Antidepressants While Breastfeeding: What You Should Know

Doctors often prescribe antidepressants to treat postpartum depression, so breastfeeding women may be concerned about the safety of those medications.

About one in seven women experience clinical depression in the year after giving birth, so this is a relatively common problem. Treating postpartum depression is critical for the health of both mother and baby. Of course, some women experience depression before getting pregnant and giving birth as well, and they need to continue receiving treatment. Many women want to breastfeed, and it’s important to take that into consideration when providing treatment for depression.

Should Breastfeeding Mothers Be Prescribed Antidepressant Medications?

Non-pharmaceutical treatments like talk therapy should be tried first, at least by women with milder symptoms of depression. In severe cases of depression, however, medications may be necessary. Women that need to take antidepressants may be able to continue breastfeeding, but if there are concerns about adverse effects on the baby, women can switch to formula.

Do Medications for Depression Pose a Risk for Breastfeeding Babies?

This is a more complex question than it might seem at first glance. The answer can depend on a number of factors. Some antidepressants may pose less of a risk than others for breastfeeding babies, but the type of medication is not the only factor that influences the degree of risk to the baby.

A baby’s liver function isn’t fully developed until three to six months of age, so before that time, a baby may be unable to properly metabolize medication. Premature infants may be especially affected by antidepressants in breast milk. Older babies, on the other hand, may experience little to no adverse effects.

How many times a day a baby breastfeeds is yet another factor to consider. Is this a toddler that only nurses once or twice a day? Does the mother combine nursing with some formula feeding? If so, the amount of medication to which the baby is exposed is significantly less than if this is a young infant fed nothing but breast milk.

Do Medications for Depression Affect Milk Production?

The Centers for Disease Control and Prevention says antidepressants are not believed to have a significant effect on milk production. Some medications do decrease milk supply though, including some over-the-counter medications like antihistamines, so make sure you tell your doctor about all medicines you take.

According to the American Pregnancy Association, signs that your baby is getting enough milk include seeing and/or hearing your baby swallow while nursing, your baby’s cheeks looking full instead of sucked in while nursing, your baby seeming satisfied and content after eating, and your breasts feeling soft instead of hard after nursing. Talk to a lactation consultant if you think your baby might not be getting enough milk. Many things besides medications can cause decreased milk supply as well.

Should Breastfeeding Mothers Stop Taking Antidepressants?

Don’t stop taking any medication for depression without consulting your doctor beforehand. Discontinuing some medications too quickly leads to serious symptoms of withdrawal and may also cause depression to worsen. It may be necessary to discontinue medication gradually over time if you want to stop taking the drug.

If breastfeeding is important to you, let your doctor know that. You may be able to both continue taking your medications and breastfeed, or you might be able to rely on non-pharmaceutical treatments instead.