Antidepressants delay breast milk production

Widely used antidepressants known as selective serotonin reuptake inhibitors (SSRIs) adversely affect lactation.

Serotonin is involved in regulating mood, and SSRIs are believed to treat depression by increasing serotonin availability in the brain. In breast tissue, serotonin appears to inhibit milk production; SSRIs, therefore, may extend the amount of time it takes for a new mother's breast milk to come in.

Researchers studied 431 American women who gave birth at a medical centre and found that seven of the eight women on SSRIs did not have their breast milk come in within the typical 72 hours of giving birth. On average, their full breast milk production was delayed by about a day compared with other mothers.

In a separate part of the study, the researchers also found that SSRI medication affected the functioning of human breast cells, and also altered breast milk production in lab mice.

After giving birth, women produce a precursor to breast milk called colostrum until their full breast milk comes in; if this shift does not happen within 72 hours, it is considered "delayed secretory activation." The issue of concern is that some infants may start to become dehydrated, and that some mothers, worried and frustrated, may give up on breastfeeding.

These findings should not prompt pregnant women on SSRIs to stop taking the drugs - which include medications like sertraline, paroxetine and fluoxetine. Future research needs to study larger population groups and effects of SSRIs on long-term breastfeeding.

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