Is It Safe to Take Zoloft (Sertraline) When Breastfeeding?

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A baby’s birth opens the horizons for overwhelming responsibilities such as taking care of and feeding a newborn. However, the stress of it all could lead to mental health issues in new moms. In such scenarios, some women may resort to medications such as Zoloft while breastfeeding to help deal with their condition.

Zoloft is an anti-depression drug known for treating mental health conditions such as anxiety and depression. When taken in a prescribed manner, this medication helps control depressive symptoms and mood disorders and aids in returning to one’s everyday lifestyle. However, not all drugs are safe to use without consulting a doctor when breastfeeding.

If you have concerns about using Zoloft, read on to understand the safety concerns and other details regarding consuming this medication while breastfeeding.

What Is Zoloft (Sertraline)?

Zoloft (Sertraline) falls under the group of Selective Serotonin Reuptake Inhibitors (SSRIs), which are medications used to treat depression. The medication controls serotonin levels in the brain. The antidepressant regulates the chemical balance to keep you calm and composed.

The prescribed medication, Zoloft, treats numerous mental disorders such as:

  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Premenstrual dysphoric disorder (PMDD)

The drug helps in improving the mood, appetite, sleep, and energy levels. All these helps rekindle your interest in other daily activities. The medication effectively treats unwanted thoughts, negative feelings, and fear.

Is Zoloft Safe While Breastfeeding?

Yes, most medical practitioners prescribe Zoloft while nursing as it is a safe antidepressant medication. The active ingredient of the effective antidepressant, Sertraline is usually low in the breast milk compared to other SSRIs and antidepressants. Thus, the ingested amount by the baby is very low and is often not detectable in infant serum.

When the nursing mother consumes the drug, Sertraline is metabolized to norsertraline (demethylsertraline). Norsertraline has about 10% antidepressant activity than that of sertraline. The weakly active metabolite norsertraline can be detected in the infant’s serum in low levels.

According to a research study, Zoloft was found to have low and significant transfer rate into breast milk (1). About 0.5% of the average or standard weight-adjusted dose of the drug was found in the breast milk. In a study conducted on 11 mother’s on Zoloft, no drug traces were detected in the milk of seven mothers, while it was minimal in others. Infant’s serum showed no detectable traces of the drug. In two other studies, Zoloft was not detected in the plasma of the infants.

Rarely, the drug gets accumulated in preterm infants with impaired metabolic activity, demonstrating symptoms similar to neonatal abstinence.

Zoloft Implications While Nursing

Some side effects are associated with Zoloft while taking the medication or when stopping it. A study showed the delay in the onset of lactation when mothers use the drug. This could delay breastfeeding in infants. Automatically, the baby’s weight would reduce, thus resulting in the mother’s depression. Once lactation is established, Zoloft may not affect a mother’s ability to nurse.

However, there are no long-term negative effects of the drug concerned with breastfeeding infants. Consult your doctor immediately in case of any adverse effects. Alternatives for Zoloft when breastfeeding include Nortiyptyline or Paroxetine.

A study was done to test how Zoloft and milk supply works. There was a decrease in the milk supply in six patients who were on sertraline. One mother reported an increase in the milk supply after stopping sertraline for a week at four months postpartum. She was on the drug since the sixth month of pregnancy (2). If you observe any decrease in the breastmilk supply, visit your doctor immediately.

Effects In Nursing Infants

Most studies reveal that nursing babies show no adverse effects when the mother is on Zoloft (3).

  • Two side effects, possibly because of the drug, were reported to the Australian Adverse Drug Reaction Advisory Committee. They are benign neonatal sleep myoclonus in a four-month-old and agitation in another infant.
  • An uncontrolled online survey on 930 nursing mothers on the antidepressant, revealed that 10% nursing infants exhibit drug discontinuation symptoms like low body temperature, irritability, uncontrollable crying, eating and sleeping disorders (4). It was more evident in babies of mothers who took antidepressants only during breastfeeding, compared to the mothers who took the drug in pregnancy and lactation.
  • Some studies say that antidepressant medications taken during pregnancy could lead to autism spectrum disorders in children. It is an indication that the prenatal exposure to antidepressants is linked to greater risk of autism (5).

Best Time To Nurse If Mother Is On Zoloft

It is best to nurse an hour before taking the pill. If your little one sleeps all night, feed her before bedtime and put her to sleep. As per a survey, in the 1997 American Journal of Psychiatry, Zoloft would be at its peak in the mother’s milk at seven to ten hours after ingestion.

Other Ways To Manage Postnatal Depression

Relying on drugs like Zoloft to deal with postpartum depression is not the solution. Adopt more natural ways to deal with it.

Seek help: Do not hesitate to ask for help from people around you to take care of your baby. Have an open communication to resolve the problems. Opt for self-help, talking therapies, cognitive behavioral therapy, interpersonal therapy and others.

Workout: Regular exercise would help to relieve the depression. Take an expert advice on what exercises you can use. You can make out the difference!

Food: Check for nutrient deficiencies in diet. Nutrients like Omega-3 fatty acid and Vitamin B are essential for health. Check out for iron deficiency as well. Healthy, nutritious food is a pathway for good physical and mental health.

Since Zoloft may not pass on to the baby through breast milk, doctors may recommend Zoloft while breastfeeding. However, Zoloft may result in decreased milk production in some mothers. Hence, if you notice that your milk supply has reduced after the intake of this medication, consult your doctor. They might suggest alternative medicines or other non-invasive techniques, such as a few changes in the lifestyle. You may also seek the combined help of a doctor and lactation consultant to know the suitable time for taking the pill such that it may not impact your feeding and milk supply.

Infographic: How Yoga And Meditation Reduce Medication Needs For Postpartum Depression

Scientific studies have found Yoga and mindfulness practices effective in reducing postpartum depression. However, that does not mean that you may do away with the medications prescribed to you for depression. These practices act as an adjunct therapy to support the medications and help you get the maximum benefit from a particular dosage. The infographic below presents various ways to achieve the same.

combating postpartum depression [infographic]
Illustration: MomJunction Design Team

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Jan Øystein Berle and Olav Spigset; (2011); Antidepressant Use During Breastfeeding.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267169/
  2. Emily Pinheiro et al.; (2016); Sertraline and Breastfeeding: Review and Meta-Analysis.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366287/
  3. Sertraline (Zoloft®).
    https://mothertobaby.org/fact-sheets/sertraline-zoloft-pregnancy/
  4. Thomas W Hale et al.; (2010); Discontinuation syndrome in newborns whose mothers took antidepressants while pregnant or breastfeeding.
    https://pubmed.ncbi.nlm.nih.gov/20807106/
  5. Prenatal Exposure to Antidepressants and Risk of Autism.
    https://womensmentalhealth.org/posts/prenatal-exposure-to-antidepressants-and-risk-of-autism/
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Shivali Karande

Shivali holds a bachelor’s degree in pharmacy and a master’s in management from Chetana's R.K Institute of Management and Research Mumbai. After working for nearly five years in the market research sector, she discovered her passion for writing and started freelancing. Her knowledge about medicines and biology, coupled with her experience in research, helps her write well-researched, informative, and evidence-based... more

Dr. Priya Shashank

(IBCLC, BAMS, MHA, IYCF, CCE )
Dr. Priya Shashank is a lactation consultant and childbirth educator, striving to bring about a change in the way childbirth and breastfeeding are perceived in India. She works with expecting couples to educate them about childbirth and the initial days with the baby, and helps new moms and babies settle down into breastfeeding routine comfortably. Working from Ludhiana in Punjab,... more

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