Wednesday, January 27, 2010

Do antidepressants delay milk coming in?

A new study that will be published in the Journal of Clinical Endocrinology and Metabolism found that women taking the most commonly prescribed antidepressants (Prozac, Paxil and Zoloft) during pregnancy had a delay in their milk coming in. Because breasts are seratonin-regulated glands, the theory goes that these antidepressants, which are selective seratonin reuptake inhibitors (SSRIs), can impact seratonin regulation in the breast. According to the study:

Researchers examined the effects of SSRI drugs on lactation using laboratory studies of human and animal cell lines and genetically modified mice. Furthermore, an observational study evaluated the impact of SSRI drugs on the onset of milk production in postpartum women. In this study of 431 postpartum women, median onset of lactation was 85.8 hours postpartum for the SSRI-treated mothers and 69.1 hours for mothers not treated with SSRI drugs. Researchers commonly define delayed secretory activation as occurring later than 72 hours postpartum.
I know that several people who read this blog are on SSRIs and were on them while pregnant and breastfeeding. Did you find this to be true? Did it take longer than the typical 3 days for your mature milk to come in? The only person I "know" who has openly discussed her use of an SSRI during pregnancy and breastfeeding is Rebecca Walker. In her book, Baby Love, Walker actually talks about how she made tons of milk, and while her son was in the NICU, she had pumped so much that she filled up their tiny refrigerator very quickly. Perhaps that is the difference, that because she was pumping from the beginning and so frequently, and without the expectation that her milk would come in quickly, she was able to successfully breastfeed. Is it possible this would need to be standard protocol for moms on antidepressants? Is the take away that moms should be informed of this possibility and be encouraged to pump? The authors of the study admit that more human research is necessary before any recommendations can be made for moms taking SSRIs.

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