sertraline and breastfeeding, please help

[sallymander]

Hello. I have a 4 week old little girl and am suffering from depression (on and off for years) and huge anxiety. My dr has prescribed Sertraline for me which I also took with my son when he was 9 months old.

Here is my dilemma, my anxiety is completely related to breastfeeding. I had incredible difficulty with my son when he was 9 months old. Because of a biting incident, the next time I tried to feed him my milk would not let down. This shocked me so much that every time I tried to feed him after that I could not get letdown because I was so anxious that it wouldn't work. I have done a lot of research online into that problem and could not find any information about people with similar issues. I felt very alone.

Anyway, whilst expecting my daughter I was extremely worried that I would have feeding problems again. And sure enough 4 weeks in, two nights ago I could not get a letdown in the night and had a huge panic attack.

I really really do not want to take medication as my daughter is still so young. I took one pill today and have noticed she was extremely unsettled and while tired she would not sleep for hours. I don't think this can be a coincidence even though at this age babies change all the time. I just feel so guilty about 'drugging' her. But I really do not want to bottle feed either because the cause of my anxiety is about failing at breastfeeding and having to bottle feed.

I feel completely lost and haven't a clue what to do. I know I need to feel well withing myself to be able to care for my two young children, but is taking medication the best thing for my baby. I can't cope with feeling so anxious, and think if I don't take the medication things will just spiral out of control. But I can't stop feeling guilty and wonder if the drugs will actually help my feeding problem.

Please could anyone advise, or have heard of anyone with similar issues. I really need some help in deciding what to do. Thank you.

Hi I am bf on 50mg of sertraline.

Sertraline makes you anxious when you first take it. It's really ironic, as it is supposed to treat anxiety - and will do wonders if you keep going. So bear in mind you might feel extra anxious but its not real.

I watched my dd like a hawk for changes I could attribute to the sertraline. One day she was really awake, another day really sleepy. This suggested to me that she was doing her own thing.

When I missed a dose and my mood spiralled I noticed her become much more distressed. I can't say for sure but I felt my mood had more of an impact on her than any drug coming through the breast milk.

My dad is a retired baby doctor and he says consider that you have tens of litres of liquid in your body, the drug goes into the blood stream and peaks momentarily there but afterwards diffuses through your body. The milk will never have more than the blood at its leak and even the blood alone is many litres so think how diluted it will be.

I'm weaning my dd now. Food and one bottle of formula a day. I think she is a little more alert but not really any mood change - certainly no personality change.

And to get away from all this anecdotal advice there has been a lot of research into sertraline and in most women it doesn't get into the Infant at all because the molecule is too big to pass through. In some it does but I think still in low levels compared to other ssris.

Thank you very much for your reply. It is nice to know there are other people in the same boat. I have decided to carry on with the pills, it is probably for the best as I just need to get better. The anxiety is awful at the moment, but it is good to know this is actually a side effect of the Sertraline and will hopefully get better soon. I just can't wait for it to kick in, because I don't want to give up breastfeeding, but am really really struggling to relax enough to get a letdown at the moment so I may have to supplement with formula until I feel better. Hope your dd is taking well to the solids. x

I took sertraline and fed dd1 for 11 months with no ill effects as far as I could/can tell. DD1 is now 5.5 yo. Fortunately I haven't had to take any dd's with dd2 but I would do if I needed to. Your mental health is so important. You're doing a great job. x