PPD, breastfeeding and drugs

[MamaKoala]

which drugs are safe for breastfeeding--zoloft? i know that prozac isnt the best option. i am meeting a doc tomorrow and i want to have all the information.

[Foobar]

I am not sure. Drugs that can be prescribed include paxil and celexa. I don't bf, so this isn't one of my concerns.

TELL the doctor about the bf. I think paxil might be safe, but I am not sure. Do a web search on the drugs and look for info on the breastfeeding.

Good luck!

[Jish]

I personally know people who take Paxil, Zoloft, Celexa, Wellbutrin, and Prozac. They are all safe. I have a friend who is in a study on AD's and breastfeeding. She is on Paxil and they would take samples of her milk and the baby's blood. The AD showed in very small amounts in her milk, but was undetctable in the baby's blood.

Hope this helps.

[mama2girls]

I was going to tell about my experience, but I see that jbcjmom beat me to it!! Please remember as I share this information with you that I am not a medical professional and I am only sharing as a way to reassure other bfing moms with ppd that in MY situation meds are working and do not seem to have affected my girls.

Here are the numbers:
(I was on 10 mg Paxil at the time.)
My blood plasma level: 17
Milk level 9.5
Baby's plasma level: 0

The letter I got with the results states: "Women whose babies have undectable levels of the drug or its metabolites may be reassured by this information, however undetectable is not necessarily the same as zero. Undetectable levels do not guarantee that your baby was not exposed to the drug. Only you and your physician can decide if taking an antidepressant while breastfeeding is right for you."

An aside: I was more worried about taking paxil through a pg, but my family dr (who delivered both girls) said that he believed that the benefits to me far outweighed any potential risks to the baby. And for the record, M is a delightful happy 5 mo. old who is doing everything she should for her age.

[pegmom]

Interesting post, AM Mom. I have taken both Zoloft (50mg) and Prozac (20mg). Both are considered safe, although Zoloft is better because it has a short half-life and thus clears your body faster. Because Prozac has such a long half-life some doctors worry that it can accumulate in your baby's system (this is especially true for newborns who do not have the ability to matabolize drugs as quickly as an older child). That said, Prozac is still considered safe by all the breastfeeding experts but would not be a first choice. I had the option of raising my Zoloft dose or trying to switch drugs to see if I could get results at a still low dose. I tried Paxil but had bad side effects. I went to Prozac next and it has worked well but I am also nursing an older child. I would like to get down to 10mg over the next few months but will see as my experiences with tapering before have been horrible. My doctor also prescribed .25 xanax to take as needed and said that in such a low dose and taken very infrequently it does not contadict bf. I rarely ever take it but it makes me feel better to know that it is there just in case. I have had a very difficult struggle with taking these drugs. I never thought that I would be in this position and looked down on other people who "resorted" to such treatments. That is until I felt the way I did with anxiety, depression and panic attacks. Yes, there are risks to taking the drugs but there are often even greater risks in not taking them. The two formost experts on drugs and lactation, Dr.Thomas Hale and Dr.Jack Newman, both state that the benefits of breastfeeding outweigh the risks of taking an ad. In other words, giving your child formula may pose a greater risk that exposing him or her to small amounts of an ad. (Both these docs have web sites--do a google search.) My ped told me to stop bf at a year because my baby "didn't really need it anyway." (She then went on to tell me that she could not continue to bf her daughter after the first few weeks because she was doing her residency and it was too much on her. As she said, "She didn't know the difference.") Well, I went out and got two more doctors' opinions and they both told me not to wean. I would say many doctors are ingnorant about ad and breastfeeding and it is always good to get several opinions unless you have someone who is very up to date with all the current info. Hope this helps. Good luck.

[mama2girls]

Originally posted by pegmom
The two formost experts on drugs and lactation, Dr.Thomas Hale and Dr.Jack Newman, both state that the benefits of breastfeeding outweigh the risks of taking an ad. In other words, giving your child formula may pose a greater risk that exposing him or her to small amounts of an ad.

Pegmom--Awesome! It's nice to have research to quote back at people (read mil) who like to question your motives!

Originally posted by pegmom My ped told me to stop bf at a year because my baby "didn't really need it anyway." (She then went on to tell me that she could not continue to bf her daughter after the first few weeks because she was doing her residency and it was too much on her. As she said, "She didn't know the difference.

That is very sad. Both of my girls were delivered by a family physician who's wife bf all four of their kids. He is such an advocate that it makes me miserable to hear of peds who don't advocate for ebf. You would think a physician would know the benefits of mother's milk. I guess we all have a lot of educating to do.

[Jish]

Jen, I told you that I talk about you. I just don't mention you by name. Your experiences are just too helpful to moms not to share them. Since you are here now, I guess I can stop spreading your information.

BTW, where were you today?

[shematrix]

I take Celexa. My OB gave me the option of Zoloft or PAxil but I've tried those in the past and I didn't like them.

Brenda

[MamaKoala]

well, here's what happened

went to doc (an internist) who knew SQUAT about bf and ad. But i had my info, and so I suggested she put me on Zoloft. I also talked to my ped who knew SQUAT about the effects of ad on babies who are breastfed. GEEZ. That said, she said it's "probably fine" to take SSRIs. All i had to do was a google search to get info--don't these docs keep up with the literature.

SO I am going to try Zoloft. My ds is 6 mos and just starting solids. I want to bf for a couple years--do you think it helps that ds is an older infant with a more developed liver etc??

I am very nervous about this. DH is even more nervous, and pretty much doesn't want me to take the drugs. But I am desperate. My anger which surfaces when I am depressed is getting a little out of control.

So 50 mgs of zoloft--will this do anything???

[mama2girls]

Have you tried talking to a pharmacist? Sometime I think they have better answers to specific drug interaction questions than the docs. Good luck, I know how the anger can be overwhelming. Please keep us posted on how you are doing.

[Jish]

I have been told by several pharmacists and my Psychiatrist that although most SSRI's are safe, that Zoloft is considered to be the safest for breastfeeding.

I wouldn't worry at all about taking it. Of course if you have an anxiety disorder like I do, you will worry anyway.

[MamaKoala]

thank you so much

i realy needed to hear that i wasn't hurting my babe by taking 50 mgs. I don't even know if it will help-have tried it before and didn't do anythign. but today i started and I feel more hopeful. i pray things get better.

thank you again.

[mama2girls]

A family friend who is a pharmacist told me that it can take several weeks for an ad to take effect. And that you need to stay on it for 9-12 months for the effects to last once you stop taking the drug. Any pharmacists out there? Did I remember that correctly?

[Jish]

Not a pharmacist, but I know from my Psychiatrist that your info is correct.

[gilnikche]

I did a search for posts from the old PPD forum that dealt with taking Zoloft. Instead of trying to duplicate these past posts; I will put up the link:

http://mothering.com/discussions/se...rder=descending

Now for anyone that wants to see all the past PPD threads. Search the "Life With A Babe" forum with the keyword PPD . Be warned! It will bring up four pages.

Carla

[Jish]

Carla, do you know an easy way to move them all back over here? I'm still the novice in the mod department.

[2girlsmom]

When DD was about 8 months old (and bfing full time) I started taking paxil 20mg once a day as prescribed by my midwife. The first week or two I definitely felt a little weird (dry mouth, spacey/stoned, tired) but then the side affects went away completely. I take it in the evening because in the beginning it made me tired so I have just kept on that schedule. I have to say that paxil has helped me so much and I feel so much better than I did. My anxiety level was through the roof and I felt so out of control and unlike myself. I feel so much even keeled now.

[mamamoo]

So what can you do about the depression/anxiety issues while waiting for the meds to take effect?

[2girlsmom]

Paxil worked with a couple days for me. I wasn't feeling like I wanted to hurt myself or the kids so I felt I was safe for a little while. I don't know what other people do because sometimes it's hard to confide in someone and admit you have this problem let alone ask them to come and help you with the kids or yourself or whatever.

[pegmom]

did you ask your doctor about taking anything? my doc gave me a script for xanax to take pnr and said that it would not hurt the baby taken only on occasion. i have only taken it a few times. i know that ambien, which is a sleep aid, is safe to take according to the aap. i have not tried it as i co-sleep and would not want to take anything that knocked me out. i think there is a link to pp support international here somewhere that gives you more info on this issue. btw, the ad should give you some relief within a week or two. the four to six week waiting period is usually to see the full effects. hope you are feeling better soon.