The finding:
This review examines the association between weaning and depression. Though there is paucity of literature on this topic, studies 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. 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.

Strength and weaknesses:
This is not a systematic review so lacks an exhaustive literature review and formal data extraction. It raises awarness about a lesser-known variant of postpartum depression.

Relevance:
It is important for C-L psychiatrists to be aware of post-weaning depression so they can educate their expectant patients.  Women are typically screened for PPD at 6 weeks postpartum, but post-weaning depression may go undiagnosed, potentially endangering the safety of both mother and baby.