Does any of you MDs out there have experience in treating post-partum
depression. A client of mine has me stumped for diagnosis...
She breastfeeds her little girl (third child, brother and sister are 9
and 14) without any problem, girl gaining well, etc... However, she has
suffered from occasional insomnia, that she treated with 1-2 Xanax
(alprazolam) a month. Now that the baby is here, insomnia is intractable,
and compounded by tremendous anxiety and guilt for taking medication
while breastfeeding. No matter of reassuring will do, including calls to
the MotherRisk program. She had to increase the medication to maximal
dosages only to sleep a littel bit. She now wants to wean, and cries of
disappointment saying so.
My feeling is that she suffers from post-partum depression, rather than
only insomnia, but I hesitate prescribing an anti-depressant, since they
can have as side-effect... insomnia. What do you all think? (I am visibly
not used to seeing this kind of problem,but this poor woman has seen so
many doctors up to now, and so many would gladly reinforce the weaning
*obligation*. Not counting the pharmacist (a woman) who refused to give
her the alprazolam, saying that it would poison the baby...)

Louise Denhez, M.D., M.P.H
Montreal, Quebec, Canada