July 26, 2007

Anti-depressants and breastfeeding

There have been several new moms visiting this blog who have shared their concern about taking anti-depressants while breastfeeding. There are so many mixed messages on this out there -- doctors saying that it's perfectly fine, that moms need to take care of themselves first in order to take care of their babies; or that there is a risk, but it's so minimal to not really count. Then there are those who say that even a minimal risk is still a risk, so why risk it?

A recent study came out from the New England Journal of Medicine that concluded that women do not increase the risk of birth defects in their babies by taking anti-depressants while pregnant or breastfeeding. And yet it also stated that "drugs such as Celexa, Paxil, Prozac and Zoloft may increase the risk for certain defects, but, even then, the absolute risk is extremely small." AND it also stated that "even if a certain drug increased rates by a factor of four, the risk of having a child affected by the problem would still be less than 1 percent."


Bottom line, and what no one seems to be talking about, is the fact that this study was funded by a few pharmaceutical companies, including GlaxoSmithKline, the manufacturer of Paxil.

Hmmmm.... what does that tell you?

In any case, when I was pregnant, I would never have entertained the thought of having even a single glass of wine, much less a drug that hasn't been completely tested in children, let alone infants. I don't know, but it seems like common sense to avoid anti-depressants while pregnant and breastfeeding.

What do you think? I'd love to hear about your own experience with or without medication.


Goldie Katsu said...

Just stopped by to check out your blog. What a great resource you have created. I enjoy reading your writing as well. It isn't just resource it is a story as well which makes it more accessible.

Kristin said...

Thanks so much for your comment, Goldie! That means a lot -- I really appreciate your visit to my blog. See you on Twitter!

Becky C. said...

an important and serious topic. I am impressed.


Kristin said...

Thanks, Becky!! Feel free to spread the word.

Louisa said...

After a 12 month PPD after babe #1 I took fluoxetine from about 6months into my pregnancy through about 8 months after. I breastfed my second exclusively throughout the time I was medicated.

I believe that I needed meds and Babe needed my breastmilk. Neither of us were going without. :)

Cheers, Louisa

Kristin said...

I celebrate your choice, Louisa. And how lucky your baby is that you've taken charge of your health. I've learned so much since I put up that post and am grateful for your comment and point of view.

I really like your blog, by the way, and admire what you do as a midwife and doula. I know I wouldn't have gotten through my postpartum after my fourth baby without the extraordinary help of a postpartum doula. Do you work as a postpartum doula at all?

Cheers to you too,

Anonymous said...

i am mental health provider and very interested in the topic of postpartum depression/perinatal mood disorders - i have two children and struggled w/ postpartum anxiety after my first child.

this topic struck me today specifically because i "had it out" with an insurance company and their "clinical review counselor" today - i am seeing a 35 year old woman who is moderately depressed, and trying to get pregnant, she is responding nicely to psychotherapy and wishes not to start medications because of her desire to become pregnant, i support this as do her physicians. the "clinical reviewer" disagreed with me because meds would make her treatment progress faster and therefore cost the ins. co. less - he cited this new literature that you cite here - i hadn't read it yet but told him that it was ridiculous to medicate someone who is responding to psychotherapy and who wants to become pregnant just to speed things up, its not worth the risk, no matter how small - his only response was that it was afterall the patient's decision -

what annoys me is that if i were not one to advocate for my clients or one who was up on the research i may have been swayed by this and felt pressured to lead the patient in that direction.

in this case, i totally feel like i won though, especially when he asked me for the expected length of treatment, i said "6 months and if she gets pregnant she'll need to be monitored throughout the pregnancy and the postpartum period because her risk of postpartum depression is increased" he said "ok" - NEVER do they say "ok" their job is to limit benefits to save money - he clearly had no clue about perinatal mood disorders

Kristin said...

Hi, Anonymous!

This is truly astounding. Thank goodness your client has you to stand up for her. This is such an important (and, sadly, common topic) that I'm going to post on it. I really, really appreciate you sharing this with me and my readers. We all need to be informed about the kind of push-back we're bound to receive from insurance companies. (I hope it wasn't Blue Cross Blue Shield -- that's my insurer, and I like to think they might care.)

Please visit again -- loved your comment!!
Warmest regards,