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October 24th, 2011
01:38 PM ET

Is it OK to take antidepressants while breast-feeding?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu.

Asked by Eliza from Indiana

I recently had my first baby and just learned I have OCD. My doctor put me on a very low dose of antidepressant and my symptoms are much better. I am breast-feeding my son and don't want to use formula but am worried about side effects. What problems should I look for?

Expert answer

Thanks for your question, and congratulations on your baby! OCD, or obsessive-compulsive disorder, has been found in some studies to be more common in post-partum women. When unwanted thoughts and compulsive behaviors become intrusive or harmful to the new mom and/or her baby, an antidepressant or other medication may be helpful.

Anything that a mother ingests can be transferred in varying amounts through breast milk to the baby. Antidepressants can be found in low or undetectable amounts in nursing infants. Depending on the exact medicine, the baby may not show any side effects, although some antidepressants have been reported to cause crying, fussiness, sleep problems, poor growth, and even seizures.

Ask our expert doctors a question

Reactions to medications in breast-feeding babies tend to be more common under 6 months of age and are usually temporary. It is not well known, however, what long-term effects these medications might have on a child's development. To minimize short-term problems, it may be helpful to time the dosing of medication to occur right after the baby has breast-fed or before a long stretch of sleep. Also, both mom and baby should be monitored closely by their respective physicians.

The benefits of breast-feeding a baby often outweigh the risks of exposure to an antidepressant, and parents with treated medical (including mental health) problems are generally better able to care for their babies. I therefore encourage mothers to talk with their physicians about best medication choices and nonmedical treatments that are safe to use while breast-feeding.

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soundoff (144 Responses)
  1. Bobby

    There are no tests to see if you have a shortage of serotonin.. There are no tests to see if Anti-Depressants actually do what they say vs. Placebo. But the side-effects are real.. Better to be safe than sorry..

    October 24, 2011 at 15:51 | Report abuse | Reply
    • LEB

      Better an emotionally stable mother than a mother sinking into uncontrollable post-partum depression.

      October 25, 2011 at 07:36 | Report abuse |
    • Aileen

      You are right Bobby. There are natural ways to boost serotonin anyway. The best one is to take 5HTP. It turns into serotonin in the body, and it had a great effect on me when nothing else was working. I feel so much better, and unlike the antidepressants, the effect actually stays when you stop taking it. I've recommended it to my family and they've all had the same good results as me. Give it a try before harming your baby with antidepressants!!!!

      December 2, 2011 at 22:07 | Report abuse |
  2. toddflanders

    Typical breast feeding dogma. Here's a good rule with regards to drugs and breast feeding: if you wouldn't give the meds to the baby, you shouldn't breast feed while taking those meds. The benefits of breast feeding don't always outweigh the unknown side effects of any med on breast feeding kids.

    October 24, 2011 at 20:32 | Report abuse | Reply
    • dreamsoftravel

      Well, Todd, that's pretty rich coming from a male who won't have to deal with the issue. If you are suffering from depression, chances are good that you forfeited taking any meds throughout the pregnancy. Once you give birth, before spiraling into a horrid postpartum depression that could affect your ability to care for your child, it's a good idea to get back on the depression medication. Your view is overly simplisitic. Yes, ingesting no caffeine of any kind, no medication of any kind, etc., is IDEAL, but sometimes that is simply not practical or even a good idea. A happy mom equals a happy baby. We aren't talking illicit drugs here-we're talking about antidepressants, and a dosage that is monitored by a physician.
      Give birth and then you can have an opinion on the subject...

      October 25, 2011 at 11:24 | Report abuse |
    • Marie

      I've given birth, and if I had to be on anti-depressants to function, I would bottle feed the baby. I have taken Prozac and Celexa, and I would not in a million years give that to a baby, any baby, especially my baby! You people are all selfish. If you need your meds, bottle feed. Your breast milk is NOT that precious!

      October 25, 2011 at 11:54 | Report abuse |
  3. Andrea

    I wish the Dr. had been more clear in her response that YES taking antidepressants (specifically Zoloft) has been established as safe for breastfeeding mothers and women do not need to choose between breastfeeding and their own mental health. Too many women suffer severe depression because they do not want to take medications while breastfeeding. Even Dr. Hale, the well known authority on safety of medications while breastfeeding says Zoloft is a safe medication while breastfeeding.
    http://www.kellymom.com/health/meds/antidepressants-hale10-02.html#Zoloft

    October 24, 2011 at 23:36 | Report abuse | Reply
    • Nate

      It is also important to understand that psychotherapy provided by a licensed mental health professional is as effective and sometimes more effective than medication. If you are a nursing mother who is concerned about taking antidepressants, I would highly recommend asking your doctor for a referral to an experienced psychologist trained in evidence based approaches to treating anxiety and depression. Nursing mothers do not have to choose between taking medication and no treatment at all.

      October 25, 2011 at 11:36 | Report abuse |
    • John

      The only issue with that is the cost of therapy. This is often not covered by insurance and can be quite expensive to most people. Just a thought...

      June 29, 2012 at 18:54 | Report abuse |
  4. Special Ed Teacher

    I've been teaching children special needs for over 20 years. Now with the influx of children with Autism and on the spectrum, I would advise against breast feeding while taking meds. There are so many staggering statistics, (like 1 in 42 children at my middle school) I would be careful and bottle feed your baby. No one can pinpoint the how or why of Autism.... I can just say I am exhausted at the end of the day when I go home, but my students' parents have to raise the child for a lifetime. Continue taking your meds, you will be a better mom for it!

    October 25, 2011 at 21:40 | Report abuse | Reply
    • Sarah

      What education do you have to prove that medications are causing the increased autism? You are a teacher and you have no idea what their parents took while they were breast feeding their children. Breast feeding has many benefits for both the baby and the mom that bottle feeding cannot reproduce. Next time know your limits before you think you're making an intelligent comment.

      March 6, 2012 at 00:09 | Report abuse |
  5. Ethics Board

    "The benefits of breast-feeding a baby often outweigh the risks of exposure to an antidepressant, and parents with treated medical (including mental health) problems are generally better able to care for their babies. I therefore encourage mothers to talk with their physicians about best medication choices and nonmedical treatments that are safe to use while breast-feeding."

    As a practicing pediatrician, I completely disagree with this statement. I have seen plenty of poor eating, sleepy infants who mothers are breast feeding and take anti-depressants. Some medications are totally unsafe, but a majority are unknown. To say that breast feeding outweighs the risks of these medications getting into a newborn is about illogical as linking maternal anti-depressant use to autism.

    May 4, 2012 at 16:22 | Report abuse | Reply
  6. Joni

    WOW! Some of these statements are just so uneducated and stupid! And do you know what is in formula? Seriously? Marie, you are an idiot.

    May 17, 2012 at 15:46 | Report abuse | Reply
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    • Adam

      that the paxil would make my brain function cocrlrtey again, and all the things that my mental state had been shoving aside and burying would come out in full force and it might be too much to handle.She was absolutely right. I found a counselor through my church and saw him weekly while on paxil, and for a while afterwards because the emotions that finally came alive could have been extremely overwhelming if I didn't have that vent and opportunity to put things in perspective.Unfortunately, not all doctors are so well informed and this is why I believe there are so many suicides while on antidepressants – they really work, but you need help to make sense of it all.Any time I hear of someone on these medications, I ALWAYS ask if they are in some kind of counseling situation – I don't care if I'm perceived as nosy, I'd rather save their life than be liked any time.As for the breast feeding issue, my son nursed until he was about two and a half, my oldest daughter for about a year, and my youngest for about six months. I was not going to deny them the comfort of this contact, public opinion be damned. What business is it of anyone's when one decides to stop nursing? There are many reasons to do it, and medical reasons are one of them, work and family pressures, etc. It's too bad that this woman felt her baby wouldn't feel loved if she stopped nursing to take care of herself, and unfortunately, she was probably not in a state of mind to be able to evaluate this rationally.

      October 11, 2012 at 18:10 | Report abuse |
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    Sorry but your doctor is a moron just like most...The problem with doctors today is that none of them deal or talk about preventative medicine....

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