When EM suffered post-partum depression and went on Prozac we stopped breast-feeding Emmett. We just felt like there wasn't enough information about how it would affect him.
There's new evidence now that taking ADs during pregnancy might be a problem. (Which, of course, is not the same thing as breastfeeding while on ADs, I realize, but I'd still be cautious.)
NYTimes article on ADs and pregnancy
Expectant mothers who took antidepressants like Prozac late in their pregnancy were significantly more likely to give birth to an infant with a rare but serious breathing problem, doctors are reporting today.
The lung disorder, called persistent pulmonary hypertension, strikes 1 to 2 newborns in 1,000, on average, and can be fatal. In babies exposed to antidepressants during the last few months of pregnancy, the study found, the rate was six times as high: 6 to 12 newborns in 1,000.
In a news conference yesterday, Dr. Sandra L. Kweder, an official at the Food and Drug Administration, which was not involved in the research, said that the study results were "very worrisome," and that the agency planned to search its own database of adverse events for further evidence of risk. She said the F.D.A. would consider whether to require manufacturers to make labeling changes and conduct postmarketing studies to clarify the risk.
The findings, published today in The New England Journal of Medicine, are the latest in a series of reports that highlight the tough choices that face millions of women with depression who are pregnant or plan to be. Untreated maternal depression can also harm a developing fetus, experts say, and last week researchers reported in a study that 68 percent of pregnant women who quit taking antidepressants relapsed, compared with 26 percent of those who stayed on the drugs.
But studies have found that up to one-third of babies exposed to antidepressants in the womb suffer temporary withdrawal symptoms like agitation. The F.D.A. has warned that one popular depression drug, Paxil, from GlaxoSmithKline, may increase the risk of rare heart problems in newborns exposed to the medication in utero.
The complete NEJM article is here.
It's worth noting that the increased risk was minimal during the first half of pregnancy - babies whose moms took SSRIs through the first 20 weeks got PPHN at about the same rate as those whose moms took other or no ADs at all.
Also, even with the comparatively gigantic jump in risk for those taking SSRIs from 20-40 weeks, the researchers conclude in the closing paragraph that:
the absolute risk among those who use SSRIs late in pregnancy is relatively low (about 6 to 12 per 1000 women); to put it in other terms, about 99 percent of women exposed to one of these medications late in pregnancy will deliver an infant unaffected by PPHN.
It's worth noting that the increased risk was minimal during the first half of pregnancy - babies whose moms took SSRIs through the first 20 weeks got PPHN at about the same rate as those whose moms took other or no ADs at all.
Thank you, JZ. It's *very* worth noting cause I was two breaths away from freaking the fuck out as I was on AD's for the first trimester with Em.
I should note that for BFing and potential BFing moms concerned about possible PPD treatment, there's a lot more information available now on medication effects and transfer rates than when Emmett was a baby, as well as a lot more treatment options, and most good doctors who know what they're doing will prescribe medication that's considered compatible with breastfeeding.
Take the two breaths and then take a third, with my compliments. Mwah!
Also, if Em had had the particular problem they're talking about in this article, it would've shown up within hours of her birth. At a year plus, she's ridiculously in the clear.
I'm still making pancakes, even with the scary pharmaceutical interaction talk.
Supper tonight at Gud's house!
Sorry, didn't mean to be alarmist.
I just know a lot of Buffistae are on ADs and folks should be conscious of the issues.
Happy Birthday, Suzi!
it basically consists of teaching wee groups of 1-4 kids from Grades 3-5 who need extra support with what they're doing in class. I think it should be pretty good, and I'll have my own classroom and computer, which is nice too.
This sounds like a good thing. Congratulations, Fay!
Cash, I hope the babies start sleeping at the same time occasionally for you.
--
Stepmom called and my cousin passed away last night. She was at home, which she wanted.
I didn't get to see her because frankly her actual parents are jackasses. But mom did get to and, since she is the person who has taken care of Brookie and taken her to every doctor appointment for the last several years, that means a lot more to me.
I came to terms with the fact that I might not get a chance to see her when I was out of town.
The fact that I was back and wanted to go directly from the airport Tuesday evening? And there was a request for no visitors for a few days? Well it strikes me as deeply deeply shitty but entirely unsurprising.
Also I am not supposed to mention anything about Brooke's passing to my neicelet. This is subject #1087 that I am not supposed to mention to her.
I am still completely reeling from my s-i-l telling us the day before my grandma died that my neicelet was being sent off to an all-girl's boarding school in Vermont the next morning. You know, I have always told her that I would never lie to her. I think I am reduced to sending notes that are just blank.
lots of apartment ~ma your way first thing tomorrow morning. I'd send it now but it'd just get there early and then wander around and get lost.
I'll take some of that too. My family is rapidly splitting itself into Those I Will Miss Terribly and Those I Should Not Wish Horrible Things Upon (But Kinda Think About Anyway) and I want to be somewhere else.
Huh. That got a LOT ventier than I intended.
