Aibu? Sertraline and breastfeeding...

[sj257]

Posting here for traffic really. I have had anxiety for a number of years. Just had a baby, managed without meds during pregnancy but anxiety is sky high right now. I've been prescribed sertraline, last week actually but haven't taken any yet. The doctor told me they have to tell me they haven't been tested on breastfeeding women etc. I Googled (I am terrible for doing this 😞) and found something about taking sertraline when pregnant causing autism and it's worried me 😞

I contacted a page on Facebook who advises breastfeeding mothers about various medications. They have said there is absolutely no evidence of this. So why can't I get past it? I hate anxiety 😔

It's horrible when anxiety stops you taking meds to help anxiety

Unfortunately I can't imagine any ADs are tested on breastfeeding mothers for obvious reasons.

You have several options

• accept the miniscule risk and take the meds and continue breastfeeding
• refuse the risk and manage without meds while continuing the bf
• refuse the risk, take the meds, switch dc to formula

Are you having counselling of any kind to help with the anxiety? CBT can be extremely helpful, although I found it easier when I was on medication as I was better able to engage with it then, but that's me personally, you aren't me!

Have you tried contacting La Leche League?
They really know their stuff with regards to breastfeeding and may be able to help. Or perhaps your local breastfeeding support group.

I'm sorry you are having these anxiety issues. I know that is just the crappiest thing! I hope it all works out for you xx

FWIW there's been no studies on breastfeeding women however minimal amount is known to pass through the milk. I'm on it and have been for 2 months and I'm breastfeeding my DD who is 18 months.

Sorry OP I was wrong I am on paroxetine. I thought it was a different name for the same drug.

Maybe you could ask about paroxetine?

Testing drugs on breastfeeding women and infants isn't ethical so obviously there isn't a lot of data.

I've taken Sertraline alongside breastfeeding for 3 years and am happy to do so.

I'm on sertraline and was put on it specifically (as opposed to any other ADs) because I was breastfeeding at the time.

I did my own research and there is a very very slight possibility of the risk of autism being raised by a teeny tiny amount.

BUT that doesn't take into account the reason why mothers took the sertraline. In my case, I am on sertraline to manage my anxiety caused by my own autism- and autism in the family raises a child's risk. So it's entirely possible that sertraline has nothing to do with it, and if my child(ren) are diagnosed as autistic later, they would have been anyway regardless of if I had taken the sertraline or not.

Like a PP says, you have to weigh up the potential risks and benefits. For me, the actual risk to myself outweighs the minute possibility of an increased risk of autism. You need to decide if that is true for you.

So sorry you're feeling so stressed

Some good advice here on who to contact.

If it's any help I was prescribed sertraline for PND - so I'm assuming it's commonly given to breastfeeding mums.

I think they have to tell you it hasn't been tested on breastfeeding mums. But then my doctor said nothing is!! They wouldn't be able to get any breastfeeding mums to 'test out a theory' with their precious baby. That's why a lot of stuff is 'not suitable if breastfeeding'.

Take care. Having a baby can be so stressful even without anxiety

I'm another who has been taking sertraline while BF. The tiny risks are far outweighed by me not being afraid to leave the house, self harming etc. Happy mother = happy household.

Hope you start to feel better soon. So much about babies causes anxiety in a 'normal' person, if you are prone to anxiety already it is very hard

Thank you, it's just so difficult isn't it? I have some days where I think I've got this I can manage without and then days where I think I definitely can't. I just wish someone could tell me what to do, I'm so bad at making decisions 😞

Why not try a low dose to start or take one every other day? That way you can see what effect they have and make a decision from there.

As PPs have said, the reason why there isn't data on using setraline and breastfeeding is because it's immoral and illegal to test drugs on breastfeeding women.

That said, looking at how setraline supposedly works, the chances of it having any effect on your baby whatsoever (let alone a negative effect) is negligible.

In an incredibly simplified explanation, setraline lowers the threshold you have for nerves transmitting happy hormones.

There is a minuscule amount involved in your dose, and only a minuscule fraction of which could make it to your milk, and only a minuscule fraction of this could make it past your baby's stomach into it's blood, and have the same effect on their nerve threshold.

For your peace of mind, it's probably worth really studying the possible side effects from setraline so you can pick these up on the very very very very small chance the active ingredient reaches your child in any recognisable quantity.

And one more thing, don't be so hard on yourself :) You're biologically wired to be more of a worrier, so it's normal for you to get this worked up. Just keep doing as you're doing and get second opinions

For clarity, I'm not a doctor but have a science degree, a history of MH issues and my job used to involve communicating how certain drugs interact with pregnancy and breastfeeding mothers. Please do speak to doctors about your concerns, if you have a good one they'll put your mind at rest :)

the only study showed a miniscule but significant increase in the number of babies with autism in mothers who took sertraline while pregnant. But this does not apply to you as it is only during pregnancy, not BF that this has been shown.
And it is a correlation, not saying it causes it.

I was told that if I needed to, sertraline was considered fairly safe to continue during pregnancy- fortunately at the moment I am well (19 weeks) but it's not ruled out as the physiological effects of anxiety pose a far greater risk than the medication would. ANd I have no doubt that I'll have to take ADs again at some point in my life.

OP the feeling of not knowing/ being unable to decide might be part of your symptoms. Please do consider the meds but ask GP about referral to IAPT who might be able to offer CBT or other talking therapies.

I was on sertraline from being 12 weeks pregnant with DD and then breastfed her until she was about one.

Wasn't on any ADs when I was pregnant with DS (older than DD). Probably should have been tbh.

Out of the two of them I suspect DS to be further along the autistic spectrum, although am pretty sure i am more so, so probably isn't as much of an issue for me.

Things would have been worse for me and hence for DD if I hadn't taken ADs while pregnant with her.

Hi I was prescribed sertraline whilst pregnant and have been on it and BF for 8 months. The perinatal psychiatrist whose care i was under said there was little to no concern when taking it and any medical professional who suggested it would do so believing the benefits outweighed any risks. She is the lead consultant in my area as well so definately knows what she is talking about. I was kept in hospital 3 days after birth of DC to monitor him for withdrawals and he was fine no problems at all. I know anxiety is a killer especially when its linked to your children but honestly you and your baby will be fine any that passes through in breast milk is minimal i wouldnt even think about it tbh :) x

I was put on sertraline whilst breastfeeding by a psychiatrist who specialised in pregnancy and new mums. I was put on that rather than other medications so that I could carry on breastfeeding! The psychiatrist said that there are only tiny, tiny amounts that are passed on through breastmilk. They have to say that they haven't done really long term studies, experimented on babies (unethical), but the general consensus is that it is safe. On the internet you will always get people who hype up anything about pharmaceuticals, making out that there is some big conspiracy to give babies autism etc but that is not true. Anti depressants are not the big money making drugs these days, so there is no incentive to hide data etc. Doctors want the best for patients, so would not prescribe you something that they didn't think was safe.

There is a far greater risk of having a poor outcome for a baby if a mother has untreated (not necessarily meaning medicated) anxiety/depression, than if teeny amounts of medication get through breastmilk. There are actual proper longitudinal studies that show this.

I'd take the meds myself. It's hard when you are in that mindset to make a decision. Sometimes it is best to leave the decision making to 'professionals' and trust that if your doctor has prescribed it then it might be worth a try.

FWIW I took paroxetine with DS2 and sertraline with DD. Both are happy, intelligent kids and have suffered no ill effects, and most importantly, I was able to be a reasonable parent when they were babies. I wasn't for the first few months of DS2 when I was unmedicated and a complete wreck, but the medication helped so much the difference was off the scale.