pospartum depression--Prozac--and breastfeeding
Q.Question for all of you moms who had or have postpartum depression--I had a beatiful baby boy four weeks ago and I'm having a hard time dealing with lack of sleep, caring for the baby, and dealing with my parents who are visiting to help take care of the baby, and my husband who has some issues with my parents. In addition, it's wintertime and I'm always more "down" during winter. A psychiatrist said to try first light therapy boxes, which I started on Sunday and I think it helps but I'm going to see her again on Monday and we are supposed to decide if I should go on medication. If things don't get better maybe I should, but I'm worried about the effect of medication on my baby (I'm breastfeeding). So questions to all of you moms out there who are and were on Prozac or other medication--how does/did that affect your baby? Did you notice any behavioral changes? What other ways of dealing with PPD are there except medicaton?
A.Depression is an illness that has a major impact on women’s lives. Canadian studies have consistently shown that women are more likely to experience depression than men, and surveys of women’s health interests consistently rate it as a major concern. Depression is most common in women between puberty and menopause. Many drug treatments have been developed for depression, and the use of a group of drugs known as Selective Serotonin Reuptake Inhibitors (SSRI) by women of childbearing age is now widespread. Drugs in this group include paroxetine (Paxil), and setraline (Zoloft). Women taking these drugs to treat depression sometimes fear that the drugs will have a negative affect on their baby, if they become pregnant. Fortunately, studies done at the University of Toronto and elsewhere in the last several years have shown that these drugs are safe during pregnancy. Whether women took the drugs in the first trimester or throughout pregnancy, there appeared to be no increase in birth defects, miscarriages, still births or premature deliveries. There was also no decrease in birth weights observed in the children.Now a new study published in the American Journal of Psychiatry adds the last piece of the puzzle. This study of the antidepressant drug paroxetine (Paxil) shows that women do not pass measurable amounts of the drug to their children during breast-feeding. The study looked at 16 women who were taking paroxetine and their babies. Although the drug was present in the breast milk, levels of the drug in the baby’s blood were below measurable levels. As well, the women in the study did not report any changes in their babies’ behavior, disposition, sleep, activity levels or bowel movements associated with the women’s daily dose of paroxetine.At the recent Women’s Health Matters Forum and Expo, Dr. Shaila Misri discussed depression and pregnancy. She noted that depression is a common complication during pregnancy and that it can disrupt the bond between mother and child. Her presentation suggested that if a woman is using a medication that effectively controls her depression, she is acting in the interests of both herself and her child. Information in this News item was drawn fromKulin NA, Pastuszak A, et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study.
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