Vol. 7, Issue 2, Part A (2025)

Postpartum psychosis (PPP) is a rare but severe psychiatric emergency that typically emerges within the first few weeks following childbirth and is often marked by affective instability, hallucinations, and delusional thinking. While the condition has been extensively described about mood and psychotic symptoms, atypical behavioral presentations, particularly those with irregular eating behaviors, remain underrecognized. We report a unique case of a 29-year-old woman with no prior psychiatric history who developed PPP characterized by delusional food aversion. She believed certain foods were poisonous and would harm her breastfed infant, leading to extreme dietary restriction and ritualistic food behaviours. Her symptoms included auditory and visual hallucinations, and the infant required hospitalization for failure to thrive. Treatment with olanzapine and supportive care led to remission of psychotic symptoms and normalization of eating behavior. This case highlights the potential overlap between PPP and avoidant or restrictive food intake patterns driven by psychosis. Given the risks of malnutrition, impaired bonding, and delayed treatment, clinicians and families must be alert to behavioural signs that may mimic or mask eating disorders in the postpartum period. Early recognition and interdisciplinary management are critical to improving outcomes for both mother and child. Broader awareness may help prevent misdiagnosis and ensure timely intervention.