Breastfeeding: Can a nursing mom use antidepressants?

I am in the midst of a depression but I'm concerned about taking medication because I'm breastfeeding my 15 month old. I don't want to wean my son yet. Are there antidepressants that a nursing mother can use safely?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

I am sorry to hear you are suffering from depression. Many mothers with depression are being treated with medications while continuing to nurse their babies.

I can't recommend a medication, but I can tell you what medications are being used and which seem to be preferred by nursing mothers and Health Care Providers (HCPs).

Although there has been limited clinical experience with the serotonin-reuptake-inhibitor medications such as Zoloft (sertraline), Prozac (fluoxetine) and Paxil (paroxetine), they are often used to treat depression in nursing mothers. The older class of antidepressants, tricyclics, are frequently not liked or well tolerated because of their side-effects.

The levels of Paxil have been measured in a mother's breastmilk, and were found to be extremely low, about 0.34 percent of the maternal dose (J Clin Psy, 1996.)

Only four studies exist that describe the use of Prozac and one of Zoloft. In "Clinical Issues in Lactation", March 1997, Thomas Hale, R.Ph., Ph.D., in an article discussing antidepressants and breastfeeding, stated: "At this time using the data provided in the literature, it would seem prudent to avoid Prozac and, instead, use Zoloft, although this is based on preliminary data that is somewhat premature."

You mentioned that you don't want to take a medication that would be dangerous in any way. I don't believe such medications exists. All medications, over-the-counter and prescription, have side-effects -- some significant and some minimal. I recommend gathering information about medications and discussing them with your HCP. It's important to make an informed choice, considering both the risks and benefits. I hope this information will help you in making your decision. Best wishes!

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