IN THIS ISSUE: Delirium | Abstract Submissions | Fellowship | Annotations | Webinar & Journal Club | A&E Abstracts
Failure to diagnose potentially endangers mother and baby
Post-weaning depression may go undiagnosed potentially endangering the safety of mother and baby is the conclusion of a research paper highlighted by Jyoti Sachdeva, MD, within the latest selection of Annotations on the ACLP website.
The research paper Weaning and Depression: A Closer Look by Sharma Wood, KN, et al, describes how the association of weaning with depression has long been recognized.
However, interest in the study of post-weaning depression has waned over the last few decades partly due to changes in the nosology of perinatal psychiatric disorders.
In this paper, the authors review the paucity of literature on the subject and conclude that post-weaning depression is a rare but severe complication of breastfeeding cessation. “Given that post-weaning depression is an understudied and often undiagnosed clinical condition, research is needed to address this important unmet need,” they say.
Studies to date have found both a protective effect of breastfeeding on postpartum depression (PPD) as well as antenatal anxiety and depression conferring increased risk of premature breastfeeding cessation.
Post-weaning depression is often mislabelled as ‘late onset PPD’. “The termination of lactation appears to be a vulnerable period for depression and post-weaning depression appears to be a severe phenotype marked by presence of psychotic features, treatment refractoriness, and higher risk of psychiatric hospitalization,” say the authors. “Abrupt cessation of breastfeeding may increase risk for such a mood episode.
“It is important to enquire about hypomanic or mixed symptoms. Resumption of breastfeeding and a gradual taper may be considered in cases of symptom onset occurring with abrupt cessation of breastfeeding.”
It is important for C-L psychiatrists to be aware of post-weaning depression so they can educate their expectant patients, says Dr. Sachdeva. Women are typically screened for PPD at six weeks postpartum, but post-weaning depression may go undiagnosed, potentially endangering both mother and baby.
The first quarter’s Annotations in 2024 is here. Each quarter, the Academy’s Guidelines & Evidence-Based Medicine Subcommittee posts commentary on recent journal articles with contributions by experts in subspecialty areas of C-L Psychiatry.