Treating mental illness in lactating women

A high prevalence of psychiatric illness has been noted in the postpartum p eriod. Recent research looks to the potential effects of maternal illness d uring this period on child development. With the promotion of breast feedin g for well-documented medical benefits, there has been increasing attention to the potential effects on the infant of exposure to medication via breas t milk. This article reviews the current literature on the secretion of psy chotropic medication into breast milk, and any known negative effects. The shortcomings of these studies are highlighted, and recommendations to the c linician are given within the limitations of the current state of knowledge . The World Health Organization (WHO) has estimated that depression will be 1 of the 2 major illness burdens confronting the world by 2020. The incidenc e of depression is 2-fold higher in women than in men, and the average age at onset is 25 years. These facts combined with the noted risk of a marked increase in psychiatric illness postpartum([1]) have serious implications. Depression occurring at this time can present with depressed mood, anxiety, and difficulties coping with the infant. Suicide, although not more common in depression, is at the severe end of the spectrum in those with puerpera l psychosis and bipolar disorder. The morbidity associated with depression is not confined to women suffering from it; there are also potential negati ve effects of maternal depression on child development, ([2]) on older chil dren, and on the woman's partner. These effects include impaired bonding an d cognitive and behavioral delays in the infant and difficulties in childho od. Moreover, the increased use of antidepressants in the Western world in combination with the strong promotion of breast feeding also has implicatio ns for the dependent infant. What do we know? And, what are the risks?.