How do you counsel patients with bipolar disorder who want to breastfeed?

This is a great question!

Many women desire to breastfeed their babies, and providers often encourage the initiation of breastfeeding in the immediate postpartum period. For women with underlying bipolar disorder, this decision can be more nuanced. Nursing a young infant requires multiple feedings ...

I educate them (https://womensmentalhealth.org/).

Then let the woman and her partner (if there is one) decide. Encourage the woman not to feel pressured to breastfeed by peers, well-intentioned health workers, or family, but to do what's best for her and her baby.

This is a complex question since it totally depends on the medications someone is taking and the level of risk the patient is willing to take. E.g., lithium, most people say no but it goes in minimal quantities and can be managed. Other antipsychotics with BD capacity also might come in manageable a...