Pregnant Women on Antidepressants Less Likely to Breastfeed

Researchers at the California Teratogen Information Service (CTIS) Pregnancy Health Information Line, a statewide non-profit organization based at the University of California, San Diego School of Medicine, have found women exposed to certain antidepressants during pregnancy were significantly less likely to breastfeed their babies compared to unexposed women. The results of the study were recently published online in The Journal of Human Lactation.

The study uses data obtained by counselors at the CTIS Pregnancy Health Information Line, a toll-free service offering evidence-based clinical information about exposures during pregnancy and breastfeeding. It focused on 466 pregnant women who contacted the CTIS Pregnancy Health Information Line over a ten year period with questions about a wide variety of exposures and, after being counseled, agreed to participate in a follow-up study of their pregnancy outcome.

The study specifically examines breastfeeding choices of women exposed to selective serotonin reuptake inhibitor (SSRI) antidepressants at the time of delivery, compared to those who discontinued use of antidepressants earlier in pregnancy, as well as to those women who report not taking antidepressants at all. The results showed women exposed to an SSRI anytime in pregnancy were about 60 percent less likely to initiate breastfeeding than women who took no antidepressant.

“While the benefits of breastfeeding an infant are very clear, this study suggests that women who are taking antidepressants in pregnancy are not engaging in this behavior as often as we would like to see,” said Christina Chambers PhD, MPH, professor of pediatrics at UC San Diego School of Medicine, CTIS program director, and co-author of the study. “Whether this is due to the mother’s fear of harming her baby by breastfeeding while taking the medication, or due to the mother’s depression itself is unclear.” According to Chambers, regardless of the reason for breastfeeding choice, the study suggests that women who have depressive disorders and/or take antidepressants in pregnancy may require additional encouragement and support when making the choice to breastfeed an infant.

Pregnancy And Antidepressants A group of U.S. researchers, led by University Hospitals of Cleveland and Case Western Reserve University psychiatrist Katherine L. Wisner, M.D., has compiled a review of new studies on antidepressant use among pregnant women. The review is designed to guide general physicians and obstetricians who treat pregnant women.

The article appears in the October 6,1999 issue of the Journal of the American Medical Association.

The risk for depression among all women of childbearing age is as high as 25 percent for women 25- through 44-years-old. Physicians traditionally have been reluctant to treat major depression with drug therapy in pregnant women because of safety concerns. Therefore, many pregnant women have been forced to choose between the debilitating effects of untreated depression and the unknown effects of antidepressant drug therapy on their pregnancy.