Differential Diagnosis
- Single most likely diagnosis
- Postpartum psychosis: The patient's recent childbirth, lack of psychiatric history, and sudden onset of symptoms such as anxiety, poor sleep, and delusional thoughts (e.g., "the doctors are trying to hurt my baby") are characteristic of postpartum psychosis. The patient's behavior, such as mixing protein powder with formula due to unfounded concerns about the infant's health, also supports this diagnosis.
- Other Likely diagnoses
- Postpartum anxiety disorder: The patient's excessive worry about the infant's health, despite reassurance from healthcare providers, and her physical symptoms such as pacing, poor sleep, and minimal eating, are consistent with postpartum anxiety disorder.
- Postpartum depression with psychotic features: Although the patient's primary symptoms appear to be anxiety and delusional thoughts, postpartum depression with psychotic features is also a possibility, especially given her tearful and exhausted appearance.
- Do Not Miss
- Postpartum thyroiditis: Although less likely, postpartum thyroiditis can cause anxiety, sleep disturbances, and emotional changes. It is essential to rule out this condition, as untreated thyroiditis can have significant consequences for both the mother and the infant.
- Obstructive sleep apnea: The patient's poor sleep and anxiety could be related to obstructive sleep apnea, which is a potentially life-threatening condition if left untreated.
- Rare diagnoses
- Puerperal obsessive-compulsive disorder: The patient's excessive concern about the infant's health and her rigid adherence to a feeding regimen could be indicative of puerperal obsessive-compulsive disorder, although this is a less common condition.
- Factitious disorder imposed on another: Although unlikely, the patient's behavior could be a manifestation of factitious disorder imposed on another, where she fabricates or exaggerates the infant's illness for attention or other gains. However, this diagnosis would require further evaluation and is not supported by the current information.