Depressed mothers are less sensitive, less attentive and more critical of their infants. The effects of untreated postnatal depression on children, compared to a control group, may include the following: impaired cognitive development from one year onwards, less warmth and positive interaction between the child and their parent, and behavioural difficulties from 18 months. Obstetric complications may increase the risk, but possibly only in those with a previous history of depressive disorder. A psychiatric history, particularly of depressive disorder, increases the risk, especially if the depression was postpartum. Postnatal depression is often under-detected and under-treated. The symptoms can easily be overlooked and attributed to tiredness, sleepless nights and the demands of coping with a new baby. Part of the management of a mother with postnatal depression involves thinking about the risk to the child. Indications for referral of a mother with postnatal depression to an adult psychiatrist are as follows: psychotic features and poor response to treatment.