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Pregnancy and lactation discussion checklist

A working framework for psychiatric medication decisions across pregnancy and breastfeeding: what to weigh, what to cite, what to reference to LactMed and MotherToBaby.

Current version: v1.1 Updated: 2026-07-15 Reviewed by Shariq Refai, MD, MBA Audience: public + clinicians

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Version-locked PDF. When we revise this reference, the URL you're on stays the same and the file below is replaced with the current version. Link to this page (not to the file) so readers always receive the current version.

Download v1.1 PDF Filename: pregnancy-lactation-quick-reference.pdf

Overview

Medication decisions in pregnancy and lactation are shared decisions. This reference names the categories to weigh, points at the primary sources (LactMed, MotherToBaby, ACOG, APA), and gives the specific questions a clinician and patient should work through together. Not a decision engine.

Contents

  • Pre-pregnancy planning: continuing, switching, or tapering before conception
  • Trimester-specific considerations for the common medication classes
  • Postpartum considerations, including PMAD screening
  • Breastfeeding: relative infant dose and where to check LactMed
  • When to involve reproductive psychiatry, MFM, or endocrinology

Sources

  • National Library of Medicine LactMed database (accessed via NIH Bookshelf)
  • MotherToBaby fact sheets, Organization of Teratology Information Specialists
  • ACOG Committee Opinion 757: Screening for Perinatal Depression, 2018 (reaffirmed 2020)
  • APA/ACOG Guidelines for the Management of Depression During Pregnancy

Review record

  • Reviewer of record: Shariq Refai, MD, MBA (psychiatrist)
  • Current version: v1.1
  • Version updated: 2026-07-15
  • Next scheduled review: July 2027
  • Correction mechanism: /corrections-policy — email [email protected] with a specific source citation and we will review within two business weeks.

Canonical concepts

This reference maps to the following canonical Shrink Network concept ids: antidepressant, ssri.

Related resources on PsychiatryRx

How to cite or link to this reference

If you're referencing this in a syllabus, institutional protocol, or academic material:

Pregnancy and lactation discussion checklist (v1.1, updated 2026-07-15). PsychiatryRx. https://psychiatryrx.org/references/pregnancy-lactation-discussion. Reviewed by Shariq Refai, MD, MBA.

Link to the URL above, not the PDF file. That way your readers receive the current version even after we revise.