New mothers who take common antidepressant drugs may not just be suppressing depression. They also may be suppressing their milk production in the early postpartum period, according to a new study.Published in the February issue of the Journal of Clinical Endocrinology & Metabolism, the study found that new mothers taking certain antidepressants may experience a condition called “delayed secretory activation,” or a delay in the initiation of complete milk secretion.
The condition can be promoted by antidepressants in the category called selective serotonin reuptake inhibitors or SSRIs, which include medications like citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft), the study found.
Among the most commonly prescribed psychiatric medications in the United States, SSRIs work by inhibiting reuptake of the neurotransmitter serotonin, thereby increasing the amount that is available to bind to nerve cells. Increased availability of serotonin has a mood-altering effect. But the breasts are serotonin-regulated glands, and activation of milk secretion is closely related to the regulation of serotonin.
In the study, which included Caroline Chantry, an associate professor of pediatrics and an expert on breastfeeding, 431 postpartum women who gave birth at UC Davis Medical Center were followed closely after delivery to monitor early lactation success. The mothers who were not taking antidepressants began lactation 2.9 days after delivery. The mothers who took SSRIs began lactating 3.6 days after delivery on average. Delayed secretory activation is defined as beginning lactation more than three days postpartum. The authors caution that more studies are needed before drawing definite conclusions because relatively few women in the study were taking antidepressants.
Chantry, a former president of the Academy of Breastfeeding Medicine, an international multidisciplinary organization of physicians, said there are a host of reasons to ensure that mothers have the best chance of successfully breastfeeding their babies.
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