Although it is not ideal to prescribe medication to breast-feeding moms or newborns, it is sometimes a necessary thing to do.
Postpartum depression is a very serious condition that can be treated with medication after childbirth. 13% of women will be diagnosed with this type of depression requiring therapy and antidepressants.
It is important to try and determine if this is the “baby blues” or true postpartum depression. Here are a few signs that you should seek professional help.
- Your symptoms get worse.
- You’re having trouble taking care of yourself or your baby.
- You’re having thoughts of harming yourself or your baby.
Some of the most common antidepressants are Prozac (fluoxetine), Celexa (citalopram), and Zoloft (sertraline). Once you have taken these for a short period of time it is likely that you will feel the depression lift.
Are these drugs safe for new mothers who are breast-feeding? Doctors agree that any harm done by the transfer rate of antidepressants to the baby far outweighs the damage postpartum depression can cause the mother and newborn.
- Zoloft is the “best drug choice so far.” It has a very low transfer rate to breast milk. A theoretical concern with Zoloft is that some babies may not gain weight as rapidly when breastfed by moms on Zoloft; so weight gain should be monitored and dosage tweaked as necessary.
- Celexa has a 4.3-16 nanogram/kg blood plasma level, but transfer rate is higher via milk. Use with caution and watch the infant for side effects.
- Prozac is the only drug cleared by the FDA for use during pregnancy. A mother on Prozac during pregnancy may wish to change drugs before birth or immediately after. The dose may also be titrated down in the last trimester because the existing blood plasma level in the newborn fetus plus the drug transfer through milk may lead to toxicity. Its effects on the breastfed infant have been reported in infants 2 months old or less.
Medications for Newborns
It is not very common for newborns to be prescribed drugs. More often than not, it is best to try to avoid prescription drugs, especially newborn antibiotics, in the first couple of months of the child’s life. However, there are occasions when it is necessary for the health of the child.
Some of the medications indicated for treatment of common conditions in newborns are:
Docusate sodium and lactulose (stool softeners) are medications prescribed for infant constipation. Constipation is common in newborns and has many of the same symptoms of colic. It is recommended that the babies change their formula in conjunction with the medication but if a baby is breast-feeding it is best to continue breast-feeding and try the stool softeners.
Chloramphenical is an antibiotic used in eye drops. This medication is used in the treatment of conjunctivitis or more commonly known as pinkeye. Newborns are particularly susceptible to pinkeye and can be more prone to serious health complications if it goes untreated.
If a baby is born to a mother who has an STD/STI, during delivery the bacteria or virus can pass from the birth canal into the baby's eyes, causing pinkeye. To prevent this, doctors give antibiotic ointment or eye drops to all babies immediately after birth. Occasionally, this preventive treatment causes a mild chemical conjunctivitis, which typically clears up on its own. Doctors also can screen pregnant women for STDs/STIs and treat them during pregnancy to prevent transmission of the infection to the baby.
Many babies are born with a narrow or blocked tear duct (called lacrimal duct stenosis), which usually clears up on its own. Sometimes, though, it can lead to conjunctivitis.
Prednisolone and dexamethasone are corticosteroids and anti-inflammatory drugs used in young children and newborns to treat the most common acute infections of the lungs and airways. It is caused by viruses, most commonly respiratory syncytial virus (RSV). The illness starts similar to a cold, but leads to fast, troubled and often noisy breathing. Most often this is a mild disease for healthy babies.
For more information on conditions that may affect newborns and new mothers and the medications to treat them, visit our Newborn Rx Category Page. Also, use the RxSearch function to look up any medications that you may have questions about.