Sertraline, breastfeeding and expressing milk (long, sorry)

[mooncat3000]

Hello,

I'd like to know if anyone has advice on taking sertraline while breastfeeding. I'm breastfeeding my boy (11 weeks) and my doctor says it's "almost certainly" safe to keep breastfeeding while taking sertraline. I've been reading about it online and they say that hardly any side effects have been seen in breast fed babies, but no one seems to say anything about long-term effects on brain development, which is what scares me about taking anti-depressants while breastfeeding, so I'm wondering whether it would be better to either switch to formula or keep trying to cope without the pills - my depression isn't terribly severe all the time, and isn't affecting bonding with my baby, but it is affecting my relationship with my husband and making our experience of looking after the new baby less wonderful than it could be as I'm irritable with him and generally anxious about life and whether I'm good enough with the baby. He thinks I should take the pills - I've had depression before and was taking fluoxetine before I got pregnant and during some of my pregnancy, and I was a lot better on the pills, as was our relationship. However, while I was pregnant and taking fluoxetine, which I was also told was "almost certainly" safe, some new research came out suggesting that antidepressants could increase the risk of autism and other developmental problems, so that was a worry, and I'm sure the same could happen with antidepressants and breastfeeding as they find out more about it.

I also have a more specific question: if I do start taking sertraline and continue breastfeeding, my doctor told me that I shouldn't breastfeed for three hours after taking a pill and feed with expressed milk during that time instead. However, everything I've read online says that drug concentration in breast milk is highest 7-10 hours after taking the pill, so doesn't that mean it would be better to breastfeed immediately after taking the pill and avoid it 7-10 hours after? Does anyone know about this?

Thank you very much x

[MigGril]

Hi I'm glad I've spotted your posted this morning as you've posted hear in not sure how many replies you'll get.

But if you've any concerns over taking durgs while breastfeeding the best people to talk to are the breastfeeding nwtworks drugs in brestmilk helpline. You can ring them on 0844 412 4665 or email them [email protected] . They will be able to answer any questions you have.

[MigGril]

oup that should be org not ork dame phone.

[weegiemum]

I'm not totally up with the current info (my youngest is 11) but I bf all 3 dc while on sertraline (for 12, 15 and 22 months) and was also on it while pg with No2 & 3. They're now 14, 12 and 11 and there has never been a hnt of anything wrong.

I was pretty determined to bf and being able to was helpful with my pnd as that was one thing I knew I was doing right!

Congratulations on your ds!

[MirandaWest]

I also don't know current research but I breastfed my DD for 11 months whilst taking sertraline (which I had been taking since I was 12 weeks pregnant with her). She's 9 now and as far as I can tell her brain development hasn't been hindered.

For me and the rest of my family the benefits of taking the antidepressants were definitely worth it.

[TychosNose]

I took sertraline through both pregnancies and bf.

Your dr is wrong about not feeding for 3hrs after taking the sertraline. Yes the studies show on average breast milk concentration peaks at 7-10hrs but this will vary and only very small amounts get into the breast milk. In all the studies I've read only in a very small number of bf babies could any sertraline be detected at all. The vast majority had no detectable sertraline in their blood at all.

The studies of the effects of foetal and/or infant exposure to ads are observational so have many flaws, which is why drs can't commit to saying "yes we know it's absolutely safe"
(This is also true of any data that links ads to autism - observational studies are very difficult to interpret)


The way I see it is:
We know bf is better for baby
We know a depressed mum is worse for baby
Therefore, sticking with what we know, I took the drugs and bf. that was and still is right for me.

Bf may also be having an antidepressant effect too, so if you switched to ff you may need to increase you sertraline dose.

You've done really well bf this far and if you did switch to ff you have absolutely no reason to feel guilty. Same with the sertraline, your baby has had the absolute best start in life being bf, even if very tiny amounts of sertraline got through your milk.

Good luck x

[mooncat3000]

Thank you very much!

[MigGril]

I can type a bit more now I'm on the PC what the BfN do say also is that as someone else has also said, stopping breastfeeding can actually make depression worse. This really should be the last course of action for a mum with depression. Taking medication and continuing breastfeeding is a far safer option, often stopping breastfeeding can make depression much worse due to the change in hormones that happens if you suddenly stop feeding and a lot of doctors don't take this into account when treating postnatal depression.

The BfN do also have a general information on drugs available www.breastfeedingnetwork.org.uk/wp-content/dibm/anti-depressants-oct14.pdf

But do get in touch with them they are very good, the lady who runs the helpline is probably the most knowledge person there is in these matters. So if you have any more detailed questions she will be able to answer them

[mooncat3000]

Thank you very much everyone xx

[mooncat3000]

I like "dame phone"