Zoloft and Breast Feeding

Is it safe to take Zoloft while breast-feeding?

Zoloft and Breast Feeding

Dr. Greene’s Answer:

I believe that sertraline (Zoloft) in the breast milk is safer for the baby than either the mother’s depression or her stopping nursing.

In some earlier studies, Zoloft could not even be found in breast milk (Am J Psychiatry 1996 Sep;153(9):1132-7). We now know that the drug is present in tiny amounts. The highest concentrations are found in hindmilk (the high-fat milk that follows the initial foremilk, which contains more water) 7-10 hours after taking the tablet (Am J Psychiatry 1997 Sep;154(9):1255-60; J of Clin Psychiatry 2003 Jan;64(1):73-80). The lowest amounts are found in the hour prior to taking the Zoloft, which is usually a once-a-day medication. Overall, nursing infants receive less than 0.3 percent of mom’s dose, even after adjusting for their weight (Br J Clin Pharmacol 1998 May;45(5):453-7).

No adverse events have been reported in babies exposed to Zoloft by breastfeeding. Where studied, developmental milestones have proceeded on course despite the fact that one baby was reported to have blood concentrations of Zoloft at half its mother’s levels (Am J Psychiatry 1998 May;155(5):690-2).

If you are taking sertraline (Zoloft) and are not nursing often, the best time to nurse is during the hour before taking the pill. If you do need to nurse at the peak period of concentration, nursing for a brief period, and discarding the hindmilk, can also reduce the amount of drug the baby receives. Hindmilk is especially rich in nutrients, so it should not be discarded at other times of the day unless there are other sources of nutrition.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Maria

    You are going through such a hard time right now, and only you can get yorlseuf through it, but hopefully it helps in some way to know that so many people understand what you’re going through, so while you must get yorlseuf through it, you are in no way alone. I’ve definitely dealt with intense anxiety attacks, and I personally know several other beautiful souls who have worked through life with them as well. I only started reading your blog a few days ago, but I have been enchanted and inspired by your words, your vision of life… I thik certain people are so open and giving that it leaves them feeling very vulnerable to all sorts of things… you want to be open to all that’s beautiful in the world, and that also leaves you open to dangers named and unnamed… everything in the world that feels so so beautiful makes the scary things feel very very scary. I understand your feelings of conflict over taking medication… I have been there. But it is nothing to be ashamed of! I have taken Xanax on and off over the years, and have never felt addicted. I always loathe to take it, because it feels as though it takes me away from the world in some way, which I so long to be part of. I think some people ENJOY that feeling of everything going away, and that same effect is what can help you through this rough time; but I believe your obvious deep desire to be a part of this world and all its beauty will keep you from becoming addicted to the feeling that Xanax creates. Though I have never met you, my very best thoughts are with you, and I know you can get through this. <3"Joy and sorrow are inseparable.Together they come, and when one sits alone with you at your board, remember that the other is asleep upon your bed." (Kahlil Gibran)

  2. Andrew

    What every breastfeeding mother really needs is a balanced diet, say doctors at Rainbow Hospital, the best hospital for women and children. Your diet needs to incorporate all your food groups – carbohydrates, protein,vitamins, minerals, and fats.


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