Nursing a toddler and antidepressants

[homedeep]

HI Dr Hale,

Firstly, this is a great forum! So helpful to nursing moms...
I am nursing my 2 yr and 3 month child. He still nurses quite a bit.
I suffer from anxiety and depression and was recently prescribed Zoloft but feel nervous to take it while nursing my child. Have there been any studies of nursing toddlers while the mom is on Zoloft?
How many hours after taking Zoloft would the concentration be highest in the breastmilk?
Thanks much!

[mmilla]

Antidepressants

Dear homedeep,
Sertraline (Zoloft) has been extensively studied in many breastfeeding mothers. The data is consistent that levels in milk are quite low and do not normally affect an infant and much less a toddler. Studies of platelet function further suggest that sertraline is poorly absorbed by the infant and at levels too low to affect platelet function. Sertraline is one of the preferred antidepressants for use during breastfeeding. Although unlikely to occur at this stage in breastfeeding, the adverse effect that you would look for in a breastfed child of a mother taking Zoloft is sedation. Hope this is helpful.
Maria Milla, MD
InfantRisk Center

[User1]

I have an 18 month old and my doctor wants to prescribe Wellbutrin. I’m completely lost on what the side effects and risks of transferring medications though breastmilk. Any insight would be helpful.

[alicia]

Wellbutrin is rated an L3 Probably Compatible. There were a few case reports in which it suppressed milk supply. So watch for changes in your milk production. There was also two cases of possible seizures in infants that have been reported. However, they could not rule out a febrile seizure in one of those cases. Watch baby for Sedation or irritability, seizures, not waking to feed/poor feeding and poor weight gain. It still should be ok. It has very low transfer into the breastmilk 0.11%-1.99%.

Alicia Nelson RN Certified Breastfeeding Specialist
Infant Risk Center