Perinatal mental health issues in consultations regarding medication use during breastfeeding: Insights from the Japan Drug Information Institute in Pregnancy (JDIIP)
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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.
期刊介绍：
Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.
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