Anxiety is a common mental health condition that affects many people, including expecting, new, and breastfeeding mothers. While breastfeeding, and even during pregnancy, many women avoid taking medications for fear that the medication will have negative affects on their baby. Whether or not a specific medication is right for you, your body, mental health history, and baby is between you and your medical provider.
To clarify – I’m an AMFT (a psychotherapist), not a doctor. But I do work with postpartum moms with anxiety daily, and I’ve experienced perinatal anxiety myself. I wish someone would have told me when I had anxiety that anxiety during pregnancy isn’t a neutral experience. Anxiety can affect a developing fetus, and the connection between an infant and their mom in powerful and lasting ways. Medication, despite its side effects may be preferable to this impact.
So here’s what might be helpful to know about medication options while breastfeeding:
The first medication that is usually recommended for breastfeeding mothers is sertraline (Zoloft). Sertraline is a selective serotonin reuptake inhibitor (SSRI) that has been shown to be safe for use while breastfeeding. Although small amounts of sertraline can pass into breast milk, studies have shown that it does not affect the growth or development of the baby, while remaining effective for moms. In my experience, most women who ask their OBGYNs and PCPs for medication management for their anxiety start out with a low dosage of Zoloft.
Another commonly prescribed medication for anxiety is paroxetine (Paxil). Paroxetine is also an SSRI and is considered safe for use by breastfeeding mothers. In various studies, researchers have found paroxetine passes into the breastmilk, but at a low concentration, and without any observable effects on the infant. However, like all medications, it should be used with caution and only under the supervision of a doctor. Some studies have shown that paroxetine may cause drowsiness, dry mouth, and other side effects in some breastfeeding mothers.
The other commonly recommended medication for breastfeeding moms is escitalopram (Lexapro). Mothers taking moderate doses of escitalopram are generally advised to continue breastfeeding, especially if the infant is over two months old.
Whenever prescribing medications to breastfeeding mothers, medical providers are likely to advise the parents to monitor the infant for excess drowsiness, restlessness, agitation, poor feeding and poor weight gain, especially in younger, exclusively breastfed infants and when using combinations of psychotropic drugs.
In conclusion, there are several medications that are safe for use by breastfeeding mothers who are suffering from anxiety. These medications include sertraline (Zoloft), paroxetine (Paxil), and escitalopram (Lexapro). It is important to note that all medications should be used with caution and under the supervision of a doctor, as some medications may cause side effects or interact with other medications that a breastfeeding mother may be taking. If you are a breastfeeding mother and are experiencing symptoms of anxiety, it is important to speak with your doctor about the most appropriate treatment options for you.
