Taking antidepressants while breastfeeding has no effect on the weight gain of infants.
But maternal depression does.
The babies of mothers who took antidepressants but still suffered from major depression weighed less than the babies of non-depressed mothers, a new study says.
"Women should not hesitate to get treated for postpartum depression, even if it involves the use of antidepressants," says Dr. Victoria Hendrick, study author and director of the University of California, Los Angeles Neuropsychiatric Institute's Pregnancy and Postpartum Program.
"Our study showed no evidence that the children's physical development is harmed by exposure to antidepressants through breast milk, whereas there is evidence that children are harmed by exposure to maternal depression," Hendricks says.
The research appears in the April issue of the Journal of Clinical Psychiatry.
Hendrick and her colleagues looked at the medical records of 78 breast-feeding mothers and their children.
All of the mothers had started taking a selective serotonin reuptake inhibitor (SSRI) either during pregnancy or within four weeks of giving birth. The women had given birth to full-term infants, had no substance abuse or alcohol problems and were nonsmokers.
The average weight for all of the infants in the study was 7.26 kilograms for girls and 7.93 kilograms for boys. This was virtually identical to infant growth data recently published by the U.S. Centers for Disease Control and Prevention.
Despite taking medicine for their anxiety or mood disorder, 11 of the women suffered major depression for two months or more after the birth of their child.
Their babies weighed less. The average six-month weight gain was 6.69 kilograms for girls and 7.25 kilograms for boys.
That's still within the normal range, but of concern nonetheless, Hendrick says. "The children of the mothers who were depressed weighed significantly less at six months than the mothers who'd been treated and were not depressed."
The study was funded by the National Institute of Mental Health.
Paula Caplan, an adjunct professor of psychology at Brown University, says the study is too small to be conclusive.
"That's a very small difference and a very small number of people in the study. I would be very careful from drawing conclusions from this," Caplan says.
Caplan says there could be other adverse affects from SSRIs that are not yet known. She cautions women against turning to antidepressants without seeking other help first from family, friends and health professionals to ease the strain of having a baby.
"Women who are depressed absolutely should get support and attention and care. They should be fully informed about what other things can help," she says. "Thanks to the medical mindset of this culture and the power of the drug companies, postpartum depression is presented as this chemical thing that we need drugs to fix. Instead, we should look harder as a society at what we can we do to make their lives easier."
No one, however, is disputing that a mother's depression can be bad for the baby.
About 12 percent to 15 percent of women suffer depression in the first six months after giving birth. Symptoms include low self-esteem, feelings of inadequacy as a parent, inability to enjoy the baby or usual activities, insomnia even when the baby is sleeping, problems with concentration and irritability.
It's possible maternal depression may influence how often or for how long the mother is willing to breast-feed. It's even possible depression may influence the biology of the breast milk itself, Hendrick says.
Where to go for help
Contact the Post Natal Depression Support Association of South Africa at (021) 797 4498 mornings only.
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