Postpartum can be a very overwhelming time, and while the birth of a new baby is a joyous time, for some it can become a battle for mental well being. Mental health isn’t always just mental and can often times require medication. There are so many barriers to obtaining medication for mental illness, and having to choose breastfeeding or your mental well-being should NOT be one of them. The great news is that it doesn’t have to be (in most cases). There are medications that can be taken while breastfeeding and have very low to no risk to the infant.
The information you will find here is simply a guide, knowledge to be used as a tool to bring to your health care professional so that you can cultivate a conversation about how to approach mental health medication while breastfeeding.
The most often used medications in controlling depression and anxiety are SSRI’s (Selective Serotonin Re-uptake Inhibitor). You should know that different SSRIs have different side effects, but this post is only going to highlight side effects for baby through breast milk. Be sure to use reputable sources for further personal research on side effects, I would advise steering clear of using discussion boards as a source of factual information and take others’ experiences with a grain of salt.
This is the preferred medication for breastfeeding mothers. There are low concentrations in the milk. The vast majority of published studies show that there is litte to no detectable amounts of the drug found in the infant, and no documented side effects for the infant.
This is another drug that has been shown to have below detection levels in the infants plasma and no linked documented side effects for the infant.
Paxil is another SSRI that is safe for breastfeeding with no side effects for the infant. However, it should be noted that several studies showed it to have side effects for the infant if taken by the mother while pregnant.
Prozac is a drug with a longer half life, which equates to higher levels in the mothers milk and side effects for baby. No long term side effects have been studied, but in the short term mothers who took Prozac while breastfeeding were more likely to have infants who experienced colic, excessive fussiness, and increased drowsiness. A fussy and drowsy baby is not only more difficult to nurse, but can create a more turbulent enviroment for a mother struggling with Postpartum Depression. If you or someone you know is taking Prozac and breastfeeding, do not discourage them from breastfeeding or suddenly stop taking the Prozac, but it is recommended they switch medications (most likely to Zoloft).
Celexa is another anti-depressant that is not recommended for use during breastfeeding. Similar to Prozac it has not been seen to have any long term side effects, but in the short term there is an increased chance of a fussy drowsy babe. If you or someone you know is taking Celexa and breastfeeding, do not discourage them from breastfeeding or suddenly stop taking the Celexa, but it is recommended they switch medications (most likely to Zoloft).
Lithium (not an SSRI)
While the majority of mental illnesses among new moms can be treated with SSRI’s, it isn’t always the case. Some mental illnesses may require the use of lithium. Lithium is about one of the very few mental health medications that is STRONGLY advised against while breastfeeding. Lithium does transfer into breast milk and can have serious side effects for the infant such as lithium toxicity. IF you or someone you know requires lithium, you/they will need to weigh the benefits of their lithium use to the benefits of breastfeeding. It’s important to remember the number one rule, and that is a fed baby is best, and while this rule doesn’t have a number, mama’s mental health is a corner stone of family happiness and health. All my love and support and good vibes to any mothers who are faced with this difficult decision.
The Dream Team
Mama’s who are faced with mental illness and mental health struggles during this precious time in life require love, understanding, and the support of health professionals who will work collaboratively to support her mental well-being AND her breastfeeding goals. In general if you are dealing with postpartum depression or other mental illness, your breastfeeding may become a struggle, with the help of a lactation consultant (IBCLC) and a doctor you can reach your breastfeeding goals and keep your sanity.