Exploring how maternal depression shapes pediatric asthma care
A new Children’s National study shows that maternal depression can make managing childhood asthma more difficult.
Asthma affects more than 4 million children in the United States and remains the most common chronic childhood condition. A new study from Children’s National Hospital highlights an overlooked factor in childhood asthma care: a mother’s mental health. Researchers in the Center for Health Outcomes Research & Delivery Science found that maternal depression can make daily asthma management – like tracking medications or spotting flare-ups – more difficult. Through interviews with 12 mothers whose children receive care at IMPACT DC, Children’s National’s community-based asthma program, the study captures how depression shapes caregiving in their own words.
Why it matters
Asthma management depends on consistent, attentive care. When depression drains a caregiver’s energy or focus, even small lapses can lead to more emergency visits, missed school days and worse health outcomes. In this study, mothers also noticed how their mood affected their children emotionally. When a mother was stressed or withdrawn, her child often felt anxious, sometimes enough to trigger an asthma attack. The connection between mental health and asthma was clear on both sides.
More than half of the mothers had clinically significant depressive symptoms and nearly all had experienced those symptoms for over a year. Four mothers also had asthma themselves and almost every child in the study had uncontrolled asthma, underscoring the complexity of care in these families. Together, these numbers paint a picture of how common and intertwined maternal and child health challenges can be.
The big picture
Many mothers described slipping into what they called “super mom mode”, pushing through depression to care for their kids while ignoring their own needs. Several mothers said the pressure to “stay strong” left them feeling guilty or ashamed when they could not do everything perfectly. Even when mothers received treatment, most found it inconsistent or incomplete. Some were taking antidepressant medication, others attended therapy but many still had moderate or severe symptoms. Limited access, long waits and therapist turnover were common barriers.
Children’s National researchers say these findings reinforce that pediatric health cannot be separated from caregiver wellbeing. Integrating behavioral health into pediatric asthma care could change that. Social workers and behavioral health specialists can help mothers manage depressive symptoms, strengthen coping skills and connect to resources, all within the same clinic visit that treats the child’s asthma.
What’s next
Building on this study, Children’s National is testing a brief, evidence-based depression treatment delivered in the IMPACT DC Asthma Clinic. The new clinical trial uses implementation science to determine how integrated care can improve outcomes for both mothers and children.
“By treating maternal depression alongside asthma, we can address the whole family’s needs,” said Rachel Margolis, PhD, LCSW, social work researcher at Children’s National and senior author of the study. “When mothers receive mental health support, children breathe easier. Integrating behavioral health into community-based asthma programs offers a path toward better control, fewer emergencies and greater equity in care.”
Read the full study, “Exploring Black Mothers’ Lived Experiences of Depression and the Relationship to Their Child’s Asthma: A Qualitative Study” in the Journal of Evidence-Based Social Work.
