Especially over the past year of the pandemic many mothers are asking about the compatibility of citalopram during breastfeeding. It has been a hard time for everyone with the incidence of anxiety and depression continuing to rise. As access to IAPT ( https://www.england.nhs.uk/mental-health/adults/iapt/) may be more difficult the prescription of medication is inevitable. Alternative CBT access may be available on line via and IESO (https://www.iesohealth.com/en-gb)

Citalopram is widely used and we have a high level of experience with it over many years. It is the drug of choice if it has been used by the mother in the past.

Unfortunately many doctors are, in my experience, still recommending that mothers should stop breastfeeding in order to take antidepressants. 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

RCGP perinatal mental health toolkit

This factsheet contains information from my book Breastfeeding and Medication. Please message me for references used or with any questions.

citalopram and breastfeeding factsheet

Breastfeeding and chronic medical conditions contains chapters on anxiety and depression

wendy@breastfeeding-and-medication.co.uk

This is the beginning of the hayfever season with the sun coming out so today I recorded the video about the compatibility of drugs to treat symptoms and breastfeeding

I’ve also uploaded the powerpoint which I used to present this that you can share

https://youtu.be/2bsCUFaeMMs

hayfever and breastfeeding powerpoint

I have for a long time been intending to compile a list of all the factsheets available on Breastfeeding-and-Medication.co.uk. A miserable, wet day has prompted me to get on with it.

So here is the list :

If you search for any word on the title the factsheet page should appear

• Accidental dose of codeine when breastfeeding
• Accidentally taking one dose of aspirin when breastfeeding
• ADHD and Breastfeeding
• Anaesthesia and breastfeeding
• Anti epilepsy medication and breastfeeding
• Anxiety and breastfeeding – need to take a drug to relieve symptoms
• Apple Cider Vinegar and Breastfeeding
• Azathioprine and breastfeeding
• Betahistine and Breastfeeding
• Bi polar disorder and breastfeeding
• Bisoprolol and Breastfeeding
• Botox and Fillers and Breastfeeding
• Botox for medical purposes
• Bowel cleansing before colonoscopy and breastfeeding
• Breastfeeding after CT and MRI scans
• Breastfeeding after VQ scans
• Breastfeeding and cocaine
• Breastfeeding and Gallstones
• Breastfeeding and Inflammatory Bowel Disease
• Breastfeeding and labarynthitis/vertigo
• Breastfeeding and lowering / stopping milk supply
• Breastfeeding and multivitamin and mineral supplements
• Breastfeeding and Oestrogen cream or pessary
• Breastfeeding and pain relief for acute back injury
• Breastfeeding and Podiatry
• Breastfeeding and Thrush (video)
• Breastfeeding with IBD – Colitis and Crohns Disease
• Caffeine and Breastfeeding
• Carbimazole in women of childbearing age
• CBD Oil and breastfeeding
• Citalopram and breastfeeding
• Collagen and breastfeeding
• Colonoscopy and Endoscopy in breastfeeding women
• Covid Vaccine and Breastfeeding
• Depression and breastfeeding
• Diabetes and Breastfeeding
• Dihydrocodeine and breastfeeding
• Ear drops and breastfeeding
• Ectopic Pregnancy and Breastfeeding
• Fibromyalgia and Breastfeeding
• Glucosamine and chondroitin supplements during breastfeeding
• Hayfever and breastfeeeding
• High Dose Vitamin D Supplements and Breastfeeding
• How to make an informed decision about drugs that you might be taking while planning a pregnancy
• Hypertension (raised blood pressure) and Breastfeeding
• Infliximab and breastfeeding
• Lack of stools / constipation in a breastfed baby
• Live vaccinations and Immunosuppressant medication taken by breastfeeding mothers
• Low dose aspirin and breastfeeding
• Lupus, hydroxychloroquine and breastfeeding
• Midazolam as a sedative for procedures in breastfeeding mothers
• Mirtazapine and breastfeeding
• Miscarriage and Breastfeeding
• MRI, gadolineum and breastfeeding
• Multiple Sclerosis and Breastfeeding
• Naproxen and Breastfeeding
• Nausea and Breastfeeding
• Norethisterone and Breastfeeding
• Opiates and the breastfeeding mother
• Oral Terbinafine and breastfeeding
• Pain relief after birth and breastfeeding
• Perinatal Mental Health in pregnancy and breastfeeding ppt
• Post operative analgesia for the breastfeeding mother
• Progesterone (Cyclogest) and breastfeeding
• Propranolol and breastfeeding
• Protein Shakes and Breastfeeding
• Raynaud’s and Breastfeeding
• Retinoid beauty creams and breastfeeding
• Rosacea and breastfeeding
• Sertraline and breastfeeding
• Sleep problems when breastfeeding
• Stillbirth and Milk Supply
• Terminations of pregnancy and Breastfeeding
• Timing of breastfeeds if taking medication
• Tranexamic acid to treat heavy periods experienced by breastfeeding mothers
• Treating babies with reflux and GORD
• Treating coughs. colds and sore throat in the breastfeeding mum (video)
• Turmeric supplements and breastfeeding
• Valproate and pregnancy

List of factsheets Breastfeeding and Medication

If you use them a lot maybe you need the books

One of the newer ways of treating depression is Mirtazapine. It is structurally dissimilar to SSRIs and tricyclic antidepressants. It produces fewer symptoms of sexual dysfunction that have been reported in SSRIs and is particularly useful if insomnia is present as part of the depression picture. We all know of those long nights as you struggle to sleep but your brain wont stop.

The literature on breastfeeding is poor with only 11 breastfeeding mothers in total studied but the poor oral bio-availability together with the studies is reassuring that little passes into milk but as with all centrally acting drugs we should be observing the baby for signs of increased drowsiness or poor feeding

Mirtazapine and breastfeeding factsheet

If you found this useful you might like to consider buying the book from which the information was taken. Please email me with any questions wendy@breastfeeding-and-medication.co.uk

It is funny how questions come in groups. At the moment many mothers are contacting me with questions about Rosacea particularly wanting to use Soolantra (Ivermectin cream).

This is the chapter from my book Breastfeeding and Chronic Medical Conditions which I hope helps.

The information on ivermectin cream is limited but Hale suggests a relative infant dose of 1.3 even after oral medication, so topical absorption is unlikely to affect a breastfed infant.

I have today (5th March 2021) reduced the price of the paperback and kindle version of Breastfeeding and Chronic Medical Conditions.

Please email me with any questions wendy@breastfeeding-and-medication.co.uk

Rosacea and breastfeeding factsheet

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. wendy@breastfeeding-and-medication.co.uk

Mirtazapine and breastfeeding factsheet