What happens to breastfed babies on antidepressants?

Understanding the Impact of Antidepressants on Breastfed Babies
The intersection of breastfeeding and antidepressant use is a complex and sensitive topic that raises important questions about the health and safety of infants. As more mothers face postpartum depression, understanding the implications of antidepressant medications during breastfeeding becomes crucial.
Antidepressants and Their Transfer to Breast Milk
Research indicates that all antidepressants pass into breast milk to some degree. The extent of this transfer varies by medication, but it is generally accepted that the amounts are relatively low. For instance, at therapeutic doses, a breastfed baby might receive between 20 to 200 micrograms per day of the medication, which is considered minimal and typically does not lead to adverse effects.
Clinical guidelines often recommend that psychotherapy be the first-line treatment for postpartum depression in breastfeeding mothers, with antidepressants like citalopram, escitalopram, and sertraline suggested as second-line options. These medications are favored due to their relatively low transfer rates and established safety profiles.
Potential Effects on Infants
While the transfer of antidepressants into breast milk is a concern, most studies suggest that the risk to infants is low. However, healthcare providers often advise monitoring breastfed babies for potential side effects, such as sedation or dry mouth. It is essential for mothers to remain vigilant and report any unusual behaviors or symptoms in their infants to their healthcare provider.
In some cases, specific medications have been associated with more significant concerns. For example, bupropion, while having a low transfer rate, has been linked to rare instances of seizures in breastfed infants, although it remains unclear if these were directly caused by the medication.
The Importance of Maternal Mental Health
The decision to use antidepressants while breastfeeding is not solely about the infant’s safety; it also involves the mother’s mental health. Postpartum depression can severely impact a mother’s ability to care for her child, and untreated depression can lead to poorer outcomes for both mother and baby. Studies show that breastfeeding rates are lower among postpartum depressed women, which can deprive infants of the numerous benefits associated with breastfeeding.
Conclusion
In summary, while antidepressants do transfer into breast milk, the risk to breastfed infants is generally considered low. The benefits of treating maternal depression often outweigh the potential risks associated with medication. Mothers should engage in open discussions with their healthcare providers to weigh the benefits and risks of continuing antidepressant therapy while breastfeeding, ensuring both their mental health and their baby’s well-being are prioritized.

Can babies have withdrawals from antidepressants?

According to observational studies and meta-analyses of observational studies, approximately one third of the neonates of mothers treated with SSRIs/venlafaxine during pregnancy develop a withdrawal syndrome (Shea et al., 2021; Wang & Cosci, 2021).

What happens to a baby when the mother takes antidepressants?

“We can say with strong confidence that antidepressants don’t cause birth defects,” says Osborne. She adds that most studies finding a physical effect on babies from antidepressants taken during pregnancy fail to account for the effects of the mother’s psychiatric illness.

Does Zoloft affect breastfed babies?

Sertraline and breastfeeding
If your doctor or health visitor says your baby is healthy, it is OK to take sertraline while breastfeeding. It is one of the preferred antidepressants to take when breastfeeding and has been used by many breastfeeding mothers without any problems.

Do newborns withdraw from antidepressants?

According to observational studies and meta-analyses of observational studies, approximately one third of the neonates of mothers treated with SSRIs/venlafaxine during pregnancy develop a withdrawal syndrome (Shea et al., 2021; Wang & Cosci, 2021).

What effects do antidepressants have on breastfed babies?

There have been a small number of case reports of adverse events in infants exposed to antidepressants in breast milk, including jitteriness, irritability, excessive crying, sleep disturbance, and feeding problems.

What effects do antidepressants have on newborns?

Preterm birth, major cardiac malformations, and neonatal respiratory distress have been associated with prenatal antidepressant use,7–13 although other large studies have failed to confirm these findings.

Can a baby have withdrawals from antidepressants?

According to observational studies and meta-analyses of observational studies, approximately one third of the neonates of mothers treated with SSRIs/venlafaxine during pregnancy develop a withdrawal syndrome (Shea et al., 2021; Wang & Cosci, 2021).

How much antidepressant gets into breast milk?

Significant published evidence shows that fluoxetine passes into breast milk in variable amounts (ranging from 0.54%–10.8% of the weight-adjusted maternal dose) with maternal doses of up to 80mg daily. Some single case reports describe much higher levels; up to 20% of the weight-adjusted maternal dose.

What is the safest antidepressant while breastfeeding?

Sertraline and paroxetine (among SSRIs) and nortriptyline and imipramine (among TCAs) are the most evidence-based medications for use during breastfeeding because of similar findings across multiple laboratories, usually undetectable infant serum levels and no reports of short term adverse events.

How do antidepressants affect the fetal brain development?

Both prenatal antidepressant exposure and maternal depressive symptoms may affect fetal brain development. Neuroimaging studies, though limited, have observed associations between prenatal SSRI exposure, maternal depressive symptoms, and alterations in white matter microstructure in the exposed offspring.