The risk of delayed lactation after giving birth was twice as great among
women in the study taking selective serotonin reuptake inhibitor (SSRI)
antidepressants as among new mothers who did not take the drugs.
Just eight, or about 2%, of the 431 study participants were taking the
antidepressants, however, so the findings are far from conclusive.
But the study is the first to explore the impact of antidepressant use on
lactation in humans.
"Delayed lactation is very common in the United States, but we don't really
understand the reasons for it," researcher Nelson D. Horseman, PhD, of the
University of Cincinnati College of Medicine tells WebMD. "This may end up
being one of the few concrete explanations for at least some of the delayed
lactation we see."
In an effort to answer the question, Nelson and colleagues followed 431
first-time mothers from childbirth through the first days of motherhood.
For the purposes of the study, the researchers considered breastfeeding
delayed when a woman did not have copious milk production within three days, or
72 hours, of giving birth.
All the women in the study were eventually able to breastfeed, whether they
were taking antidepressants or not.
But the average time to lactation for the eight women taking SSRIs was
almost 86 hours after childbirth, which was almost a day later than the average
time it took women who did not take the antidepressants to establish a milk
Lactation specialist Laurie Nommsen-Rivers, PhD, tells WebMD that this extra
day can be the difference between success or failure for women anxious to
provide their babies nutrition.
A co-author of the study, Nommsen-Rivers is also an epidemiologist with
Cincinnati Children's Hospital Medical Center. "That delay can be the point
where many women throwing in the towel and decide they can't breastfeed," she
says. "It is important to point out that all the women in our study eventually
lactated. SSRI use doesn't prevent women from breastfeeding, but it might take
SSRI users a little longer."
Support for New Moms
Nommsen-Rivers says that while all new moms should have access to
breastfeeding support, such support may be especially important for new moms
who take antidepressants.
The study appears in the February issue of the Journal of Clinical
Endocrinology and Metabolism.
"These women need to know that delay doesn't mean it isn't going to happen,"
Texas Tech University Medical School health psychologist and lactation
consultant Kathleen Kendall-Tackett, PhD, points to numerous studies that have
explored the impact of SSRIs on babies born to women who use them.
"To my knowledge this lactation delay has not been documented before," she
tells WebMD. "I would guess that if this is happening, it is rare."
She points out that pregnant women are at the highest risk for depression in
their last trimester and in the early weeks after giving birth.
While she feels too many women may be taking antidepressants when other
treatments might work for them, Kendall-Tackett also warns that moms-to-be and
new moms should never stop taking SSRIs or any other prescribed antidepressant
without their doctor's approval.
"Generally speaking, if a woman is on an antidepressant during the last
trimester of pregnancy she probably needs to stay on it, and she should never
go off it on her own," she says.