Can I Breast-Feed While on Antidepressants?

Treating your depression is very important for your baby. Breast-feeding is good for your baby's health and your baby's bond with you, too. At best, you will be able to treat your depression and breast-feed your baby. But if you decide to choose between taking medicine and breast-feeding, treat your depression.

Talk to your doctor and your baby's doctor about your antidepressant choices. Any antidepressant can get into breast milk, but some antidepressants do so in such small amounts that they can't be measured in the baby's blood.

• Of the SSRIs, sertraline (Zoloft) is usually the first-choice medicine for breast-feeding mothers. It is most studied and generally does not seem to affect breast-feeding babies.
• There have been reports of side effects in babies exposed to paroxetine (Paxil), fluoxetine (Prozac), and citalopram (Celexa).
• Fluvoxamine (Luvox) has not been well studied.

Some SSRIs, such as fluoxetine, are passed on to the breast-fed baby more than others. And every woman uses (metabolizes) and passes on medicine in different amounts. The level of medicine in your breast milk depends in part on when you take your daily dose. Talk to your doctor about when the level of medicine in your breast milk is lowest.

Researchers are studying children who breast-fed while their mothers took SSRIs. So far, they have seen no signs of unusual problems in these children into their preschool years.

How long do I need to take antidepressant medicine for postpartum depression?
Antidepressants are typically used for at least 6 months or longer, first to treat postpartum depression and then to prevent a relapse of symptoms. To prevent a relapse, your doctor may recommend that you take medicine for up to a year before considering tapering off of it. Experts recommend long-term antidepressant treatment for women who have had three or more depressive episodes in the past.