impact on other clinical outcomes and mother–infant interaction remains unexplored. OBJECTIVE: This study evaluated whether M4M, delivered within the Scaling-up Arts-Health Programmes: Implementation and Clinical Effectiveness Research-Postnatal Depression (SHAPER-PND) trial, improved mental health, well-being outcomes and mother–infant interaction, among mothers with PND. METHODS: 199 mothers were randomised 2:1 to a 10-week long singing (treatment group) or non-singing community activity (active control group). Mental health, well-being and social support were assessed at baseline, week 6 (midpoint), 10 (end of intervention), 20 and 36 (follow-up points) using the Hamilton Depression Rating Scale (HDRS) as well as self-report measures. Mother–infant interaction was assessed using the Infant Child Adult Relationship Experimental (CARE) Index at baseline, week 10 and week 36. FINDINGS: Mothers in the singing group experienced a sharper decline in their depressive symptoms (HDRS: F(1,171)=9.27, p=0.003, ηp²=0.05) postintervention and reported improvement in social support (F(4,139)=5.93, p<0.001, ηp²=0.15). While all other secondary outcome measures improved gradually over time, there were no group effects or time × group interactions for stress, anxiety, well-being, loneliness or self-esteem. Both groups showed improvements in measures of mother–infant interaction, including dyadic synchrony F(2,150)=9.01, p<0.001, η(2)p=0.107. CONCLUSIONS: These findings underline the benefits of M4M, highlighting parallel improvements in social support. However, neither well-being nor mother–infant interaction appear to underlie these improvements. CLINICAL IMPLICATIONS: Singing interventions, particularly M4M, remain as a promising adjunct treatment in the management of PND, requiring further confirmatory research. TRIAL REGISTRATION NUMBER: NCT04834622.