You Asked: Is Smoking While Breastfeeding Safe?
This is one of the most common questions sent in to our website. Many women ask if it is safe to smoke while they are breastfeeding. Smoking is relatively common during pregnancy, with about 10% of all women smoking at some point during their pregnancy. The rates are even higher among women with psychiatric illness. While many women may be able to stop smoking or reduce their intake during pregnancy, most women resume smoking during the postpartum period.  And women who suffer from postpartum depression are at even higher risk for smoking relapse.
Psychological Distress in the Mother May Affect Levels of Immunoglobulins in Breast Milk
We have seen multiple studies which indicate that postpartum depression (PPD) interferes with breastfeeding. Postpartum women who suffer from depression are less likely to breastfeed, and they typically breastfeed for a shorter duration than women who are not depressed. A recent study looks at an entirely different question, asking whether postpartum stress affects the quality of the breast milk. In this study, the researchers focused on levels of immunoglobulin A (IgA) in the breast milk. (Immunoglobulins or antibodies are passed from the mother to the baby through the breast milk and help to confer immunity.)
Progesterone Reduces the Use of Cocaine in Postpartum Women with Cocaine Use Disorder
It has been suggested in prior literature that the effects of cocaine are partially modulated by the gonadal hormones, estradiol and progesterone, which may account for sex differences in the use and abuse of cocaine (Evans et al. 2002 & Jackson et al. 2006). Because previous studies have shown that women who use cocaine tend to use less of this drug during periods of high endogenous progesterone levels, as in pregnancy or during the luteal phase of the menstrual cycle, a recent study explored whether progesterone replacement could be effective in reducing cocaine use in postpartum women with a cocaine use disorder. In this recent double-blinded study performed by researchers at Yale School of Medicine, women were eligible for the study if they met DSM IV criteria for cocaine abuse or dependence in the 6 months prior to conception or during pregnancy and were within 12 weeks of delivery.
Clinical Update: Use of Topiramate (Topamax) During Pregnancy
Topiramate (TPM, marketed as Topamax) is an antiepileptic drug which is also used for migraine prophylaxis, weight loss, and, less commonly, as a mood stabilizer. Over the last few years we have seen several studies suggesting an increased risk of oral clefts in infants exposed to topiramate during the first trimester of pregnancy. You can read more about those studies here:
FDA’s New Labeling Rule: Clinical Implications
The following post was first published in OB/GYN News.
Parent’s Suicide Attempt Increases a Child’s Risk of Suicide
Previous studies have shown that children who have lost a parent to suicide are more likely to attempt suicide than children whose parents died unintentionally. One obvious explanation for this finding is that the parents who attempt or commit suicide are more likely to have a mood disorder or serious psychiatric illness and that their children share this genetic vulnerability and are therefore more likely to have a psychiatric illness which increases their risk for suicide.