Taking antidepressant while nursing

[rcg85]

Two years ago I had my first baby and went through a terrible time with PPD. One of my biggest concerns when I was told to get on medicine (20 mg of Cymbalta) was I didn't want to stop nursing. My son was 5 months old when I realized that I could no longer push off getting on the medicine and I found a psychologist that specializes in women's health and she felt that it would be safe for the baby to continue nursing while I was taking the Cymbalta, as long as I kept on eye on him. My husband was extremely anti the idea and from day one wanted me to stop nursing and give formula while on the medicine. He had no actual research to base his feelings off of - they were just feelings, and it made me feel so guilty and selfish for wanting to keep nursing even while taking medicine that maybe could cause harm. Eventually he came to terms with it, I nursed my son for 18 months and there never seemed to be an issue.

Now that he is almost two we'd like to try to have another baby. Because PPD is a concern we want to come up with a real action plan now before I get pregnant so we are more prepared to prevent and deal with my emotional health. While we were talking he mentioned that he still is uneasy about me nursing while taking medicine, that his gut feeling tells him it's bad, and he doesn't want to find out in 20 years that we somehow messed up our baby because I nursed while taking medicine.

I feel like an awful mother. I love nursing and I love the close bond it creates. Am I just being selfish and putting my future baby at risk by taking my medicine while nursing? Has anyone else taken medicine for PPD and nursed their baby - if so, what are your thoughts? I need some real support, I feel like maybe because of the PPD I was just never meant to be a mother...

[Mosaic]

LOTS of mothers take antidepressants while nursing, and there are some that are considered totally safe. I understand not wanting to expose your baby to any medication, but really and truly, antidepressants are LIFE-SAVING. I've taken them while nursing both of my children (still am, in fact), and I don't regret it one bit.

[Megan73]

Please, please be gentle with yourself. PPD is an illness not a moral failing. Nor is wanting to breastfeed selfish!
Here's a link from Dr. Thomas Hale, the expert in drugs and breastfeeding: http://www.infantrisk.com/forum/showthread.php?269-Cymbalta
You can contact Dr. Hale at InfantRisk for more info.
As he says, PPD must be treated. The balancing of potential risks from medication and the known risks of formula feeding (although it is a safe, adequate substitute when mother's genuinely can't nurse) is something only you can do.
I have to say I would be frustrated by your husband's attitude. His "gut feeling" is somehow more legitimate than your considered decision based on research and expert opinion?

[rcg85]

Thank you both so much. It is very helpful both to see a response from a dr, as well as hearing from another mother that she has taken medicine while nursing. Mosaic - do you mind me asking which medicine you take? I know that zoloft is known to be well researched, but zoloft does nothing for me. Cymbalta seems to be the only one that works. My husband's "research" has been finding things online that prove that formula is just as good as breastmilk, and he's never spoken to the psychologist who specializes in this, although I have asked him to. When I weaned my son at 18 months he was only nursing one time a day and I could tell he was barely getting any milk, it was more for the cuddles. Even so, when he stopped that morning feeding, my husband voiced some concerns that maybe he was acting more cranky because he was having withdrawal from the medicine. It was so hard for me to hear that because even though I am fairly sure what with the small amount of milk he was getting he was getting the tiniest amount of my medicine, and he was being a little cranky because of other things, it still made me feel so guilty.

Thanks again, it's very helpful to have support.

[redbirdlady]

I nursed two babies on Lexapro.  (Zoloft never did anything for me; never tried Cymbalta.)  One of them, I was on it from the get-go (within several days of birth), and the other, I was put on a few months after giving birth.  They are both awesome kids, so I don't think the meds had an adverse effect on them.  ;)  Is there the possibility that we'll find out about some effect 20 years from now?  Absolutely.  But I also put DD1 in disposable diapers, they both played with plastic toys, etc....so in 20 years, who knows what effect any of the environmental stuff will have had on them.  And had I put either/both of them on formula, who knows what effect THAT could have had as well.

The alternative was a severely depressed mom who may not have been able to function day-to-day (and I was a single mom with both of them, so that would have made formula feeding that much harder for me, what with the cost and the cleaning and whatnot.)   This is why doctors say that you should take antidepressants if the benefits outweigh the risks.

I don't think Lexapro is technically approved for breastfeeding, but it was my midwife that gave it to me, and I wasn't really in any position to go researching anything, so I was a "bad mom" and took it blindly without doing my research.  But, because I have used it before and it worked so well, we will have a prescription ready, should I need it following the birth of the baby I am currently pregnant with, and I am okay with that.

[annaconda]

I'm currently nursing on Zoloft and it has saved my life and the sanity of my housemates.

Hopefully you can come up with an action plan that DH supports.  There's no extra guilt you need to take into the process.

[Mama2ChicknLil]

I feel for you mama. I understand your DH is coming from a polace of love and concern, and it's wonderful that he cares enough to even think about this. He is, however, wrong on all counts (sorry!!). Not only is formula nowhere near as good for a baby as BM, but it can cause problems, health issues, allergies, possibly behavioral problems, digestive issues, etc. There are KNOWN risks to formula feeding. While there are risks to BF while on any medication, the risks are within the same realm.

Also, breastfeeding is itself a great antidepressant (I'm not suggesting it can take the place of medications when necessary), as the oxytocin floods in moms brain during a feeding session can help keep depressive symptoms in check. Also, and I can't stress this enough...because I had a million people tell me to 'just give the baby a bottle" thinking they were letting me off the hook while I stuggled. THAT DID NOT HELP! You are strong and intelligent and capable of providing for your baby. You will creat, birth, and then feed your child and you will be fine, and so with your baby.

Do your research, speak with your psychiatrist (heck, I'd see a regular therapist as well, assuming your psychiatrist doesn't to talk therapy) regularly and make up you rmind about what is important to you. DH went along the first time, and I belive he will again if it comes down to it.

Good luck mama

[rainface]

I just had my six week postpartum appointment with my midwife yesterday, and we talked about this exact thing. I have an appointment with a psych ARNP next week to talk about going back on meds. I have a history of depression and anxiety, and I was taking Zoloft and Welbutrin before I got pregnant. I knew that there was a distinct possibility that I would need meds again after my daughter was born, and I was right. Quite honestly, I'm struggling, and it's not worth it to me to struggle when I can be healthier mentally and a better momma to my LO. (I'm also a mental health therapist, so I spend a lot of time with these issues...) I've been very upfront with my care providers all along that a healthy pregnancy and breastfeeding are my top priorities. I do trust my midwife when she tells me that Zoloft is ok to take while breastfeeding. You're not a bad momma, you're being very thoughtful and careful about this. Be gentle with yourself.