Some antidepressants seem to be safer than others. A recent study of the most commonly used antidepressants during pregnancy, SSRIs, found no significant risk of major birth defects, although these results are far from definitive. The researchers did, however, report some instances of three specific birth defects: a defect of the brain, a type of abnormal skull development, and a gastrointestinal abnormality. How much antidepressant medication passes on to the baby during breast-feeding is not certain, but experts say the effect seems to be minimal.
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Should you give up breast-feeding?
Sarah, 41, of New York City, suffered postpartum anxiety when her son was born. The psychiatrist she consulted prescribed Effexor, an SNRI (serotonin and norepinephrine reuptake inhibitor), and was aware of the scientific literature on the effects on antidepressants on nursing babies. "He advised me to give up breast-feeding if I took it because the drug could come through my breast milk. But breast-feeding my son seemed like the only thing I could do right as a mother," she says. Despite her husband's pleas that she to go on meds, Sarah endured the turmoil. After two months she decided to switch her son to formula and get relief from the drug.
Shoshana Bennett, PhD, a psychologist and founder and director of Postpartum Assistance for Mothers who has counseled more than 15,000 postpartum women, says the decision to take medication while nursing is one that women need to make in consultation with their doctors. She believes it's fine for women to stay on antidepressants, even as they nurse, although she's more a proponent of good nutrition and adequate sleep. "The most important thing is a happy, rested mom," she says. "This is the only job where breaks are not mandated by law."
