MGH Center for Women's Mental Health

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.

By MGH Center for Women's Mental Health|2021-09-13T08:41:24-04:00February 11th, 2015|Nicotine, Outcomes, Perinatal Substance Use, You Asked|Comments Off

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.)

By MGH Center for Women's Mental Health|2015-04-03T10:58:53-04:00February 9th, 2015|Child Outcomes, Outcomes, Psychiatric Disorders During Pregnancy, PTSD and Stress Related Disorders|Comments Off

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.

By MGH Center for Women's Mental Health|2015-02-13T12:09:29-04:00February 4th, 2015|Cocaine, Hormone Therapy, Perinatal Substance Use, Prevention|Comments Off

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:

By MGH Center for Women's Mental Health|2015-05-25T20:50:06-04:00February 2nd, 2015|Anti-Epileptic Drugs, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

FDA’s New Labeling Rule: Clinical Implications

The following post was first published in OB/GYN News.

By MGH Center for Women's Mental Health|2015-05-01T12:02:29-04:00January 28th, 2015|Pregnancy & Medications|Comments Off

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.

By MGH Center for Women's Mental Health|2015-04-03T11:11:21-04:00January 26th, 2015|Child Outcomes, Postpartum Psychiatric Disorders|Comments Off

Opioids and Women of Reproductive Age: A Growing Problem

This report from the Centers for Disease Control (CDC) was published yesterday and is a good, albeit alarming, companion to the post we published yesterday on obstetrical outcomes.

By MGH Center for Women's Mental Health|2015-07-17T10:54:22-04:00January 23rd, 2015|Opioids, Perinatal Substance Use|Comments Off

Opioid Abuse and Dependence in Pregnancy: Impact on Obstetrical Outcomes

In a recent study, researchers looked at the rising nationwide trend of opioid abuse and dependence in pregnancy and obstetrical outcomes in this patient population. Previous research has focused on neonatal outcomes, such as neonatal abstinence syndrome; however, maternal complications have not been well-studied. In this study, data was collected from the Nationwide Inpatient Sample (NIS), including nearly 57 million American women who were admitted for obstetric delivery between the years 1998-2011. Overall 113,105 of those women (0.2%) were identified as abusing or being dependent on opioids. The prevalence increased by 127% from the beginning of the study in 1998 until its completion in 2011, reflecting the growing opioid epidemic. The increase was mostly represented in women 20 to 34 years or age.

By MGH Center for Women's Mental Health|2015-02-13T10:11:40-04:00January 22nd, 2015|Opioids, Perinatal Substance Use|Comments Off

Folic Acid is Essential for All Women of Reproductive Age

Last week was National Folic Acid Awareness Week at the Centers for Disease Control (CDC), so this seems like a great time to remind women (and their caregivers) of the importance of folic acid in the prevention of birth defects. By taking the recommended dosage of folic acid daily, women will reduce the risk of neural tube defects by 50% - 70%. In addition, women who take folic acid supplements are less likely to give birth to a child with an autism spectrum disorder.

By MGH Center for Women's Mental Health|2018-06-09T17:45:25-04:00January 19th, 2015|Psychiatric Disorders During Pregnancy, Risk of Malformations|Comments Off

Avoid Valproic Acid in Women of Reproductive Age

The European Medicine Agency (EMA)'s Pharmacovigilance and Risk Assessment Committee recently recommended strengthening the restrictions on the use of valproic acid in women of reproductive age. Over the last few years, we have seen a host of articles documenting the deleterious effects of valproic acid on the developing fetus:

By MGH Center for Women's Mental Health|2015-04-03T13:19:35-04:00January 16th, 2015|Anti-Epileptic Drugs, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

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