- Frequency of breastfeeding consultations (7,863 cases) remained consistent; proportion related to mental disorders unchanged after guideline publication.
- Psychiatrists were the most common prior advisers, followed by obstetricians; fewer providers advised stopping breastfeeding after guideline publication.
- Most mothers received multiple psychotropic medications; benzodiazepines were most discussed but related consultations declined significantly post publication.
Arch Womens Ment Health. 2026 Jul 6;29(4):105. doi: 10.1007/s00737-026-01743-w.
ABSTRACT
PURPOSE: We comprehensively identified the challenges associated with psychotropic-medication use during breastfeeding in Japan and explored strategies to enhance breastfeeding support.
METHODS: We analyzed breastfeeding-consultation records of cases involving postpartum mothers received by the Japan Drug Information Institute in Pregnancy (JDIIP) between February 2012 and March 2022, and corresponding questionnaire responses regarding the use of psychotropic medications. The “Perinatal Mental Health Consensus Guide” was used as a benchmark to examine temporal trends. To assess changes in consultation patterns over time, the study period was divided into a pre-publication (2012-2016) and post-publication phase (2017-2022).
RESULTS: 7,863 breastfeeding consultations were analyzed. Before and after the guide’s publication, no significant difference was observed in the proportion related to mental disorders. Among consultations involving mental disorders, psychiatrists were the most common healthcare providers from whom advice had been sought before consultation, before and after the guide’s publication, followed by obstetricians. Although approximately half of the healthcare providers had previously indicated that medication use during breastfeeding was possible, the proportion advising mothers to discontinue breastfeeding while taking psychotropic medications decreased after the guide’s publication. Most mothers were prescribed multiple medications, with benzodiazepines being the most frequently discussed. However, the proportion of such consultations decreased significantly after the guide’s publication.
CONCLUSIONS: Consultations with specialized counseling agencies regarding psychotropic medication use during breastfeeding occurred at a consistent frequency regardless of guideline dissemination. While the guidelines’ publication appears to have influenced healthcare providers’ awareness, further examination is necessary to determine how best to provide information supporting breastfeeding.
PMID:42406152 | DOI:10.1007/s00737-026-01743-w
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