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Subject:
From:
Patricia Young <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 23 Aug 2020 14:34:48 +0000
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I sorted the psychotrophic/antidepressant articles out and divided  SSRI & serotonin articles out . 
one article (2000) observed decrease in milk supply that was adjusted by increased fluids & increased frequency of feeds.  The same article reported a marked increase in milk supply in one mom who stopped med.Marshall's 2014 article is very complete about serotonin & BFing and says  mothers may need help with initiating lactation.  
another article  (2005)observed neonatal signs in mom who took SSRIs in last 3rd of pregnancy.  
2013 article in BF Med reported on NAS sx in babies when mom was on SSRIs during pg. and a preterm infant who had significant problems2015 article (Orsolini & Bellantuono). "Serotonin reuptake inhibitors and breastfeeding: a systematic review" stated that Literature review clearly indicates paroxetine & sertraline should be the preferred  as first line treatment in nursing women who need antidepressant tx.and another 2015 said basically the same.
2013 & 2011 case reports were  on hyperlactation
Almost all of the articles found amounts of SSRIs in moms milk to be acceptable/low. Most of the articles agreed that there aren't enough studies.
Which brings us back to -if mom needs antidepressants in pp period she also needs Support, SSRIs in moms milk is low generally, baby needs observation for any glitches, and SSRIs in last 3 mo of pg is presently questionable.
I thought it was reassuring that milk levels are low.  And I will do some searching for the 100+ references on one of the review articles.  Pat in SNJ

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