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Breastfeeding Moms Breastfeeding Moms

Nursing on anti-anxiety/depressants.. quick question.

Posted by on Nov. 12, 2011 at 3:08 PM
  • 5 Replies

If you have been on anti-depressants or anti-anxiety meds while breastfeeding, what did you take and how did it effect nursing?

I ask because I had severe ppd after giving birth to my son last year, and I've been fighting the same feelings of depression when this little one isn't even here. I may not need them again, but i'd like to know a few bf-safe options to discuss with my midwife on Thursday, in the event I do feel like I need the help.

by on Nov. 12, 2011 at 3:08 PM
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Replies (1-5):
larissalarie
by Platinum Member on Nov. 12, 2011 at 3:14 PM
I think Zoloft is the preferred one to use in bf, but pretty much anything is ok if you really need it.

I personally took buspar & xanax for a few months. My nursling was 15-18 months at the time and around 30 lbs, so I wasn't really very concerned. They were also the lowest doses.
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cricketdawn81
by Member on Nov. 12, 2011 at 3:19 PM

I take 50mg of Zoloft and it hasn't affected bfing at all. 

deathbysexiness
by on Nov. 12, 2011 at 3:23 PM
I'm on 1/4 mg of xanax 3x daily and it's a very low dose...doesn't affect him at all. He's 3 months old. When I'm not nursing, I'm on 1 mg 3x a day.
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mitty18
by Bronze Member on Nov. 12, 2011 at 4:23 PM
I take zoloft. Doesn't effect baby girl @ all
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maggiemom2000
by Ruby Member on Nov. 12, 2011 at 4:25 PM

The following information comes from MEDICATIONS AND MOTHERS’ MILK by Thomas Hale, 2010.  He assigns every drug a lactation risk category:  L1, safest; L2, safer; L3, moderately safe; L4, possible hazardous; and L5, contraindicated. He also lists if a drug has been reviewed and/or approved by the American Academy of Pediatrics (AAP) for use in nursing mothers.  Possible risks to mother and baby are listed as well as possible effect on milk supply.

If you are talking to your doctor about anti depressants, ask him about which SSRI he recommends.  The three most popular are Prozac, Zoloft, and Paxil.  An important factor to consider is the half-life of the drug.  A drug with a shorter half life is generally better for a breastfeeding mom because it is eliminated from the blood stream and therefore the milk more quickly.


Of these three, Zoloft has the shortest half life.  (Prozac has a very long half life and should be avoided if Zoloft or Paxil will work.)  Here is a quote from an article by Dr. Thomas Hale:


"The use of Zoloft, on the other hand, has been reported in more than 30 breastfed infants, and appears to transfer poorly to the infant and with no reported effects.18,19 Thus far plasma levels in most infants have been close to or below the limit of detection, with no reports of untoward effects in the infant. At this time, Zoloft is probably the SSRI of choice for nursing mothers. Several reports of Paxil use suggest that its levels in breastmilk are exceedingly low, and the amount transferred to the infant would be minimal."


ZOLOFT

The following information comes from MEDICATIONS AND MOTHERS’ MILK by Thomas Hale, 2010.  He assigns every drug a lactation risk category:  L1, safest; L2, safer; L3, moderately safe; L4, possible hazardous; and L5, contraindicated.  


Zoloft is listed as L2.  Many studies are sited in the book, a summary is as follows:  "These studies generally confirm that the transfer of sertraline (Zoloft) and its metabolite to the infant is minimal, and that attaining clinically relevant plasma levels in infants is remote at maternal doses less than 150 mg/day.”


“In another study of 3 breastfeeding patients who received 50-100 mg sertraline daily,...plasma levels of sertraline and its metabolite in the 3 breastfed infants was below the limit of detection.”


There are some newer anti depressants, but because they are newer, not as much is known about then and their effect on nursing babies.


Please discuss all of this information with your doctor.


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