Many women receive advice on the termination of breastfeeding when they need treatment. Conscious continuation of breastfeeding while taking medication is much more important than the possible risk of getting this medication through the mother’s milk. This decision affects many aspects related to the child, the family, and society as a whole. Weaning sometimes causes much more risk. So, what is better: weaning or breastfeeding while taking medications? And what about Zoloft and breastfeeding?
Breastfeeding and Mother’s Treatment
The traces of the majority of medicinal products are found in breast milk. But most often their number is too small. Some drugs can affect the health of the baby even in small doses but most medications are compatible with breastfeeding. If you are told that you should stop breastfeeding because of the incompatibility of medications, ask your doctor to check the compatibility of the drugs according to the reliable sources.
We have mentioned that most drugs can be found in milk only in small quantities. The concentration of substances in breast milk depends on their concentration in the mother’s blood which is measured in micro- or nanograms per milliliter. For comparison, a nursing mother can take the medicine in milligrams or even grams. Also, not all drugs penetrate into the breast milk. Only those substances that do not bind to the plasma protein penetrate into the milk. Most drugs bind to the plasma protein by almost 100%. Thus, the baby cannot get the same amount of the drug as their mother. The concentration will be much less in terms of the weight of the child.
Breastfeeding and Antidepressants
Before giving birth, many mothers feel that they are ready to take on their maternal duties but as soon as they return home they cease to feel happy and comfortable. Some mothers begin to feel upset and get depressed without even knowing what causes depression at the time when they should feel happy. Postpartum depression comes out, and mothers have no idea how to deal with it.
Before your baby is born, you need to pay attention to your feelings very carefully. Most mothers undergoing postpartum depression begin to feel its effects even before the baby is born. They can start feeling sad for no particular reason. Women should immediately report this to their gynecologist or a supervising doctor.
Some doctors may prescribe pregnant women antidepressants during the third trimester if the fetus is healthy. Especially, if they have been depressed in the past. Some pregnant women are very worried about this. What if these drugs affect the development of my baby while they are still in the womb? How will taking medications affect the breast milk?
Several studies have been conducted on the effects of taking antidepressants during pregnancy and breastfeeding. Of course, there exists a risk associated with taking medications during pregnancy and breastfeeding. But doctors believe that this insignificant risk can in no way be compared to the risk that arises when one needs to take medication to get rid of postpartum depression. Zoloft is considered to be one of the least dangerous antidepressants for mothers.
What Is Zoloft?
Zoloft (also known as Sertraline) is an antidepressant from a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It’s not fully understood the way Sertraline works. Zoloft positively affects communication between nerve cells in the central nervous system. The drug also restores chemical balance in the brain. In therapeutic doses, Sertraline blocks the seizure of serotonin in human platelets. It has no stimulating, sedative or anticholinergic action.
Zoloft is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).
Zoloft may also be used for other purposes. It does not cause drug dependence and an increase in body weight with prolonged admission.
Who Can Take Zoloft?
Zoloft is used to treat the symptoms of depression which is accompanied by a sense of anxiety in the presence or absence of mania in the anamnesis.
After obtaining a satisfactory effect, continued treatment with Sertraline helps prevent recurrences of the initial episode of depression and their occurrence in the future.
Zoloft is indicated for the treatment of obsessive-compulsive disorder.
After the initial effect was obtained with long-term Sertraline treatment, persistent efficacy, safety, and good tolerability are usually observed for at least 2 years. Zoloft is indicated for the treatment of obsessive-compulsive disorder in children as well.
Zoloft is also used to treat panic disorders with the presence or absence of agoraphobia. Sertraline is indicated for the treatment of post-traumatic stress disorder (PTSD).
Zoloft is indicated for the treatment of social phobia (social anxiety disorder). With a satisfactory response to the treatment of continuation of therapy, Zoloft is an effective means of preventing recurrence of primary manifestations of social phobia.
How to Use Zoloft?
Zoloft is prescribed 1 time per day in the morning (if possible) or in the evening. Sertraline pills can be taken regardless of eating.
Zoloft While Pregnancy. Zoloft and Breastfeeding
There are no controlled results of the use of Zoloft in pregnant women, so it is necessary to prescribe them only if the expected benefit for the mother exceeds the potential risk to the fetus. Women of reproductive age who are supposed to be prescribed Sertraline should be recommended to use effective contraceptives if they don’t plan a pregnancy.
Zoloft is found in breast milk, and therefore combining treatment with Zoloft and breastfeeding is not recommended. Though there are no reliable data on the safety of its use. If treatment is still necessary, then breastfeeding may be temporarily stopped. In the case of Zoloft during pregnancy and breastfeeding, some newborns whose mothers have been taking antidepressants from the SSRI group may have symptoms similar to the drug withdrawal response.
Breastfeeding and Zoloft
There are limited data concerning the level of Sertraline in breast milk. At the same time, it is known that the level of Zoloft in breast milk is higher than in maternal plasma. That’s why it is better not to combine Zoloft and breastfeeding. The exception is the cases when, according to the opinion of the doctor, the effect of taking the drug exceeds the possible risk.
If Zoloft is used during pregnancy and/or breastfeeding the physician should be aware that certain manifestations, including those similar to withdrawal symptoms, are described in some infants whose mothers took CI33C antidepressants including Zoloft. Women of childbearing age should use appropriate contraceptives while taking Sertraline.
Impact of Zoloft on Breast Milk
Antidepressants can get to a baby with breast milk but in much lesser amounts than during pregnancy. Some drugs are better compatible with breastfeeding, others penetrate into milk in a greater concentration. A recent meta-analysis of 67 studies of the level of antidepressants received by a baby with milk systematized 337 experimental cases where 238 children were examined. The study included 15 antidepressants including Zoloft. Traces of all medicines were found in breast milk.
Fluoxetine was detected in children in the highest concentration. The content of Citalopram also turned out to be quite high. The levels of Citalopram in children’s plasma were highly correlated with the doses of the medication that the mother received. What concerns Zoloft, this correlation turned out to be weaker. Fluoxetine showed the highest ability to accumulate in the body of the child receiving breast milk. The level of Zoloft in breast milk is lower.
- Digestive system: nausea, vomiting, diarrhea, constipation, abdominal pain, pancreatitis, dry mouth.
- Cardiovascular system: heart palpitations, tachycardia, arterial hypertension.
- Muscle cramps.
- Central and peripheral nervous system: fainting, drowsiness, headache, migraine, dizziness, tremor, insomnia, anxiety, nightmares, suicide, coma.
- Reproductive system and mammary gland: a violation of sexual function (delayed ejaculation, decreased sexual vigor), menstrual irregularity.
- Organs of vision: visual impairment.
- Allergic reactions.
- Other: weakness, redness of the skin, ringing in the ears, facial edema, photosensitivity reaction, increased sweating, decreased appetite (rarely – increase), possible anorexia, decrease or weight gain, bleeding (including nasal or gastrointestinal), etc.
Zoloft and Breastfeeding: Summary
Zoloft is one of the antidepressants that are considered to be safe while breastfeeding. The level of Sertraline which is the main component of Zoloft is usually very low in breast milk as compared to other antidepressants that are used by nursing women. According to most doctors, Zoloft is a safe and a better medication to take especially when breastfeeding since it does not pose any great risk to your child.
The effect of medications on the baby is usually not as bad mother’s depression. Postpartum depression is a very serious disease and it needs to be treated.
Many antidepressants, while observing the prescribed precautions, are safe for use while breastfeeding. In fact, some mothers even enjoy the increase in the amount of milk after taking psychotherapeutic drugs but this, of course, is not the reason for taking them. It’s interesting that some mothers who needed antidepressants before pregnancy do not need to take these medications during breastfeeding or can take reduced dosages.
Nevertheless, before taking this or that medication, consult a doctor. Zoloft and breastfeeding are not an exception!