Breast-feeding is a very important component in establishing the maternal–infant bond, therefore it should definitely be promoted in the care plan of any woman with low mood. Indeed, post-natal depression (i.e., low mood for longer than 2 weeks) may be triggered in part by breast-feeding “failure”.1 Consequently, there are strong reasons to encourage women at risk of depression to continue breast-feeding for as long as possible.1 Prompt identification of depressive symptoms is important while the mother is still feeding: she needs appropriate treatment together with counselling and support, so that she is less likely to give up.1High rates of adverse events have not been found in breast-fed infants exposed to commonly prescribed antidepressants, including tricyclics.2 However, mothers should try to take these medications immediately after breast-feeding, before the baby’s main sleep period, to minimize exposure to peak drug concentrations.2

References1. Dennis CL, et al. The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review. Pediatrics 2009; 123: e736–751.

2. Payne JL. Antidepressant use in the postpartum period: practical considerations. Am J Psychiatry 2007; 164: 1329–1332.

From: Journal of Family Health Care Bulletin. Directory of Breast-Feeding Advice. December 2009. Published with JFHC 2009; 19(6). http://www.jfhc.co.uk/images/stories/breastfeeding.pdf