Post natal depression and medication

[Starheart]

I've been advised that I would benefit from medication for post natal depression from my health visitor . I'm feeling very torn about taking medication as I'm breastfeeding and worry about the effects long term on my baby brain development . I don't know if I am being unreasonable or not by worrying about this because I am quite anxious just now . Has anyone any advice they can give on this ? Many thanks .

I was advised that fluoxetine (Prozac) has been used by pregnant and nursing mothers for many years now and it seems to be ok. I took it all through pregnancy and nursing. Expect DD will be okay.

Hello. I had PND. I was breast feeding while medicated. BF was taken into account when I was prescribed.
No medical professional would prescribe any meds that would harm your baby.
I know it's hard, but you need to trust your doctors
My baby is 29 in July. She is amazing and NT.
She has a good management job. Lovely fiance. Lovely home. It's all good.
Take the support. It is offered from a good place.
I wish you well x

Mine was fluoxetine too.

I'd suggest talking to your pharmacist. There is a book called Medications and Mother's Milk that they may have. This discusses the effects of medication on nurslings and whether the meds are safe for breastfeeding.

Your body will process different drugs in different ways. You will only be prescribed a drug that will not effect your baby whilst breastfeeding. Your GP and pharmacist will be aware of this.

Paroxetine and sertraline are recommended by the Specialist Pharmacy Service as the SSRIs of choice for a breastfeeding woman because of their shorter half-lives and lower passage into milk.

Although sertraline and paroxetine have the lowest reported levels of exposure, sertraline is the preferred option in breastfeeding, according to British Association for Psychopharmacology consensus guidance,

Sertraline seems to be prescribed regularly for breastfeeding mothers and no one I know has had any issues with it. Speak to your GP though as it was a little irresponsible for your HV to just discuss medication. Therapy or a combination are far more effective (based on my experience and gp advice).

Just wanted to mention that Paroxetine can be very effective and is often a 'go to' prescription for breastfeeding mothers, however it has more side effects than similar anti-depressants and it isn't easy to stop taking (when the time comes), again due to side effects. Many GPs don't mention this when prescribing. I'd request Sertraline (this seems to be most commonly prescribed for breastfeeding mothers) as your first choice.

I agree with blackcat, your HV was irresponsible to suggest anti-depressants without mentioning other options (and/or that a combination of anti-depressants and therapy is usually most effective).
It would be worth a chat with your GP to see whether there are any services you could access (counselling, PND groups, etc.). You might even wish to try those options before medication or alongside.

I totally understand where you're coming from as I felt similar. I held off until DS was 10 months. I started on sertraline 2 weeks ago and take it straight after morning feed. He doesn't feed much now and as the drug has a shorter half life I don't feel too bad. It had got to the point where I had to do something.

With older DC I took venlafaxine until 37 weeks pregnant and then started citalopram 4 months pp (bf until 6 months), he's 15 now and fine!

It's cost benefit analysis - is the hope that meds help worth the potential benefit to you and consequently your baby?
I would 100% try cbt as you will be fast tracked on the NHS. It may be that with learning ways to manage you won't need medication. I think we live in a very medicalised world and you're right to be concerned.

Thanks for all your replies . It's been useful to read a range of perspectives and think about it some more . I am booked in for a doctors appointment next week so will use the next few days to consider my options and ask some further questions also just to add I have had one session of counselling so far and will continue with that .

Here's a fact sheet from the breastfeeding network regarding anti-depressant medication and breastfeeding. It is written by Wendy Jones, a UK pharmacist who has written factsheets on all sorts of medication for nursing women.

breastfeedingnetwork.org.uk/wp-content/dibm/antidepressants%20and%20breastfeeding.pdf

They won’t prescribe you something that will harm your baby. Think logically about that.

So just to update . Received a referral for talking therapies and visited gp yesterday. Have been prescribed paraoxetine. I said to the gp that the breastfeeding network recommended seratiline but was told that by gp they would recommend paraoxetine.