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Antidepressant medications and their effect on lactation

Earlier this year, in the Journal of Clinical Endocrinology and Metabolism, a study was published which linked a commonly used class of antidepressant medications with temporarily delays in achieving lactation. What the study showed was that in some cases where women must use selective serotonin reuptake inhibitor (SSRI) drugs, such as Zoloft or Prozac, to counteract depression, these women may not establish full lactation as quickly during the first few days following birth as they would have if they were not taking medication. This is due to the fact that, even though they are considered compatible with breastfeeding, these drugs do affect serotonin, a key player in mammary gland development. Normally, mature milk is beginning to develop around 3 days following delivery, but there may be some delays in this process when SSRI's are used. In the research study, the women using SSRI medications achieved milk production in about 85.8 hours on average, while the women who were not on these medications had their milk by about 69.1 hours. If a woman were not aware of this issue, she may believe inaccurately that her milk just is not going to come, and may switch to formula use unnecessarily. Proper support and education can help her and her baby overcome this temporary set back.

The good news is that these delays are generally temporary, and proper support of the newly-delivered mother by health care providers can help to increase her opportunities for success in breastfeeding. Most women who take SSRI medications do so because without the medication, their struggle with depression is unbearable. Therefore, the authors of the study do not suggest that women avoid these medications. Instead they point out that “while women on SSRIs may be at a greater risk of a delay in the establishment of a full milk supply, with proper supportive care from pediatricians, nurses and lactation consultants those difficulties appear to be only temporary.” The key is to begin the process of stimulating milk supply early and often, to assist the body's normal mechanisms for milk development.

In Fresno, many women who are prescribed antidepressants also wish to breastfeed. The lactation support offered by an International Board Certified Lactation Consultant (IBCLC) is crucial to these mothers. Fresno's lactation resources are listed on this page, and include some hospital-based providers, some options for low income mothers, such as consultants at WIC, and a private home-visit based lactation service, that offers one-on-one support by an IBCLC. The main thing to remember is that it is not a good idea to give up too early, if lactation is delayed. Things may very likely look better in just a few days, and there is help available which can easily bring mom and baby to their breastfeeding goals.

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