Generally, it is safe to take antidepressants while breastfeeding under a doctor's supervision, especially if the only other option is for a depressed mother trying to care for an infant. Several different selective serotonin reuptake inhibitors (SSRIs) are considered safe; numerous studies show no harmful effects to an infant. Taking certain other antidepressants while breastfeeding can, however, pose risks to the infant and are usually not prescribed to nursing mothers.
Studies have shown that an infant under the care of a depressed mother for over two months may gain less weight and lack attachment to the mother. There is also a risk of lower IQ and possible aggressive tendencies once the child is older. Treating a mother's depression, experienced by one in 10 postpartum women, is essential to both the health of the mother and baby. Several medications pose little to no risk to a nursing infant.
The safest antidepressants for nursing mothers include sertraline, also known as Zoloft, and paroxetine, also known as Paxil. Many large studies have found that the amount of these medications passed to the infant during nursing is so small that most regular labs will not detect it. This is because sertraline and paroxetine quickly leave the blood, which is what makes up most of breast milk. This fact, coupled with the natural filtering of chemicals that occurs in the breast, make these medications extremely safe to take when nursing in most cases. Studies conducted over a 20-year period have found no indication of fatalities, malformations, or any other health issues in infants exposed to these two drugs while breastfeeding.
Fluoxetine, also known as Prozac, is also considered safe while nursing, although there are some side effects. In the first three months of a child's life, exposure to this drug can cause the infant to be excessively cranky, nervous, or gassy. This is because fluoxetine stays in a woman's blood stream for several weeks, thereby causing the infant to be exposed to higher concentrations. After a child is three months old, these side effects almost always disappear; by this age, a baby's body is extremely adept at filtering out antidepressants while breastfeeding. As with sertraline and paroxetine, fluoxetine has not been found to cause any long-term damage.
Lithium and diazepam, also known as Valium, are not considered safe antidepressants while breastfeeding. Lithium has been found to be extremely dangerous for nursing infants because it limits growth, mental development, and greatly increases the risk of sudden infant death syndrome (SIDs). Diazepam has been shown in several studies to make infants extremely groggy and can also increase the risk of SIDs. If a mother needs to take these medications, it is best to discontinue nursing and feed the baby a high quality formula.
Breast milk is considered the ideal food for infants. Even when a mother needs to take antidepressants, her milk is still considered the optimal choice in many cases. If a medication not conducive to nursing is needed to treat a mother's depression, formula is the best option. A happy, health mother is infinitely more important to a child's development then the type of food he or she is fed in infancy. Recent advances in antidepressants make it possible, in many cases, for a child to have both.
