I have recorded the presentation which I have frequently given about perinatal mental health and breastfeeding. It should be used after listening to ” How drugs get into milk”
as it contains the pharmacokinetic data of drugs prescribed for perinatal mental health including SSRIs, anti anxiety medication and anti psychotics. It also includes research studies about the links between mental health and breastfeeding.
I hope this may increase prescriber’s knowledge as well as empower peer supporters and parents.
I have recorded this powerpoint to help everyone understand how drugs pas into milk and by appreciating this how we can evaluate the information within specialist sources. I hope it is useful CPD for professionals. The information is in all my books if you want to read more.
If you have a question please message me
Another medication used during breastfeeding for anxiety and depression is mirtazapine. It may be used where other SSRIs have not been effective or tolerated. Mirtazapine may be also be seen as an option where insomnia is a symptom of anxiety or depression.
The baby should be observed for signs of drowsiness and ineffective feeding.
Care should be taken with co sleeping because it is likely to cause drowsiness in the lactating mother. Falling asleep in chairs or on sofas should be regarded as an even greater risk https://www.basisonline.org.uk/
LactMed summarises that “Limited information indicates that maternal doses of up to 120 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months.” In practice the normal dose is 15mg taken at night.
Professionals may find the RCGP Perinatal mental health toolkit a useful resource https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/perinatal-mental-health-toolkit.aspx
The information in this factsheet is taken from my book Breastfeeding and Medication. Please message me with queries or the references used. firstname.lastname@example.org
Especially over the past year of the pandemic many mothers are asking about the compatibility of sertraline during breastfeeding. It has been a hard time for everyone with the incidence of anxiety and depression continuing to rise. As access to IAPT and IESO is more difficult the prescription of medication is inevitable.
Sertraline is the first choice medication for breastfeeding mothers as virtually none gets into milk and that we have a high level of experience with it over many years.
Unfortunately many doctors are, in my experience, still recommending that mothers should stop breastfeeding in order to take it. This may be that they think life would be easier if someone else could help with care of the baby or that the mother may get more sleep. Sadly, this doesnt always happen and the loss of oxytocin may also lower mood further.
There is often an assumption that pressure to breastfeed can lead to depression but in my experience pressure to stop breastfeeding in order to take medication may increase depression and may also stop mothers accessing professional help to avoid having that discussion.
This link to the RCGP perinatal mental health toolkit may be useful for professionals and parents
This factsheet contains information from my book Breastfeeding and Medication. Please message me for references used or with any questions.
Breastfeeding and chronic medical conditions contains chapters on anxiety and depression