Does Zoloft pass into breast milk? (3+ precautions)

In this article, we will answer the query: “Does Zoloft pass into breast milk?” Further, we will talk about what the research suggests, the factors that may affect the transfer of Zoloft into breast milk, and the safety guidelines for nursing mothers on Zoloft. 

Does Zoloft pass into breast milk?

Yes, Zoloft does pass into breast milk when mothers take Zoloft and breastfeed their infants. However, only a small amount of the medication may pass into breast milk. This small amount of Zoloft may not cause any problems in the newborn (6). 

What does research suggest?

In a reported case study, a nursing mother on Zoloft was examined, and the levels of Zoloft were checked in her breast milk. Additionally, blood tests were conducted for both the mother and the baby.

Zoloft levels were checked in the mother’s breast milk throughout the day. It was found that the medication was in the lowest amount just before she took it, and levels rose a few hours after taking the medicine. However, Zoloft levels were undetectable in the baby’s blood. 

This study suggested that even though the amount of Zoloft was changing in breastmilk, it appeared to be very low and didn’t show up in the baby’s blood. Therefore, the baby didn’t have any problems, and they continued to breastfeed (1,2). 

Several research studies have been conducted, and all of them have not shown any problem in breastfed newborns (3,4,5). 

What factors affect the transfer of Zoloft into breast milk?

Some factors may influence the amount of Zoloft that passes into breast milk of a nursing mother, including:

Dosage: If you have taken a higher dose of Zoloft, it is more likely to pass into breast milk. Your doctor may reduce the dose to lower the chances of Zoloft passing into the baby through breast milk. 

Dosage schedule: You may take Zoloft after you have finished breastfeeding your newborn, this may help to reduce the baby’s exposure to Zoloft. 

Drug metabolism: Variations in an individual’s metabolism may also affect the presence of Zoloft in the breast milk of nursing mothers. 

Why nursing mothers are prescribed Zoloft?

New mothers often experience postpartum depression, and healthcare providers frequently prescribe Zoloft, an antidepressant, to treat this condition.

Zoloft is a selective serotonin reuptake inhibitor (SSRI) used for the treatment of various mental health disorders, including major depressive disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and panic disorder. 

While Zoloft is unlikely to harm newborns, some mothers choose not to take it while breastfeeding to avoid any potential risk to their babies. It is important to weigh the risks of untreated depression against not breastfeeding the newborn.

Breastfeeding has many health benefits for both the mother and the baby. It provides the best nutrition for babies and protects them from certain illnesses. Additionally, babies who are breastfed have a lower risk of obesity, and breastfeeding reduces the risk of breast and ovarian cancers, type 2 diabetes and hypertension in new mothers.

All these benefits must be considered before deciding not to breastfeed your child due to the risk of exposing the baby to antidepressant medication (5).  

What are the safety guidelines for breastfeeding mothers on Zoloft?

Following are the safety guidelines for breastfeeding mothers on Zoloft:

  • Take Zoloft exactly as prescribed by your doctor.
  • Before prescribing Zoloft, your doctor should evaluate your current symptoms, medical history, and your response to the medication. 
  • Be vigilant for any side effects such as nausea, vomiting, headaches, dizziness, fatigue, constipation, or diarrhoea.
  • If any of these side effects persist or become bothersome, please inform your doctor immediately.
  • Monitor your baby for any unusual behaviour, such as irritation, insufficient feeding patterns, and excessive sleepiness while you are taking Zoloft. 

Conclusion

Zoloft can be detected in breast milk when breastfeeding mothers take the medication, but the amount that passes into breast milk is very low and unlikely to cause any problems for the baby. 

It is important to consider that the decision to take Zoloft while breastfeeding should be made after weighing the risks and benefits. Postpartum depression is a common condition reported in new mothers, and Zoloft can effectively treat it. 

However, breastfeeding mothers taking Zoloft should vigilantly observe their baby for any unusual behaviours that may be side effects of the medication. If anything similar occurs, please consult your doctor immediately.

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References

1.-

Altshuler LL, Burt VK, McMullen M, Hendrick V. Breastfeeding and sertraline: a 24-hour analysis. J Clin Psychiatry. 1995 Jun;56(6):243-5. PMID: 7775366. Available from: https://pubmed.ncbi.nlm.nih.gov/7775366/ 

2.-

Stowe ZN, Owens MJ, Landry JC, Kilts CD, Ely T, Llewellyn A, Nemeroff CB. Sertraline and desmethylsertraline in human breast milk and nursing infants. Am J Psychiatry. 1997 Sep;154(9):1255-60. doi: 10.1176/ajp.154.9.1255. PMID: 9286185. Available from: https://pubmed.ncbi.nlm.nih.gov/9286185/ 

3.-

Stowe ZN, Hostetter AL, Owens MJ, Ritchie JC, Sternberg K, Cohen LS, Nemeroff CB. The pharmacokinetics of sertraline excretion into human breast milk: determinants of infant serum concentrations. J Clin Psychiatry. 2003 Jan;64(1):73-80. doi: 10.4088/jcp.v64n0114. PMID: 12590627. Available from: https://pubmed.ncbi.nlm.nih.gov/12590627/ 

4.-

Mammen OK, Perel JM, Rudolph G, Foglia JP, Wheeler SB. Sertraline and norsertraline levels in three breastfed infants. J Clin Psychiatry. 1997 Mar;58(3):100-3. doi: 10.4088/jcp.v58n0302. PMID: 9108810. Avaiable from: https://pubmed.ncbi.nlm.nih.gov/9108810/ 

5.-

Pinheiro E, Bogen DL, Hoxha D, Ciolino JD, Wisner KL. Sertraline and breastfeeding: review and meta-analysis. Arch Womens Ment Health. 2015 Apr;18(2):139-146. doi: 10.1007/s00737-015-0499-y. Epub 2015 Jan 15. PMID: 25589155; PMCID: PMC4366287. Available from: https://pubmed.ncbi.nlm.nih.gov/25589155/ 

6.-

Zoloft. Highlights of Prescribing Information. FDA [Internet]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839s74s86s87_20990s35s44s45lbl.pdf 

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