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Infant feeding

Get advice and support with infant feeding from other users here.

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Original poster

Do I NEED to stop breastfeeding to take AD's?

31 replies

lua · 01/02/2006 21:07

Wise Mners,
I am considering taking ADs, however I reaaaaaly don't want to stop breastfeeding. GP tells me I should take at night and skip morning bf. I researched actual data and seems to be all over the place...
Can anyone point to a good source of data?

Also, anyone out there had to make this decision? How did you sorted out????

OP posts:

starlover · 01/02/2006 21:09

no, you don't./ there are plenty of ad's you can taske that don't affect it at all (think prozac may be one)

mummytosteven · 01/02/2006 21:09

No you don't need to stop breastfeeding to take ADs, but certain ones may be more appropriate to take when breastfeeding. I ended up on Prozac at 30 weeks PG, and the psychiatrist, the pharmacist he consulted, and the obs/gyn consultant were all happy with my breastfeeding whilst on Prozac. Apparently research has been done indicating that very small traces of Prozac pass into the breast milk, but they have no effect on the baby.

You might be able to find something useful on the BMJ website?

PiccadillyCircus · 01/02/2006 21:11

I take sertraline and I breast feed. I have been taking it since I was 3 months pregnant.

Original poster

lua · 01/02/2006 21:22

Thanks for the quick response!

mts - what is bmj?

hummm... so no one was advised to stop or skip?!
I sawthat american sites clearly say not totakewhile breastfeeding under any circunstace....

How long did you took AD's? and how soon did you notice an improvement?

OP posts:

mummytosteven · 01/02/2006 21:26

british medical journal. I started feeling some improvement within say 3 weeks of taking Prozac, and a significant improvement within a couple of months.

Original poster

lua · 01/02/2006 21:34

mts - sorry to ask so many questions !

it would probably be unreasonable then to plan to skip morning breastfeeding for just a few weeks and go back into it later??

OP posts:

mummytosteven · 01/02/2006 21:46

I don't see that it's very practical to skip the morning feed anyway- from the point of view of your milk production - i.e. it would mean a lot of expressing to get your milk back up again once your body had adjusted. Is your HV any use, maybe she could reassure you. Or you could look at kellymom site (meant to be good US site on bfing) or took to La Leche League for a bit more experienced advice.

chicagomum · 01/02/2006 21:51

This was on the bbc news website today
antidepressants and pregnancy .

It doesn't say anything about breast feeding though.

mummytosteven · 01/02/2006 21:54

very interesting article chicagomum, thanks for that. I wonder how much the assumption that PG would protect women with depression is part of the general cultural assumption that PG woman should be blooming/happy/excited....

mummytosteven · 01/02/2006 23:00

what the Royal College of Psychiatrists has to say about bfing and ADs:-

"Do antidepressants have side effects?
Modern antidepressants are safe. They may cause nausea or an increase in anxiety in the early stages, but these usually wear off. Others can make you sleepy or give you a dry mouth. Make sure that your doctor knows that you are breast-feeding. It should be safe to continue breast-feeding as there are antidepressants which do not pass into breast milk to any significant degree, so your baby should not be affected by them. Some people get mild withdrawal symptoms when they stop these medicines, so it's best to come off them slowly. For more information, see our Leaflet on antidepressants."

this is the link to their leaflet on PND:-

www.rcpsych.ac.uk/info/help/pndep/

VeniVidiVickiQV · 01/02/2006 23:03

I take sertraline and have continued to b/feed my 9mth old. He doesnt seem to be suffering any effects from it.

HE certainly isnt any happier anyway, lol.

When i went to gp there was never any question about not taking them. But GP very openly looked up in her book about which ones were safe for me to take.

Glad you have seen your GP though lua. How are you doing?

Original poster

lua · 01/02/2006 23:24

mts - thanks very much for your link! To be honest, I have seen similar results. Dh however, is making me feel nervous because he said SSRI affect neurogenesis. Thus, he feels like nobody really knows what can be the long term effects of babies being exposed to it....

QV - Thanks for asking. I am feeling better. I have sorted some help, and I think that reduced my panic attacks. I still have to tackle depression though.... Thus, this thtread!
Last week I would have said, Ad's are needed period. We'll have to take a risk on long-term consequences.... Today, I say I can probably wait on ADs....
It would be nice though to stop the roller coaster while up!
am I dreaming?

OP posts:

mummytosteven · 01/02/2006 23:27

I think Prozac tends to be the best researched of the SSRIs as it's been around the longest. I think they have done a study of children aged up to 7, where the mums took Prozac whilst PG, and found no problems. Is your DH from a medical background, lua?

VeniVidiVickiQV · 01/02/2006 23:29

Lua - good to hear you are feeling better.

Just remember, everyone has up and down days, so dont beat yourself up if you find yourself dipping again

Cristina7 · 01/02/2006 23:41

I take prozac and BF. I read somewhere that it is at its peak in the milk about 7 hours after taking it, which is why your dr might have said about missing the morning feed. (Obviously, if this is the AD he recommended.) Sertraline is supposed to pass even less into the milk - if at all - but I'd had prozac before and GP said we shouldn't change since we know it works for me. Good luck. Big difference for me.

Original poster

lua · 02/02/2006 12:07

GP is reccomending sertraline. I have never taken ADs before. Been offered before, but had always been scared of it.
yes, it is because of the peak at 7 to 9 hours that she suggested not breastfeeding in the morning. I do enjoy the bf so much though, that I think I'll end up passing on the Ad's..
I am also afraid that if I don't bf at 5 Am,I will have to actually wake at 5 Am, and that will probably make me feel worst for lack of sleep, iyswim.

mts - no, dh is in science oriented, but not in the medical field...

OP posts:

Cristina7 · 02/02/2006 13:38

Lua, read up on sertraline. It is the safest of them for the baby AFAIK and it might make a big difference to you. I continue to BF my 11 month old regardless of the time of day.

hunkermunker · 02/02/2006 13:40

Lua, ring the Breastfeeding Network's Drugline, or have a look on the website here

Best info I know of re drugs and bfeeding.

PiccadillyCircus · 02/02/2006 13:47

lua, sorry about short reply last time, here is a longer one.

I have been taking sertaline since I was 12 weeks pregnant. At the time I was borderline suicidal (I realised in retrospect). It took about two weeks for the ADs to start having a real effect (and they did make me sick, although DD was doing that anyway).

I am SO glad that I started taking them as they have improved the quality of my life so much. I know that it is scary to think about taking ADs and I will say that I sometimes feel frustrated that I "need" to take them, if that makes sense, but I really would advise you to think again about not taking them.

DD seems to be fine (as far as I can tell ) having been inside me with me taking ADs for about 6 months, and having been breastfed for over 4 months outside me.

Hope my experience helps you a bit to decide what is best for you to do.

madmarchhare · 02/02/2006 13:50

Choose carefully, I took citalopram whilst pg, but was advised not to when bfing.

Original poster

lua · 02/02/2006 14:30

Thanks Pc for your more detailed account. I am glad you are feeling better, and is encouraging to know it can work well!

Hunker - many thanks for the link! I'll give them a ring because now I'm confused....
Sertraline is reported as the safest - because they have a hard time reading any traces on baby plasma... But it peaks after 7-8 hours.

But Citalopram, has a much shorter half-life and thus might be easier to work breastfeeding around it?!

Any pharmacists around to help interpret the data???

OP posts:

madmarchhare · 03/02/2006 10:22

Hospital contacted manufacturer re Citalopram, and they advised against it. Maybe they were being over cautious because they could rule out any issues 100%.

Tbh, I wish I'd have had more energy to get more information (wasnt aware of any issue and just assumed that it would be OK as midwives knew I was taking when pg). Grrr, .

tiktok · 03/02/2006 10:39

This study should help:

here

madmarchhare · 03/02/2006 14:46

Even more now.

Surfermum · 03/02/2006 14:52

I had a very confusing time trying to work out if I could breastfeed on Dothiepin. My midwife didn't know so, phoned the drug company, who said that I shouldn't. I was lucky though, I used to work for a psychiatrist who really knew her stuff and she emailed me a load of research and told me that it would be OK. I ended up taking the papers in to my midwife so she would know for the next patient.

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