When prescribing pharmacological treatments, the potential for harm to the foetus and the breastfed infant must be carefully balanced against the likelihood of harm to mother and foetus/infant if the mother remains untreated.
- Select treatment based on the woman’s preferences.
- Consider the risks and benefits to the woman and foetus/ infant of treatment versus non-treatment.
- Minimise possibility of harm to the foetus or exposure of the infant during breastfeeding.
- Involve a psychiatrist when considering prescription of clozapine, sodium valproate or lithium.
- Consult guidelines for the use of pharmacological treatments in the general population (Therapeutic Goods Administration (TGA), Electronic Therapeutic Guidelines and Australian Medications Handbook).
- Explain risks and benefits, side effects and any delay in onset of effect.
- Closely monitor and have a plan to identify relapse early.
Due to the overall paucity of evidence, no absolute assurance can be given about any medication used during pregnancy or breastfeeding.