Zoloft and Breastfeeding
Zoloft has been the most popular
antidepressant medication used by new mothers because
of studies that show lower concentration of Zoloft in
the breast milk. But moms committed to breastfeeding
are often skeptical about taking any kind of drug not
supported with long-term studies.
This website offers extensive information about therapies
that can help you fight postpartum
depression. You should explore those
options even if you begin treatment with Zoloft or
other anti-depressant medications. A huge
misconception is that we choose either a medication
approach or a "natural" approach ala Tom Cruise.
Depression is such a complicated disease that we
really need to create a treatment strategy that works
for us; there are no one-size-fits-all treatment
plans. I strongly encourage you to read more
about postpartum depression
on this
website.
Zoloft: No
one-size-fits-all answer
A friend of mine called to tell me she was starting
Zoloft. She sounded sheepish because she knew I did not
take anti-depressant medications in my first pregnancy. I
spent over two years in deep cycles of depression and had
several instances of psychosis and never took
prescription medication. I know that many people think
that getting by for over two years makes them strong, but
I consider myself lucky that I did not harm myself or my
baby. I needed help and I floundered. My friend, on the
other hand, was working with a medical professional and
trying a medication. I wished her luck and I hoped she
would do well. She did do well and I am pleased that she
found a solution. She is a Zoloft success story. I
directed her to my information on nutrients and depression
because many
of those nutrients improve your depression above and
beyond the possible improvement of a prescription
medication.
Not everyone responds well to Zoloft which is why it is
critical to you to keep working with your doctor so that
you can find something effective for you. In my second
pregnancy, after I had developed this website and written
the Rebuild book, I described survival
tools that I used. I encourage you to follow that
story and pick and choose what might be best for you.
Peak
Concentrations of Zoloft and Breastfeeding at Low
Concentrations
Back when I was considering using Zoloft, I investigated
breastfeeding strategies that would help me reduce baby's
exposure to Zoloft. You might consider doing the same,
but if this strategy adds to your stress and obsession,
it is probably best not to worry about Zoloft
concentrations in your milk.
In developing your strategy, understand first that when
you take your daily dose of Zoloft, it will enter your
bloodstream, the levels will gradually build, and then
the levels will decline. What you want to do is try to
get baby’s feeding schedule to line up with the low
concentrations of Zoloft in your blood.
According to a study in the 1997 American Journal of
Psychiatry, Zoloft will peak in your
milk at 7-10 hours after your dose.
If you are lucky enough to have a baby who sleeps through
the night, you could take your dose about two hours
before bedtime (or even at bedtime) and let baby sleep
through those peak concentrations of Zoloft. Ideally you
would begin breastfeeding about 14 hours after the dose.
That is a very long time, but look at the
actual study. Note Figure 2 on page
1258. Not breastfeeding during 4-12 hours after your
dose is your next best strategy.
Non-Sleepers
I am well aware that there are many babies who don’t
sleep for more than a couple of hours. I have many hours
of sleep loss to prove it.
If that’s the case, you’ll be nursing in the 7-10 hour
peak time and in the 4-12 hour range. One way to manage
this situation if you want to reduce baby’s exposure is
to keep these breastfeeding sessions short. During peak
concentration, have short nursing sessions where baby
primary gets fore milk.
There are higher concentrations of the medication in the
hind milk.
The hind milk is the milk that our bodies produce several
minutes into the nursing session. The first milk that
comes out is more watery, the low fat version of human
milk. The hind milk is the whole milk. If baby is loaded
up with milk during lower concentration periods, baby
might be content with a short nursing session and a
little fore milk at peak hours.
Scheduling
my baby is going to drive me crazy
I know. It might be better to forget all of this
information. But for people who are interested, I have
provided it. Not all moms and all babies fit into the
schedule that this research suggests.
Quit
Breastfeeding?
Don’t entertain the question. Just because this article
suggests reducing baby’s exposure to Zoloft, the most
important thing for baby is to receive your milk. Your
milk has the nutrients your growing baby needs and you
are providing immunities to disease to that young person.
The reason Zoloft is so often recommended for
breastfeeding mothers is that only trace amounts of the
medication make it into the milk. Forge ahead!
Improving
my depression
If you are struggling with depression, consider your
nutrient status. Improving your nutrient status will
alleviate your depression. Depending on other
circumstances in your life, nutrient therapy may take
care of your depression in pregnancy altogether.
Look at your Omega-3 fatty acid and B-vitamin
intake. These deficiencies are
common. Our need for Omega-3s and B-vitamins is higher
in the third trimester of pregnancy and during
breastfeeding than at any time in our lives. Read
my Omega-3 round-up
article.
Have your doctor check your iron. You may need to take a
prenatal vitamin with iron, but you should also increase
the iron in your diet. We have extensive information
on iron rich foods
in our
downloadable e-book.
Read my story recapping my second pregnancy, when I put
the tools on this website and in my book to the
test: Second baby, second
chance.
Best of luck.
Check
out: How I had a baby and survived!