BREASTFEEDING AND MATERNAL MENTAL HEALTH
Most maternal health problems are treated in the community rather than hospital setting. It is still important for hospital professionals to understand how breastfeeding and mental health problems can be interlinked, in both positive and negative ways, when seeing mothers and children for other reasons. See the GP Infant Feeding Network information on maternal mental health and our own resources on medication and lactation, which include antidepressants.
When admission is needed for maternal mental health problems
Rarely, admission to hospital is needed for mothers with postnatal psychosis, severe postnatal depression or exacerbations of existing severe mental health problems. NICE guidance is that women with a severe mental illness requiring hospital admission should ideally be admitted to a Mother and Baby Unit. There is very little evidence available on breastfeeding in this situation. One study reports that a third of mothers in a mother-baby inpatient psychiatric unit maintained some breastfeeding.
Full links related to antipsychotics and lithium in lactation are signposted here - these medications are not completely contraindicated in breastfeeding but families and prescribers need to fully understand the risks and monitoring required. NICE says "discuss breastfeeding with all women who may need to take psychotropic medication in pregnancy or in the postnatal period. Explain to them the benefits of breastfeeding, the potential risks associated with taking psychotropic medication when breastfeeding and with stopping some medications in order to breastfeed. Discuss treatment options that would enable a woman to breastfeed if she wishes and support women who choose not to breastfeed"