Risk-benefit Analysis of Antidepressants Use during Breastfeeding to Treat Postpartum Depression | Chapter 6 | Medical Science: Recent Advances and Applications Vol. 5

 

Postpartum depression is classified as a major depressive disorder, and the causes are not well known. Postpartum depression affects approximately 14.5% of women, and it can affect both mother and infant. Therefore, rapid attention and treatment are imperative. The causes of postpartum depression are not well known; but there are many factors that may increase the risk of developing the disease. Women should be carefully evaluated after childbirth for depressive or anxiety symptoms with adequate screening tools and methods to avoid diagnostic errors; especially when dealing with women who present risk factors. The pharmacological approach often represents one of the most realistic options for treatment. However, women may be reluctant to take antidepressants because of the fear of adverse effects on the infant, since most drugs pass into breast milk. The objective of this review is to evaluate the risk-benefit of using antidepressants during breastfeeding to treat postpartum depression.

 

An electronic search was performed by using the PubMed database from January 2001 through December 2010. The search was limited to articles in the English language and to articles that relate to human research. Manual searches of bibliographies were also conducted to identify additional pertinent studies.

 

The use of antidepressants that do not appear in infants’ plasma, for which use during breastfeeding is better documented and at standard therapeutic doses is recommended, such as sertraline and paroxetine. Fluoxetine has a long half-life, which can lead to a long infant exposure through breast milk, and citalopram can cause adverse effects in infants exposed through breast milk. Therefore, citalopram and fluoxetine should not be used as first-line treatments. If these drugs are used by a nurse, they should take the lowest effective dosage, and their infants should be monitored. 

 

This study focused on emphasising the importance of postpartum depression treatment, always considering its repercussions for the breastfed infants. Studies are needed with larger samples to properly evaluate the short and long-term effects of antidepressants on infants exposed through breast milk, so that clinicians can create standard decisions regarding the treatment of postpartum depression, without putting infants at risk.

 

Author (s) Details

Leal, Vânia
Pharmacy Department, Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal.

 

Fonseca, Ana Paula
Pharmacy Department, Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, S. Martinho do Bispo, 3046-854 Coimbra, Portugal and H&TRC - Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, S. Martinho do Bispo, 3046-854 Coimbra, Portugal.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v5/5520

Microplastic Exposure to Infants | Chapter 4 | Innovations in Biological Science Vol. 6

 The present study summarizes the possible exposure of infants to microplastics (MPs) as well as the detection of possible released MPs in infant feces, breast milk, and infant formulas. Microplastics are small plastic pieces with sizes less than 5 mm. People are in close contact with microplastics, which, due to their physical and chemical properties, have a negative effect on human health. Exposure to microplastics even in small amounts already in childhood can affect human health throughout life. The potential risks of microplastics may be greater for infants because they do not have sufficiently developed metabolizing enzymes, have less ability to remove microplastics, and have highly sensitive target organs. The specific behavior of children, such as crawling, hand—to—mouth movement, makes children more exposed to harmful substances than adults. Infants should be breastfed for the first six months of life. Breast milk is considered to be the most complete and suitable source of nutrition. However, if breastfeeding during this period is not possible, it is necessary to use formulas designed for infant initial feeding. Infants may be exposed to higher levels of microplastics through infant foods or plastic products.

It follows from the results of several studies, polypropylene feeding bottles, plastic packaging for baby food and plastic toys should be considered as potential sources of microplastics. Studies have found that infant formula prepared in a polypropylene bottle releases up to millions of microplastics. Polyamid content was higher in meconium than in placenta. The amount of microplastics in feces was higher in children who used to suck plastic toys.

There is still not enough data available for this study area. Therefore, it is necessary to pay increased attention to minimizing the negative effects of microplastics on human health. The microparticles, which are created by the degradation of plastics, have spread to all areas of the environment, with a negative impact on human health and the overall ecosystem. Our review is based on scientific studies to clarify the extent of the presence of microplastics in various aspects of life, including breast milk, baby bottles, toys, and milk forms.

Author(s) Details:

Csilla Mišľanová,
Faculty of Nursing and Professional Health Studies, Institute of Nutrition, Slovak Medical University, 833 03, Bratislava, Slovakia.

 

Martina Valachovičová
Faculty of Nursing and Professional Health Studies, Institute of Nutrition, Slovak Medical University, 833 03, Bratislava, Slovakia.

 

Please see the link here: https://stm.bookpi.org/IBS-V6/article/view/14926