Many women have symptoms of depression before, during and after pregnancy, and selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa® ), fluoxetine (Prozac® ) and sertraline (Lustral® ) are often used to help treat these.
Any medication taken during pregnancy can potentially have effects on the baby – in this leaflet we will discuss the potential effect of SSRIs, and how we will help care for your baby.
As a mother, one of the most important things for your baby’s health and wellbeing is that you are healthy and in the best possible state of mind. We would not recommend that you stop taking antidepressant medication during or after pregnancy, unless advised otherwise by your doctor or midwife.
Will there be any effect on my baby during pregnancy?
There are a number of studies examining several thousand infants, suggesting that there is no increased risk of birth defects or malformations.
Will there be any effect on my baby after birth?
One study reported a slightly increased risk of a rare disorder called Persistent Pulmonary Hypertension of the Newborn (PPHN), a condition where blood flow through the heart is slow to adapt after birth. However, the risk still remains low at approximately 1 in 300 babies.
Some babies may experience some form of ‘withdrawal’ symptoms from SSRIs. These symptoms may include irritability, poor feeding, jitteriness/shaking and breathlessness. Symptoms can present at any time over the first week of life, but usually resolve within a few days and do not require any medical intervention.
Can I still breastfeed?
Your breast milk is the best source of nutrition for your baby. There are lifelong benefits for your baby and for you if you breastfeed. Most medications taken by mothers will pass into their breast milk in small quantities. For antidepressants, including SSRIs, the amounts that pass into the milk are very small, and there is no evidence that this has any effect on the baby.
We recommended that being on antidepressant medication should not affect your choice to breastfeed. Staff will help you to feel confident in feeding your baby whichever mode of feeding you choose.
What will happen to my baby after birth?
- As with all babies, your baby will have a full physical examination, carried out by a Paediatrician/Advanced Neonatal Nurse Practitioner (ANNP)/Midwife
- Your midwife and other staff on the postnatal ward will support you in feeding your baby, and make sure that your baby is feeding well before you go home
- The midwives and doctors looking after your baby will be aware of the possible effects of antidepressants, and will discuss any concerns with you
- Provided you and your baby are well, you will not normally need to stay in hospital for any longer because of antidepressant use in pregnancy
- If you have any concerns that your baby may be struggling to feed, or showing any other symptoms, you can discuss this with your midwife or health visitor at any time
What if I am taking other medications?
This leaflet is written for women taking SSRI antidepressants in pregnancy. If you are taking other antidepressants, or any other medications, please discuss this with your midwife or doctor who will be able to give further advice.
If you would like to discuss the contents of this leaflet, or have questions not answered here, please speak to your midwife or General Practitioner (GP), or one of the paediatricians on the postnatal ward.
Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.
In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics.
Further information is available via Gateshead Health NHS Foundation Trust website (https://www.qegateshead.nhs.uk/fairprocessing) or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email email@example.com.
This leaflet can be made available in other languages and formats upon request