This is post #2 in my Mental Health and Breastfeeding series. The other posts can be found here, here and here.
In her article Does breastfeeding really protect against postpartum depression? Lauren Hale from the Atlanta Northside New Moms Examiner discusses one study’s findings that postpartum depression is the result of biochemical hormonal changes in the postpartum period.
She also discusses that although breastfeeding is touted as a way to cope with PPD, for some women, breastfeeding can cause more anxiety and stress, thus compounding their mood disorder symptoms. Moreover, some doctors won’t prescribe antidepressants when a mother is nursing, which is one reason why some moms with PPD wean.
Dr. Hale’s book Medications and Mother’s Milk and his website provide information about all drugs and their compatibility during pregnancy and breastfeeding. I personally think all physicians need to have a copy of this book in their offices so they can properly support breastfeeding mothers.
Kellymom has a nice run-down of all of the anti-depressants Dr. Hale’s recommends as to their suitability for pregnancy or breastfeeding. According to the website, Dr. Hale’s anti-depressant of choice hierarchy is as follows: Zoloft, Paxil, Celexa, Effexor, Prozac. Click on the Kellymom link provided to read about the pros and cons of each drug. However, you don’t have to go far to find contradictions to Dr. Hale’s findings. For instance, although the Kellymom site shows that Prozac is the only anti-depressant cleared for safety during pregnancy, and that the breastfeeding mom would be advised to switch drugs before birth or immediately after, it does not actually say that the drug isn’t safe for breastfeeding. However, in a 2002 Mothering Magazine article titled “But Is It Safe For My Baby? Medications and Breastfeeding,” Dr. Hale wrote that Prozac had been shown to induce coma in breastfed infants [Source]. So how safe is it?
Contradictory “findings” are everywhere. No wonder so many Americans are up in arms over The Melanie Blocker Stokes MOTHERS Act. Some bloggers argue that it is meant to educate and empower women and should be supported, while others say it’s nothing more than “disease mongering” – pharmaceutical companies finding a new way to profit from a vulnerable sub-group of women – new mothers (and their dependent infants) and that if it goes through more new mothers will be taking drugs than ever before, possibly risking the health of their babies if they continue to breastfeed, and of course, possibly risking the health of their babies and those horrible feelings of guilt for not breastfeeding if they choose (or are forced by their doctor) to stop.
Christian Delahunty is vehemently against The MOTHERS Act. Even though Dr. Hale says “Effexor is the preferred SNRI for nursing mothers, [and] there have been no adverse effects reported” [Source], she blames Effexor for the September 2008 death of her six week old daughter, Indiana. She says her family doctor told her that Effexor is safe to take during pregnancy and breastfeeding; however, the doctor in the delivery room told her that “It’s not good for the baby and it needed to be stopped in the first trimester.” Her baby was born two months early, didn’t cry, had difficulties breathing, a low APGAR score and extreme difficulty breastfeeding. Six weeks later baby Indiana died. To read the whole story go here.
So if The MOTHERS Act is passed does this mean more doctors will start prescribing anti-depressants willy-nilly putting all mothers and their unborn babies at risk? I hope not. But silly me, I expect doctors to do their research before they prescribe anything! I also expect that doctors will put their patients before drug companies and formula companies and just do what’s right instead of what will put more money in their pockets. Don’t people become doctors because they really want to help people? Or am I that naïve?
Certainly there are no simple answers. It is very important to discuss medication options with your family physician. But if your physician isn’t up to date on the latest research or won’t take the time to weigh the risks of your desire to continue breastfeeding with the side effect risks of an anti-depressant, then I think it is important for you to do some research of your own. Then show your research to your doctor and discuss it. Get a new doctor if you have to. It’s your body and your baby. In fact, I urge all nursing mothers to always do at least some research of their own before filling any prescription. Whether for myself or my children, I always take my prescription home and google it before I fill it. I know this isn’t always easy, especially if you’re depressed and overwhelmed and the last thing you want to do is research, but unfortunately medication contradictions are everywhere and doctors don’t know everything.
Related posts:
- Bravado Breastfeeding Information Council ~ A Survey for All Moms
- I Lied to My Shrink, and Other Hazards of Breastfeeding
- Breastfeeding? Scheduled for a biopsy? Read this and pass it on!
- Links To Some Great Breastfeeding Posts
- Breastfeeding Moms Don’t Have To Introduce Cow’s Milk
Tags: anti-depressants, breastmilk, Celexa, Dr. Hale, Effexor, Kellymom, Medications and Mother's Milk, Mothering Magazine, Paxil, PPD, Prozac, The MOTHERS Act, Zoloft
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[...] This is Post #1 in my mental health and breastfeeding series. To read post #2: How Contradictory Medication Information and Advice Wrecks Breastfeeding and Moms go here. [...]
Hmm…I read the link to the description of the Act that you provided. I don’t see anything really wrong with it, and it seems well motivated. The Act doesn’t refer to pharmaceutical interventions particularly. I think more research does need to be done into PPD.
Women used to have their families usually in the same town where they themselves grew up. There was thus a familial support structure in place that was important during times of stress caused by life changes like the arrival of new babies. I can see the benefits of this kind of support structure in my family that lives in Ontario; they all live close to each other, and support each other in so many ways. I have been many times envious of the tight knit support structure they enjoy, because there are times in my life when it really could have benefited me to have something like that, especially after my second daughter was born when I became severely depressed.
I think the issue of PPD is becoming more prevalent in our society not because drug companies are pushing it as a means to make money, but in large part because most women today do not have their families in the same town they grew up. Families, and extended families, are also becoming smaller. Familial daily support structure is thus no longer the norm, and if women have the baby blues, it cannot help that they (and their spouse) basically have to go it alone in handling it. Additionally many women these days also work outside the home, and there are a lot of stressors associated with that that can push women with baby blues into full blown depression.
This of course doesn’t mean that women who live in the same town as their family, and who don’t work outside the home can’t get PPD, and/or that all women who work and who don’t live close to family do get PPD. I just think the latter situation is probably more prone to it, and that’s why we are seeing it become more prevalent in society.
I am so glad you are writing this series about PPD. Excellent postings, and an issue that well deserves the attention you are giving it.
To say that there have been “no adverse events reported” for Effexor is ridiculous, misleading and false. Not to mention dangerous. While I think it’s good to refer people to the story about baby Indi’s death, the article clearly outlines numerous adverse events that have been reported. Your referral of people to sources like Thomas Hale and the associated content article completely misses the fact that the top researchers into antidepressants and breastfeeding have been found to be completely corrupt and are under Senate investigation. Here are a few links where you can read the adverse event reports to the FDA for yourself, info on the corrupt researchers, etc.:
http://www.cchrint.org/psychdr.....rsAct.html
http://momsandmeds.wordpress.com/
http://momsandmeds.wordpress.c.....kexposure/
Effexor is far more toxic than an SSRI. The LactMed database that some people continue to refer to is not the FDA MedWatch database. Nor is it likely to collect adverse reports since the majority of gung ho breastfeeding activists like to pretend that antidepressants are benign and tell women that it could not possibly be the antidepressants causing their child problems.
@Sherry – You are so right that family support (or a close knit group of friends) plays a crucial role in the health and well being of a new mom. If our society was better equipped and more accepting of mental health issues I think we’d see a lot more help coming from alternative avenues and doctors wouldn’t be so ready to push anti-depressants on patients because there would just be so many more resources available.
As far as The MOTHERS Act goes, of course this is American legislation and as a Canadian living in Canada the Act only recently came to my attention and I certainly have not given it the time it deserves to be combed over and dissected. Basically I wanted to share that this Act is out there (getting figured out by the American powers that be) and that there are people loudly making their opinions known – for both sides of course as is always the case.
I know I did not do the Pros and Cons of the Act justice. But I found a lot more information on websites “dissing” the Act than supporting it.
The main thing I want to emphasize that you said is “I think more research does need to be done into PPD.” ABSOLUTELY! And maybe *that* is the main problem right there!
Melodie´s last blog ..How Contradictory Medication Information and Advice Wrecks Breastfeeding and Moms
@AMy – The point of this post is to show people how contradictory the “evidence” is. I think it is ridiculous too as it shows how someone who is held in high esteem by the breastfeeding community is just as easily prone to reporting contradictions and/or not being completely informed about this issue as anyone else.
I appreciate your links and hope people will read them. Education from all sides is so important to making an informed choice.
As for your claim that “the majority of gung ho breastfeeding activists like to pretend that antidepressants are benign and tell women that it could not possibly be the antidepressants causing their child problems,” I think that is unfair. I know a lot of breastfeeding mothers and the ones I know *personally* (in real life, not on-line) who have struggled with PPD, meds and breastfeeding, were accutely sensitive to watching for side effects on their baby. Most moms I know who’ve taken anti-depressants refused to take them until they realized they just couldn’t deal with their symptoms any other way. There was guilt, there was second-guessing, there was wondering if weaning would be better or if it *would* all be okay in the end. Some of them got support from their doctor, others didn’t. Everyone is different but a woman’s sensitivity to her child, especially a well educated and informed breastfeeding mother is so obvious that I think it is ridiculous to assert otherwise. But I guess you have your personal experiences too. That’s where all of our personal values stem from isn’t it?
I had a pretty severe case of PPA (Post Partum Anxiety) when my third son was born. It is so tough to navigate mental illness, medications, treatments, counsellors, resources, and social support systems with a new baby. You want to be thoughtful and research everything and shop around, but the thought of the energy involved is overwhelming. The thought of a shower was sometimes overwhelming, let alone researching medications on my own. Thus, it would be nice to be able to trust one’s doctor when it comes to treatment of mental illness when breastfeeding (extended breastfeeding was always nonnegotiable for me). But in our current system most doctors I know are overtaxed for time and energy, and rely on drug companies to educate and inform them of the latest drugs and treatments, which is a frightening amount of trust to place in a mercenary organization(s)!!
All of the women I met with PPD or PPD/A (I’m the only one I’ve met so far who had only PPA) quit nursing within a few months, either from lack of support or because of medications they were on. I think it is tragic that the breastfeeding relationship is only deemed valuable and supportable in a healthy individual for whom it comes easy for many in the medical profession and society at large. Those of us with mental illnesses should still be encouraged and supported to breastfeed, even if it is more difficult and takes some ingenuity!
I’m grateful there are resources out there like this website and Medications and Mother’s Milk, and Jack Newman’s website to help us navigate the difficult choices involved!!! Thanks so much for posting about this sensitive and very important issue.
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Well I certainly hope that you are naïve. Because to start there is no objective lab test for PPD. It is a crime and an act of insensibility to turn a natural process of giving birth into a disease. Psychiatrist take natural processes that are difficult for a woman like the hormonal changes, and fabricate an illness. Whoever says she has suffered or is suffering from PPD has a right to believe it but that does not make it real. It’s not what one believes it’s what one can prove. There are no lab tests that support this hoax. And you build a blog based on a fraud. Well I don know if you are naïve or if you are being paid to be naïve.
These are the most barbaric times in human history. Antidepressants have no better theraupeutic benefits than a sugar pill. That has been well documented by Dr. Irving Kirsch. There is no lab test to prove depression is a patholgy stemming from an organic ethiology.There is only proof that psych drugs cause calamity for the victims of this well marketed scam and lots of money for the unholy drug cartels and there drug pushers. It’s sad that we have to debate with people that are suppose to protect babies and are committed to extend the benefits of breastfeeding yet with there confusion about the antidepressant hoax are mixing heaven with hell. Being naïve does not exempt a person of causing damage. And promoting antidepressants which represents an obscene lucrative hoax for pregnant and breastfeeding mother’s is as bad as it can get. Or can it get worse? DC:0-3.
My wife breastfed our children. It is a labour of love. Being pregnant and having a baby is not easy yet rewarding. My love and admiration grew inmensely during that period. Also my admiration and respect to womanhood. I gave her all the support she needed. I took good care of her. We improved food quality and she took vitamins. Under your pro psychiatric intoxication narrative it would be better breastfeeding moms did not unite.
I appreciate your contribution to my post. I’m not sure if you picked up on it or if your own agenda overrode your ability to read it clearly but the purpose of the post was to show mothers that there are two sides to this story. I am not pushing drugs on anyone. lt is my way to take the middle road and let women think for themselves. I am showing women that they need to do their own research and bring light to the fact that while we hope our doctors know what they are doing, Christian Delahunty’s story is an extremely sad piece of evidence that reveals they don’t. Many women would argue your belief that true PPD doesn’t exist. It is the very change in the brain’s chemistry that does effect the diagnosis of a mental health disorder. I will look at Dr. Kirsch’s studies, but I can tell you right now that just because he has found some evidence doesn’t mean it’s proven. Many doctors of many disciplines have found evidence to things that cannot be scientifically proven. Including our very own Dr. Hale! The heap of contradictory evidence on psychiatric drugs and their safety during breastfeeding is just a wake up call for people who aren’t already aware. Your point of view is important too though, so thanks for your time. Breastfeeding Moms Unite is about supporting all moms in their breastfeeding choices, and if you read the article again I hope you see that.
Tom Cruise, is that you?
I was lucky enough to dodge anything worse than the normal “overwhelmed new mother going through breastfeeding struggles blues”, but a friend is currently going through the exact problems you outline in your post. The worst symptom of her PPD is insomnia – she CAN’T sleep when the baby sleeps. Or at all. Although her doctor prescribed Zoloft for depression, he told her point blank she had to choose between a prescription sleeping pill and nursing. Our lactation consultant suggested getting a second opinion but my friend is afraid no matter where she goes they’ll refuse because of conflicting information, even though she carries a copy of Dr. Hale’s book around with her. It’s terrible to have to ask a new mom to choose between nursing and her sanity, especially when she’s already overwhelmed.
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Ha! Suzanne – I thought the same thing about Tom Cruise.
Great article – I have never suffered from severe PPD but I did have an extremely hard time nursing my two kids, which I ended up being very successful at and staying with for a year. I could not have stuck with it without great support from my family and my doctors. All women should have this support.
Brittany at Mommy Words´s last blog ..DIY Craftsman Porch Storage Bench
See, the Effexor endorsement from Hale is exactly why I don’t trust any doctor who’d recommend a pharmaceutical to me before any other possible solution. I learned more about post-partum mood disorders from the freaking chick at Whole Foods than I did from my doctors when they were prescribing me the Zoloft. And I *KNOW* that it caused my son’s weight gain issues (which nobody mentioned could happen, and was something they tried to get me to formula feed over, but I did my research and simply removed the source of the problem rather than continuing the problem and introducing formula as a Band-Aid.)
I don’t think we should be ignoring Perinatal mood problems, but I hope that mothers can learn about other options outside of mainstream drugs. Studies have shown that the placenta sucks all the DHA out of a mother’s brain toward the end of pregnancy, and the lack of DHA in a mother can cause post-partum depression. http://www.medscape.com/viewarticle/431587 That’s why I started taking a Fish Oil supplement. I can’t tell yet if it has cured me, but I do feel a little better. Could be a placebo effect, I don’t know, but either way I’m not anxious about what’s going into my brain or bloodstream as long as I’m taking non-pharmaceutical alternatives.
All around, perinatal mental health needs to be more thoroughly researched, and mothers suffering NEED support and options for treatment.
TheFeministBreeder´s last blog ..An Alternative Feminist Perspective on the Twilight Saga
@The FeministBreeder – That makes so much sense! I was just saying over at my other post that I have advocated for clients to their psychiatrist for them to try nutritional supplements but it is always met with a resounding “no!” and I have never understood why. I think many psychiatrists just don’t have the info on food and nutrition and how it works in the body to be comfortable recommending it. Their world is one of meds meds and more meds. They go to conferences about the latest meds and take part in research studies on the latest meds, but to actually go out of their way to learn about food and vitamins? I guess they see it as a waste of their time. So sad really. Dr. Hoffman of Victoria, BC, who just died of very old age a few years ago was a world renowned psychiatrist who treated schizophrenia with mega-vitamin therapy. It didn’t work for all but worked for some. His research was extensive and my clients often knew more about it than their psychiatrist. They’d go with their family members with hope in their eyes only to be told it was junk science and not supported. If the clients got released from care sometimes they told me they would try it on their own. I don’t know what the results were because they were off my radar at that point too. But I think if it’s safe and a food source, what could possibly be wrong about it? (Now I’m talking oils not Mega vitamins).
One of my doula friends just became a Placenta Encapsulation Specialist, because ingesting the placenta can help prevent or drastically reduce post-partum depression, AND boost milk supply. This sounds like a subject for BreastfeedingMomsUnite to explore! *wink*
http://www.placentabenefits.info/
TheFeministBreeder´s last blog ..Bed-sharing for Just the Children?
Yeah, Tom Cruise! I guess he’s entitled to his opinions, eh? I know my PPA was very freaking real to me. What’s a man doing spouting off about womens’ issues anyways? More listening, less talk, dude.
I’m also of the more natural bent, and I consulted a naturopath for some supplements to take for PPA (and SAD which I also have…well, my PPA has resolved now, so I guess I should omit the ‘also’). Good quality fish oils was on the top of her list, as well as Vitamin D, simple B vitamin, and a prenatal multi. For SAD I add St John’s Wort and an adreanal support with a huge long name I can’t remember off the top of my head. I’m aware that the affect may have a placebo component, but I have to tell you that if I forget one or more dosages, it takes me days to recover. It works wonders for me. Like, I feel like I’ve finally found something that can help me feel normal and stable enough to have the energy to expend to stay on top of my moods and my thought patterns enough to be happy. The supplements don’t make me happy, they make me stable, so that I can do the mental work it takes to be happy and peaceful.
And peace, my friends, is priceless. Especially for an anxiety sufferer.
(I had also heard of Placenta Encapsulation; sounds equal parts fascinating and gross!)
Melissa´s last blog ..Some Riley photogs
One of my doula friends just became a Placenta Encapsulation Specialist, because ingesting the placenta can help prevent or drastically reduce post-partum depression, AND boost milk supply. This sounds like a subject for BreastfeedingMomsUnite to explore! *wink*
one of the women on our forum did this!!!!
visit naturalparents.co uk for more info
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