Antidepressants and breastfeeding

Put your oxygen mask on first. When there is an emergency on a plane, we are instructed to put our mask on first before helping others. This is also critical when caring for our children. Stress, depression, and anxiety can play major roles in how we care for our babies and for ourselves. Antidepressants are OK to take while breastfeeding. When maternal mental illness is not addressed, research shows this not only has a negative impact on the mother’s overall health, but can impact the baby as well.

The risks of not addressing maternal mental health include:
✏️Poor infant growth, language and cognitive development
✏️Poor gross and fine motor development
✏️Less efficient breastfeeding or weaning from breastfeeding earlier than desired
✏️Poor infant sleep and increased maternal stress.

When considering antidepressant use during lactation, while most medications are considered safe for mom and baby, there is no “zero risk” option. However, the benefits of using a medication to help decrease depression and anxiety usually outweigh the risks acostares with taking a medication. If a mother has been on a certain med prior to breastfeeding and it worked well for her, it would be reasonable to resume that medication while breastfeeding. Sertraline (Zoloft) is a first-line drug for breastfeeding, due to documented low levels of exposure in breastfeeding babies and the very low number of adverse events described in case reports. Prozac is generally considered safe to take while breastfeeding; however, research shows that the average amount of the drug in breastmilk is higher than with other SSRIs.

When taking any medication, you want to monitor for side effects both in you and the baby. Most common side effects when taking antidepressants are:
🥛 Changes in milk supply
🛌 Sedation/sleepiness in baby
Poor feeding or weight gain in baby

Antidepressants can work well to help you feel balanced again. Work closely with an IBCLC while starting antidepressants to help continue and feel supported in your breastfeeding journey

Depression with weaning

Weaning blues. If postpartum depression weren’t enough, it’s also possible to have depression and mood shifts from weaning from breastfeeding. During breastfeeding, oxytocin, the cuddle or love hormone, is released every time milk lets down. This feel good hormone helps reduce the risk of post partum depression and aids in bonding with baby. Prolactin, the hormone that actually makes the milk, also brings a feeling of well-being, calmness and relaxation. There is very little research on the subject, but it’s hypothesized that when you wean, the decrease in prolactin and oxytocin can make some feel moodiness, sadness or even anger. The faster the weaning process the more abrupt the shift in hormone levels, and the more likely that you will experience feelings such as being tearful, sad or mildly depressed. Some also experience irritability, anxiety, or mood swings. These feelings are usually short-term and often go away in a few weeks. Dropping no more than one feeding per week is a gentle way to wean and adjust to shifting hormones. People who are forced to wean before they are ready (or for reasons beyond their control) and those with a history of depression are also more likely to experience depression after weaning. Even for those who are ready to wean and doing so gradually, there may still be a sense of loss and sadness. Your breastfeeding relationship has been a major part of your parenting journey and it is understandable that you’ll feel a wide range of emotions.