How much antidepressant gets into breast milk?

Understanding Antidepressant Transfer into Breast Milk
The question of how much antidepressant medication transfers into breast milk is a significant concern for new mothers dealing with postpartum depression (PPD) who wish to continue breastfeeding. Research indicates that while all antidepressants do pass into breast milk, the amounts are generally low, and the implications for infant health are often manageable.
Low Transfer Rates
Studies have shown that the transfer of antidepressants into breast milk is typically low to very low. For instance, medications such as paroxetine and sertraline are noted for their minimal transfer rates, making them suitable options for breastfeeding mothers. In fact, a pooled analysis revealed that infants exposed to these medications were least likely to have detectable or elevated serum drug concentrations, with levels often remaining below 10% of the maternal dosage .
Specific Medications and Their Transfer Rates
Different antidepressants exhibit varying degrees of transfer into breast milk. For example, bupropion has a transfer rate with a relative infant dose (RID) ranging from 1.4% to 10.6%. However, there are concerns regarding its safety, as some cases have reported seizures in infants breastfed by mothers taking this medication, although a direct causal relationship has not been established.
In contrast, nortriptyline, paroxetine, and sertraline have shown particularly favorable profiles, with low concentrations in breast milk and minimal impact on nursing infants.
Balancing Risks and Benefits
Experts generally agree that the benefits of breastfeeding, combined with the treatment of postpartum depression, outweigh the risks associated with antidepressant use during lactation. The consensus is that mothers should not be advised to discontinue breastfeeding solely due to antidepressant treatment.
Moreover, while the transfer of these medications into breast milk is a valid concern, the majority of breastfed infants tolerate these medications well, and adverse effects are rare.
Conclusion
In summary, while antidepressants do enter breast milk, the amounts are typically low, and many commonly prescribed medications are considered safe for breastfeeding mothers. It is crucial for mothers to consult healthcare providers to make informed decisions that prioritize both their mental health and the well-being of their infants.

Which SSRI is least secreted in breast milk?

Sertraline has the lowest passage of SSRI drugs into breastmilk. Citalopram also passes into breastmilk in low levels. If a breastfeeding mother has found an antidepressant previously prescribed of benefit, that may influence the choice of drug prescribed.

What is the best anxiety medication to take while breastfeeding?

Safe medication in breastfeeding
They include, in no particular order: SSRI antidepressants e.g. sertraline, citalopram, fluoxetine, paroxetine all have anti- anxiety activity. They take 4 to 6 weeks to exert full benefit. Tri-cyclic antidepressants e.g. amitriptyline, imipramine.

How does Zoloft affect the baby?

Sertraline and pregnancy
Sertraline can be taken in pregnancy. Some studies have suggested that sertraline might occasionally affect the development of a baby’s heart. However, if there is any risk, it is small, and the majority of babies born to women taking sertraline have a normal heart.

Do antidepressants affect the fetus?

But overall, the risk of birth defects and other problems for babies of pregnant people who take antidepressants is very low. Still, some antidepressants are linked with a higher risk of health problems for your baby. Talk with your health care team about your symptoms and your medicine choices.

Do I have to pump and dump after taking medication?

If it is a short-term medication, pumping and dumping will keep your milk supply up until you can resume nursing. If you are on incompatible medications for the long term, discuss options with your provider. While you may need to wean, donor breast milk is an option for your baby or you may choose to use formula.

What drugs don’t go into breast milk?

Table. Examples of drugs contraindicated in breastfeeding.

Drug	Comment
Iodine	High doses (>150 micrograms daily) lead to risk of infant hypothyroidism
Lithium	Breastfeeding only feasible with rigorous monitoring
Radiopharmaceuticals	Contact obstetric information service
Retinoids (oral)	Potential for serious adverse effects

How much medication goes into breast milk?

Although most medicines are excreted in breast milk to some degree, the amount is usually less than 10% of the maternal dose. Medicines excreted at less than 10% are considered compatible with breastfeeding.

Do antidepressants get into breastmilk?

Infant exposure of antidepressants through breast milk is generally low to very low. We consider that when antidepressant treatment is indicated in women with postpartum depression, they should not be advised to discontinue breastfeeding. Paroxetine and sertraline are most likely suitable first-line agents.

How much Lexapro goes into breastmilk?

Overall, with a mean relative infant dose of 5.3% of the weight-adjusted maternal dose for escitalopram plus its major demethyl metabolite, our study shows that escitalopram is safe (notional level of safety < 10%) for use during breastfeeding and, because the absolute infant dose is lower, it should be preferred over ...

How much Zoloft gets into breastmilk?

Does Zoloft pass into breast milk? Yes, Zoloft can pass into breast milk. While more research is needed in this area, current research indicates that only a very small amount passes through. (Peak levels in the hindmilk were typically found 8 to 9 hours after a dose.)