{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T09:11:24Z","timestamp":1765876284630,"version":"3.48.0"},"reference-count":48,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In maternal bipolar disorder, decisions about early infant feeding are complex, and may depend on maternal mental health stability, sleep protection needs, and medication safety in lactation. We aimed to explore early infant feeding practices in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This population\u2010based cohort study in Ontario, Canada (2012\u20132018) compared mothers\/birthing parents with bipolar disorder (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911,398), depressive and\/or anxiety disorders (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009209,929) and no mood or anxiety disorder (referent,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009417,588) on exclusive feeding with breastmilk at hospital discharge (primary outcome), breastfeeding intention, early skin\u2010to\u2010skin contact and initiation of breastfeeding, and in\u2010hospital breastfeeding support. Within mothers\/birthing parents with bipolar disorder, we compared those prescribed each of antidepressant, antipsychotic, valproic acid, lithium, or other antiepileptic monotherapy and 2 or more of these medications (polypharmacy) to those not prescribed any of these medications. Modified Poisson regression generated relative risks (RR, 95% CI) adjusted for socio\u2010demographics and clinical characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Maternal bipolar disorder was associated with reduced exclusive feeding with breastmilk at discharge (57.4% vs. 62.3% in the referent, aRR 0.95, 95% CI 0.93\u20130.98), but maternal depression and\/or anxiety disorder was not. Bipolar disorder was also associated with reduced intention to breastfeed (88.5% vs. 94.1%), early skin\u2010to\u2010skin contact (79.2% vs. 81.0%) and in\u2010hospital breastfeeding support (88.9% vs. 94.4%) compared to those with no mood or anxiety disorder. Among those with maternal bipolar disorder, lithium and polypharmacy were each associated with reduced likelihood of the outcomes compared to those not prescribed any psychotropic medication; antidepressants, antipsychotics, and antiepileptics were not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These data support the case for additional supports and services to support mothers with bipolar disorder in early infant feeding initiation, and for research into how to best utilize medications in lactation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bdi.70070","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T16:28:03Z","timestamp":1763396883000},"page":"578-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Population\u2010Based Cohort Study of Early Infant Feeding Initiation in Maternal Bipolar Disorder"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0467-5734","authenticated-orcid":false,"given":"Neda","family":"Askari","sequence":"first","affiliation":[{"name":"Women's College Hospital, Department of Psychiatry  Toronto Ontario Canada"},{"name":"University of Toronto, Temerty Faculty of Medicine, Department of Psychiatry  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shakked","family":"Lubotzky\u2010Gete","sequence":"additional","affiliation":[{"name":"Women's College Hospital, Department of Psychiatry  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Crocker","sequence":"additional","affiliation":[{"name":"Ices  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy C.","family":"Barker","sequence":"additional","affiliation":[{"name":"Women's College Hospital, Department of Psychiatry  Toronto Ontario Canada"},{"name":"University of Toronto, Temerty Faculty of Medicine, Department of Psychiatry  Toronto Ontario Canada"},{"name":"Ices  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilary K.","family":"Brown","sequence":"additional","affiliation":[{"name":"Women's College Hospital, Department of Psychiatry  Toronto Ontario Canada"},{"name":"Ices  Toronto Ontario Canada"},{"name":"Department of Health and Society University of Toronto Scarborough  Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjie","family":"Huang","sequence":"additional","affiliation":[{"name":"Ices  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"Taylor","sequence":"additional","affiliation":[{"name":"Women's College Hospital, Department of Psychiatry  Toronto Ontario Canada"},{"name":"University of Toronto, Temerty Faculty of Medicine, Department of Psychiatry  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Crystal T.","family":"Clark","sequence":"additional","affiliation":[{"name":"Women's College Hospital, Department of Psychiatry  Toronto Ontario Canada"},{"name":"University of Toronto, Temerty Faculty of Medicine, Department of Psychiatry  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy\u2010Lee","family":"Dennis","sequence":"additional","affiliation":[{"name":"University of Toronto Faculty of Nursing  Toronto Ontario Canada"},{"name":"Lunenfeld Research Institute, Sinai Health System  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone N.","family":"Vigod","sequence":"additional","affiliation":[{"name":"Women's College Hospital, Department of Psychiatry  Toronto Ontario 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