Although a large literature supports the benefits of breastfeeding, this review suggests that breastfeeding is less common among postpartum depressed women, even though their infants benefit from the breastfeeding. Depressed mothers, in part, do not breastfeed because of their concern about potentially negative effects of antidepressants on their infants. Unfortunately these findings are not definitive because they are based on very small sample, uncontrolled studies.
As in the literature on prenatal antidepressant effects, the question still remains whether the antidepressants or the untreated depression itself has more negative effects on the infant. It is possible that the positive effects of breastfeeding may outweigh the positive effects of the antidepressants for both the mother and the infant.
In addition, some alternative therapies may substitute or attenuate the effects of antidepressants, such as vagal stimulation or massage therapy, both therapies being noted to reduce depression. Further studies of this kind are needed to determine the optimal course of therapy for the benefit of the ruptured disc and low vitamin d, breastfeeding mother and the breastfed infant. Breastfeeding has been noted to have significant benefits for both mothers and infants.
In this paper, recent literature on breastfeeding and farm animals lesson plans is reviewed, and suggestions are made for future research. Later in infancy, they are reputedly more active and show easier temperament including less irritability and greater sociability Field et al. Some have attributed the benefits of breastfeeding to components in the breast milk, for example, the higher prozac and breastfeeding of docosahexaenoic acid DHA in breast milk Hart, prozac and breastfeeding, Boylan, Carroll, Musick, Lampe, There are, of course, many other possible underlying mechanisms, e.
Prozac and breastfeeding median duration of breastfeeding was 26 weeks for women with early-onset depression, 28 weeks for women with late-onset depression, and 39 weeks for women without depression. After controlling for potential confounds, the early cessation of breastfeeding was significantly associated with postpartum depression.
Similar data have been reported in the US. Although postpartum depressed mothers choose not to breastfeed or do so for relatively short periods of time Field et al. The one-month-old infants of depressed mothers who had stable breastfeeding patterns were less likely to have reactive temperaments, and at one month, they did not show the abnormal frontal EEG asymmetry patterns that are typically seen in infants of depressed mothers.
In addition, they went on to have better mother-infant interactions when the infants were 3-months-old, prozac and breastfeeding. Thus, the depressed mothers and infants benefited from breastfeeding, although in this study it was not clear whether the mothers were taking antidepressants. Curiously, prozac and breastfeeding, antidepressants were never mentioned in the Jones et al. The benefits they reported may not pertain to infants of depressed mothers who are taking antidepressants.
A recent paper detailed a novel method for quantifying the concentrations of multiple selective serotonin reuptake inhibitors SSRIs and tricyclic antidepressants in breast milk.
The authors showed the method to be highly accurate and a precise technique for measuring multiple antidepressants simultaneously. Several reviews have been conducted on breastfeeding and antidepressants. At the prozac and breastfeeding of their review, prozac and breastfeeding, there were no published controlled studies on the use of antidepressants by breastfeeding women, so the review was based on published individual case reports, case series and pharmacokinetic investigations.
The authors noted that no serious adverse events had been reported on infants exposed to antidepressant medications through breast milk. They also noted that sertraline was the most prescribed antidepressant and had not had any reported adverse effects. However, the authors suggested that the most practical approach may be to have depressed mothers continue therapy with the previously effective drug. In another recent review of eleven studies examining a total of childrenno impairment of infant neurodevelopment was noted following exposure to SSRIs, prozac and breastfeeding, although the author suggested that two studies examining 81 children had unwanted effects of SSRI exposure, but the exposure had occurred during the fetal period Gentile, prozac and breastfeeding, a.
The unwanted effects included subtle motor development and motor control problems. Mothers receiving clinical doses of sertraline experienced blockade of the platelet 5-HT serotonin transporter. However, platelet 5-HT uptake in the breastfeeding infants of the treated mothers was unaltered. This study suggested that while the SSRI sertraline decreases the serotonin levels in the mother, prozac and breastfeeding, breastfeeding does not affect the peripheral or central serotonin transport in their infants.
The fact that the sertraline-infants came from a sample twice to seven times the size of the other samples could explain this finding. Despite the greater detectability of sertraline, none of the infants in the study experienced adverse sequelae. However, the mean estimated dose the prozac and breastfeeding experienced ranged from. Once again, no adverse drug reactions or unusual behaviors were reported for the infants.
Once again, greater concentrations were found in the hindmilk than in the foremilk. The authors concluded that these data parallel the available data on other selective serotonin reuptake inhibitors. Detectable levels of paroxetine were noted in all maternal serum samples and in 24 of the 25 breast milk samples. However, in all of the infant serum samples, the paroxetine concentrations were below the lower limit prozac and breastfeeding quantification with the mean infant dose being 1.
The authors rightfully pointed out that while there were no short-term adverse effects, future studies would be needed to address a more systematic method for observing and prozac and breastfeeding adverse effects, and future studies need follow-up assessments to evaluate potential long-term effects of paroxetine exposure.
The parents, pediatricians and nurses completed forms on infant weight and developmental milestones at ages three, six and twelve months.
The paroxetine apparently did not affect weight gain or development in omni directional hd antenna plans infants, prozac and breastfeeding.
The authors, however, added a caveat that paroxetine would be an acceptable drug for depression in breastfeeding women assuming that they adhere to the lowest dose per day 20 mgthat they took the dose at bed time, that they avoided combinations of drugs and that they ensured close medical follow-up of their infants.
Relatively higher concentrations have been noted for fluoxetine throat neck and tongue cancers breast milk and infant plasma.
The average infant-maternal plasma ratio was calculated for each drug, and correlations between infant plasma level and maternal dose, as well as between maternal plasma level and breast milk level were calculated, prozac and breastfeeding.
In the studies reviewed, paroxetine and sertraline effects were usually undetectable. Thus, the authors concluded that paroxetine and sertraline may be the preferred choices by breastfeeding women, and they recommended limited use of fluoxetine and citalopram.
The infants were approximately 4-months at the start of the study. In this sample, all but one infant experienced little or no decline in whole-blood platelet 5-HT concentrations. These data suggested that most infants continued to breastfeed without experiencing clinically significant changes in platelet 5-HT transport while their mothers were being treated with 20 to 40 prozac and breastfeeding of fluoxetine. Citalopram has typically been the highest concentration SSRI antidepressant, when it has been compared to sertraline, paroxetine and fluoxetine.
However, in studies that have only measured citalopram, negligible or no effects have been noted, prozac and breastfeeding. The problem, again, however, prozac and breastfeeding, was the small sample size. In addition, the depressed women sample taking citalopram was three times the sample size of the group of depressed women who were not undergoing the therapy.
Finally, as in most of these studies, there was no specification or no operational definition of adverse events. However, many of the comparison studies have potential confounding variables like severity and duration of depression and variability of drug timing and dosage.
Further, as already mentioned, this literature is based primarily on case studies. Randomized controlled studies have not been performed, as prozac and breastfeeding true for many antidepressant protocols, even in those studies that have treatment and no treatment groups. The failure to randomly assign and to stratify on confounding variables leads to unmatched groups. The dependent measures in these studies are also limited to breast milk and serum measures, thus making it difficult to determine the effects of the antidepressants on maternal depression itself and prozac and breastfeeding infant growth and development.
Although the drug exposure, in general, seems to be higher during pregnancy through placental passage than during the postpartum period through breast milk, prozac and breastfeeding, no definitive conclusions can be made from a case study database.
Certainly, controlled studies are needed. Using breast milk alone would make these studies less invasive. Thus, these studies have limitations including, as already mentioned, the prozac and breastfeeding sample sizes, the difficult problem of random assignment and the lack of control groups and long-term follow-up studies.
Other potentially confounding variables prozac and breastfeeding have not been controlled, for example, severity and duration of depression, are factors that are not typically considered. However, for the mothers who relapsed for major depressive episodes lasting two months or more, the infant weights were significantly lower than the weights of infants whose mothers relapsed for brief depressive episodes of less than two months, prozac and breastfeeding.
Thus, although mere exposure to antidepressant medications did not appear to affect the infant weights, prozac and breastfeeding, infants exposed to maternal depression lasting two months or more appeared to experience significantly lower weight gain than infants of those experiencing brief major depressive episodes.
It is also prozac and breastfeeding that the women receiving the antidepressants were more severely depressed, and the more severe depression could confound prozac and breastfeeding effects. The data from this study highlighted the many factors that interact with the assessment of antidepressant effects on breast milk, prozac and breastfeeding, breastfeeding and infant development.
In summary, although a large literature supports the benefits of breastfeeding, this review suggests that breastfeeding is less common among postpartum depressed women, even though their infants benefit from the breastfeeding. Although sertraline and paroxetine concentrations are not detectable in infants, prozac and breastfeeding, fluoxetine and citalopram do have detectable levels. Both antidepressants and untreated depression have notable negative effects, prozac and breastfeeding.
It is also possible that the positive effects of breastfeeding may outweigh the positive effects of the antidepressants for both the mother and the infant. Further studies are needed on the negative side effects of psychotropic medications during breastfeeding and on the side effects of abruptly removing this therapy Gentile, prozac and breastfeeding, b.
Studies of this kind and professional guidance on the course of therapy on a case-by-case basis are needed for the benefit of the breastfeeding mother and the breastfed infant.
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Tiffany Field 1, 2. See other articles in PMC that cite the published article. Abstract Although a large literature supports the benefits of breastfeeding, this review suggests that breastfeeding is less common among postpartum depressed women, even though their infants benefit from the breastfeeding, prozac and breastfeeding.
Breastfeeding Benefits for Depressed Mothers and their Infants Although postpartum depressed mothers choose not to breastfeed or do so for relatively short periods of time Field et al.
Breastfeeding and Antidepressants Several reviews have been conducted on breastfeeding and antidepressants. Fluoxetine Prozac Relatively higher concentrations have been noted for fluoxetine in breast milk and infant plasma. Citalopram Celexa Citalopram has typically been the highest concentration SSRI antidepressant, when it has been compared to sertraline, paroxetine and fluoxetine.
Summary In summary, although a large literature supports the benefits of breastfeeding, this review suggests that breastfeeding is less common among postpartum depressed women, even though their infants benefit from the breastfeeding. Breastfeeding during maternal antidepressant treatment with serotonin reuptake inhibitors: Journal of Clinical Psychiatry.
Vagal tone as an indicator of treatment response in major depression. Behavioral and heart rate pattern differences between breast-fed and bottle-fed neonates. Use of psychotropic medications in treating mood disorders during lactation: Maternal sertraline treatment and serotonin transport in breast-feeding mother-infant pairs.