<p><strong>OBJECTIVES: </strong>The American Academy of Pediatrics recommends postpartum depression (PPD) screening. It is unknown if pediatricians are effective in linking mothers to mental health services. The objectives of the current study are to determine: 1) mental health care utilization among women with Medicaid insurance after a positive PPD screen and 2) maternal and infant factors that predict the likelihood of mental health care utilization.</p>

<p><strong>METHODS: </strong>Retrospective cohort design of mothers attending their infants' 2-month well child visit at one of five urban primary care practices between 2011-2014. A linked dataset of the child's electronic health records, maternal Medicaid claims, and birth certificates was used. The primary outcome was mental health care utilization within six months of a positive PPD screen. Multivariate logistic regression was used to estimate maternal and infant clinical and sociodemographic factors that predict service use.</p>

<p><strong>RESULTS: </strong>3,052 mothers met study criteria, 1,986 (65.1%) completed the PPD screen, and 263 (13.2%) screened positive for PPD of whom 195 (74.1%%) were referred for services. Twenty-three women (11.8%) had at least one Medicaid claim for depression within six months of screening. In multivariate modeling, mothers with a history of depression in the prior year (OR=3.80, 1.20-12.11) were more likely to receive mental health services after a positive screen.</p>

<p><strong>CONCLUSIONS: </strong>Few mothers who screened positive for PPD received mental health services. Mothers without a recent history of depression treatment may be especially at risk for inadequate care. Additional mechanisms to improve access to mental health services following PPD screening are needed.</p>

<p><strong>BACKGROUND: </strong>Social media is a common way for mothers to seek advice about their infants. However, little is known about how low-income urban mothers use social media to obtain infant health information and whether this information is consistent with expert pediatric recommendations.</p>

<p><strong>OBJECTIVES: </strong>(1) identify the types of health questions asked by low-income mothers of infants in a social media parenting group; (2) describe whether peer answers are consistent with or contradict AAP guidelines; (3) identify the practices that mothers post about that are inconsistent with AAP guidelines.</p>

<p><strong>METHODS: </strong>Forty-three low-income mothers were enrolled in Grow2Gether, a private Facebook group intervention focused on infant care and moderated by a psychologist. All health questions posted by mothers were coded thematically; answers to questions from the group were assessed for consistency with American Academy of Pediatrics (AAP) guidelines related to infant feeding, sleep, screen time, and safety. Additionally, all unique posts that contained practices inconsistent with these AAP guidelines were thematically coded.</p>

<p><strong>RESULTS: </strong>In total, 215 posts were coded. Participants posted 61 questions related to infant health, most commonly solid food introduction (8/61), teething (8/61), and breastfeeding (7/61). Of the 77 answers given by peers, 6 contradicted guidelines. Separately, mothers had 73 posts demonstrating practices inconsistent with AAP guidelines [safe sleep (43/73) and screen time (21/73)].</p>

<p><strong>CONCLUSIONS: </strong>Mothers' Facebook group interactions in the context of an infant care intervention revealed that when mothers posed direct questions regarding infant health, their peers generally gave answers that did not contradict AAP guidelines. In contrast, mothers' posts simply describing sleep and screen time practices commonly contradicted guidelines.</p>