Antidepressants Linked to Lactation Difficulties

/ Author:  / Reviewed by: Joseph V. Madia, MD

According to a new study in the Journal of Clinical Endocrinology & Metabolism, women taking commonly prescribed antidepressants may experience delayed lactation after giving birth and may need additional support to achieve their breastfeeding goals.
Breastfeeding benefits both infants and mothers in many ways, as breast milk is easy to digest and contains antibodies that can protect infants from bacterial and viral infections. The World Health Organization recommends that infants should be exclusively breastfed for the first six months of life.

This new study shows that certain common antidepressant drugs may be linked to a common difficulty experienced by new mothers known as delayed secretory activation, defined as a delay in the initiation of full milk secretion.

"The breasts are serotonin-regulated glands, meaning the breasts' ability to secrete milk at the right time, is closely related to the body's production and regulation of the hormone serotonin," said Nelson Horseman, Ph.D., of the University of Cincinnati, and coauthor of the study. "Common antidepressant drugs [such as] fluoxetine [Prozac], sertraline [Zoloft] and paroxetine [Paxil] are known as selective serotonin reuptake inhibitor (SSRI) drugs, and while they can affect mood, emotion and sleep, they may also impact serotonin regulation in the breast, placing new mothers at greater risk of a delay in the establishment of a full milk supply."

In this study, researchers examined the effects of SSRIs on lactation using laboratory studies of human and animal cell lines and genetically modified mice. Furthermore, an observational study evaluated the impact of SSRIs 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 SSRIs. Researchers commonly define delayed secretory activation as occurring later than 72 hours postpartum.

"SSRI drugs are very helpful medications for many moms, so understanding and ameliorating difficulties moms experience can help them achieve their goals for breastfeeding their babies," said Horseman. "More human research is needed before we can make specific recommendations regarding SSRI use during breastfeeding."

Aaron Lohr

Reviewed by: 
Review Date: 
September 16, 2010