Can Antidepressants and Breastfeeding Go Together?

Many new mothers are happy and excited about their newborn babies. However, some women feel overwhelmed soon after they have their babies, and the bliss of being a new mother seems not to last too long. Instead, they experience postnatal depression, a natural, yet very challenging feeling, especially to lactating women. Then can antidepressants and breastfeeding go together?

Can You Take Antidepressants While Breastfeeding?

The decision of taking medical treatment for depression while breastfeeding may not be simple. You have to consider the benefits and risks of treating symptoms of depression while exposing a baby to the same medication, versus leaving your illness untreated, and versus not breastfeeding at all. The best thing to do is to discuss your options carefully with a doctor, including your baby's pediatrician, and of course, your partner. Some of the things to consider will probably include the severity of your depression, the baby's age, and your emotional need to nurse.

Generally, it is considered safe to take some types of antidepressants while breastfeeding a baby. Although these medications do pass through milk, the levels your baby gets are quite low. Certain antidepressants called SSRIs or selective serotonin reuptake inhibitors are considered safe and are therefore often prescribed to women suffering from depression while nursing. Taking antidepressants may also be safely done by using certain SNRIs or serotonin norepinephrine reuptake inhibitors and tricyclic antidepressants.

Here is a summary of what treatments are safe and potentially unsafe. Consult your doctor before using antidepressants and breastfeeding.

Safe Antidepressants While Breastfeeding

Anti-Depression                           

 

 

  • Bupropion (Wellbutrin)    
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Trazodone
  • Tricyclic antidepressants (Elavil, Pamelor,Tofranil)

Anti-Anxiety/ Tension; Sedative

  • Barbiturates (Fiorinal, Fioricet)
  • Lorazepam (Ativan)
  • Oxazepam (Serax)

Anti-Mood Swings

  • Anticonvulsant (Depakote, Dilantin, Tegretol)

Potentially Hazardous While Breastfeeding

Anti-Depression

  • Citalopram (Celexa) – (can cause drowsiness in baby)
  • Doxepin (Sinequan)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac, Serafem)
  • Venlafaxine (Effexor)
  • Nefazodone (Serzone)

 

Anti-Anxiety/Hypertension

  • Benzodiazepines (Librium, Valium, Dalmane)
  • Reserpine

 

For Mood Swings

  • Lamotrigine (Lamictal)

For Bipolar Disorder

  • Lithium (Lithobid)

Sedative

  • Phenobarbital

Stop Breastfeeding?

Your doctor may advise you to continue breastfeeding, but you may feel that antidepressants and breastfeeding should not go together. If you're not sure, just stop breastfeeding but continue to pump out breast milk with a glass or plastic pump without giving the milk to your baby. This will ensure that your milk flow does not diminish, just in case you decide to breastfeed again. Once you discontinue medications, you can ask your doctor if you can restart breastfeeding. Be sure to ask your baby’s doctor about giving your baby a safe formula while you are not nursing.

Never Leave the Depression Untreated

It is always best to get treatment for depression. Studies show that babies with depressed mothers who go untreated tend to have poor brain development. Mother-baby bonding is usually poor and they usually have less attachment. Developmental delays also occur. It is therefore advisable to take a safe medication than to go untreated while taking care of a baby.

Other Ways to Manage Postnatal Depression

1. Some Self-Help Tips

  • Get lots of sleep and rest. Ask your partner or someone to help you care for the baby. Relax and take a warm drink. Put on some music and take a nap while the baby is asleep. Try to reduce your work load.
  • Eat a healthy diet. Have balanced meals to get enough fuel and support your immune system. Avoid dips in your blood sugar, which can cause you to feel tired and run down.
  • Exercise. Instead of worrying antidepressants and breastfeeding, get some light exercise to improve your mood and help you feel better. This can include a light walk, Pilates exercises or yoga, which can also help you relax.
  • Meet other moms. Postnatal depression is common, and it may help to talk to other moms about your feelings. They can help you cope with daily challenges and get some reassurance that you are not alone.
  • Get support and advice. Family and friends can help you recover from your physical and emotional challenges. They may be able to offer some help in taking care of your baby while you rest and in giving you emotional support when you need it. Try to talk about your feelings instead of bottling them up.

2. Psychological Treatments

  • Try cognitive behavioral therapy (CBT). Ask professional help in changing your way of thinking and behavior. Unrealistic thoughts often lead to negative behavior. CBT helps break this vicious cycle and helps you find better ways of thinking to help you behave more positively. This type of treatment often lasts for 3-4 months.
  • Try guided self-help. This is similar to CBT, but you will learn from reading, watching videos, or computer-based info. You do things at your own pace, but it also involves talking to a therapist who will guide you through it.
  • Try interpersonal therapy which involves interacting with a therapist about your problems. The goal is to identify your problems in relationships with your family, partner or friend, and how they may contribute to your depression. This type of treatment usually lasts for 3-4 months.
 
 
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