Anti depressants: advised to stop breastfeeding

[catski]

I have a history of depression, going back many years. When DC1 was born I was strongly advised to take anti depressants and was prescribed sertralin (zoloft) as it was considered the safest one to take whilst breastfeeding.

When trying to conceive DC1 I stopped taking the anti depressants, and I have had a very tough year in terms of mental health whilst pregnant (no anti depressants, DC1 diagnosed with autism as well as background of living outside the UK in a place I don't want to be with little support). I always intended to go back on anti depressants when DC2 was born.

It's taken me three months to get up the energy to make and go to the doctors. However, at the appointment they told me that I need to stop breastfeeding before I start taking anti depressants. I got the impression that they would only prescribe them if I was feeling suicidal. I feel devastated that I've been given conflicting information from when my son was born and that I may have caused his atuism. I would never have taken them if I thought he would be harmed at all.

I don't know what to do. Every option feels like a no win situation. If I take anti depressants, I may harm my baby. If I don't take them, I may harm her anyway (from a developmental point of view I mean, not in a physical way) because I might not be interacting with her (eye contact etc) enough. If I stop breastfeeding I may not be giving her the best I can because she's not getting all the immunological benefits and closeness that breastfeeding brings.

Has anyone been in a similar situation? What did you do?

Sorry, I meant to say "When trying to conceive DC2 I stopped taking the anti depressants"

Have not been in same situation. My friend needed anti depressants, took them and stopped breastfeeding. She didn't want her dd to get her medicine too. Not sure if it was after doctors advice

That's what I would do. Look after yourself first. Bottle feeding your child is fine and I would have thought the benefits in terms of you getting better far outweigh the risks of you not treating yourself.

Hope you start to feel better soon.

No no, this is all wrong.

Sertraline is perfectly safe to take during breastfeeding, and you must insist on being prescribed it. It is more expensive than other ADs which may explain the reluctance of your Dr to prescribe.

I have been taking sertraline and BFing for the last 10 months.

ADs are fine to take during bfing.

See kellymom or Breastfeeding Network for details.

By all means stop bfing if you want, but you can combine ads and bfing with no problems. Formula feeding allows for plenty of closeness too and you won't harm your wee one.

My consultant spent AGES researching and said the benefits of bfing far outweighted any small risk from meds crossing into milk.

Sertraline is one of the most suitable during pg and bfing.

It is also fine to take ADs during pg. It saved me twice.

Makes me really that this disinformation is bandied about by ill-informed health professionals. Especially when you are vulnerable. Hope you feel better soon. You sond so low.

I have been taking sertraline since ds3 was 6 months old - perfectly safe to take - he is now 17 months old

So sorry for giving you wrong advice.

Think another reason for her to stop feeding her dd was so she could try to get full night sleep and her dp take over at night.

And forgot to say she is feeling better now, not 100%, but certainly better.

Thank you for your replies. The advice they gave me this morning certainly did contradict my understanding of anti depressants whilst breastfeeding, and of course what I was recommended the first time round with DC1. They hummed and hahed and suggested prescribing me 25mg as a 'compromise', although I was on 100mg with DC1.

I think they will prescribe them for me if I insist, but the seeds of doubt have been planted now and I'm not sure if the benefits of taking them will outweigh the anxiety of doing some long term damage to my daughter.

I asked to go away and think about it and for another appointment next week which I'll also ask my husband to come to as he'll help with the language barrier (the country I'm in is not english speaking). Bizarre and unsettling that I have been given such different advice from the same medical centre (although different practioners) from one child to the next. Lack of continuity's a bugger.

It's so sad when you are feeling low after a baby, and all this worry about treatment just adds to it. I am on 100mg sertraline and breastfeeding. I don't see the point of taking 25mg as that is half of the minimum dose so is unlikely to be able to lift your mood.

I agree with nickytwotimes - its all about risk versus benefit.I also agree with alibaba that sertraline is not the cheapest and thus not the first drug of choice in the UK, but this shouldn't impact on a clinical decision.

Hang in there, take each period that you are awake at a time, and don't forget that you are doing a fab job as a mum!!

Have a look at LACTMED - "Drugs and Lactation Database (LactMed) - A peer-reviewed and fully referenced database of drugs to which breastfeeding mothers may be exposed. Among the data included are maternal and infant levels of drugs, possible effects on breastfed infants and on lactation, and alternate drugs to consider."

The summary for Seratraline:
"Summary of Use during Lactation:
Because of the low levels of sertraline in breastmilk, amounts ingested by the infant are small and is usually not detected in the serum of the infant, although the weakly active metabolite desmethylsertraline is often detectable in low levels in infant serum. Most authoritative reviewers consider sertraline one of the preferred antidepressants during breastfeeding."

I'd print the page out and take it back to your GP.

I've taken sertraline since Dec 2006 in doses from 25mg to 100mg. I have been bfing or pg or pg& bfing ever since then and have feed DD1 from 9 months on it, DD2 from birth to now (27m/o) and DD3 from birth to now (20 weeks). I know someone who bfed from birth on 200mg.

I took the view that bfing whilst taking sertraline was an unquantifiable (but considered relatively safe) risk, formula was a known risk and bfing with no sertraline was certain death.

I took what I considered to be the least risky and most beneficial option to my DCs and so far it has paid off - I'm still here, the children are happy, intelligent, not sedated (sometimes though would be nice ) and are developing normally. Obviously the plural of anecdote is not data but Thomas Hale agrees with me.