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Purpose <p>We comprehensively identified the challenges associated with psychotropic-medication use during breastfeeding in Japan and explored strategies to enhance breastfeeding support.</p> Methods <p>We analyzed breastfeeding-consultation records of cases involving postpartum mothers received by the Japan Drug Information Institute in Pregnancy (JDIIP) between February 2012 and March 2022, and corresponding questionnaire responses regarding the use of psychotropic medications. The “Perinatal Mental Health Consensus Guide” was used as a benchmark to examine temporal trends. To assess changes in consultation patterns over time, the study period was divided into a pre-publication (2012–2016) and post-publication phase (2017–2022).</p> Results <p>7,863 breastfeeding consultations were analyzed. Before and after the guide’s publication, no significant difference was observed in the proportion related to mental disorders. Among consultations involving mental disorders, psychiatrists were the most common healthcare providers from whom advice had been sought before consultation, before and after the guide's publication, followed by obstetricians. Although approximately half of the healthcare providers had previously indicated that medication use during breastfeeding was possible, the proportion advising mothers to discontinue breastfeeding while taking psychotropic medications decreased after the guide’s publication. Most mothers were prescribed multiple medications, with benzodiazepines being the most frequently discussed. However, the proportion of such consultations decreased significantly after the guide’s publication.</p> Conclusions <p>Consultations with specialized counseling agencies regarding psychotropic medication use during breastfeeding occurred at a consistent frequency regardless of guideline dissemination. While the guidelines’ publication appears to have influenced healthcare providers' awareness, further examination is necessary to determine how best to provide information supporting breastfeeding.</p>

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Perinatal mental health issues in consultations regarding medication use during breastfeeding: Insights from the Japan Drug Information Institute in Pregnancy (JDIIP)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Sachi Koinuma,
  • Yasuha Ogawa,
  • Chie Kohno,
  • Izumi Fujioka,
  • Mikako Goto,
  • Koushi Yamaguchi

摘要

Purpose

We comprehensively identified the challenges associated with psychotropic-medication use during breastfeeding in Japan and explored strategies to enhance breastfeeding support.

Methods

We analyzed breastfeeding-consultation records of cases involving postpartum mothers received by the Japan Drug Information Institute in Pregnancy (JDIIP) between February 2012 and March 2022, and corresponding questionnaire responses regarding the use of psychotropic medications. The “Perinatal Mental Health Consensus Guide” was used as a benchmark to examine temporal trends. To assess changes in consultation patterns over time, the study period was divided into a pre-publication (2012–2016) and post-publication phase (2017–2022).

Results

7,863 breastfeeding consultations were analyzed. Before and after the guide’s publication, no significant difference was observed in the proportion related to mental disorders. Among consultations involving mental disorders, psychiatrists were the most common healthcare providers from whom advice had been sought before consultation, before and after the guide's publication, followed by obstetricians. Although approximately half of the healthcare providers had previously indicated that medication use during breastfeeding was possible, the proportion advising mothers to discontinue breastfeeding while taking psychotropic medications decreased after the guide’s publication. Most mothers were prescribed multiple medications, with benzodiazepines being the most frequently discussed. However, the proportion of such consultations decreased significantly after the guide’s publication.

Conclusions

Consultations with specialized counseling agencies regarding psychotropic medication use during breastfeeding occurred at a consistent frequency regardless of guideline dissemination. While the guidelines’ publication appears to have influenced healthcare providers' awareness, further examination is necessary to determine how best to provide information supporting breastfeeding.