Medication and Postpartum

Medication is a hot button topic within the realm of mental health, and in postpartum care specifically. Some clients I work with come to me upon referral or recommendation from their primary care doctor after having started medication for symptoms of postpartum mood or anxiety disorders, while others come to me with the symptoms and not having met with their primary care doctor at all. Some clients are interested in medication to help treat symptoms of PMAD, while others have no interest at all.

As a therapist with more than a decade of experience, I can honestly say that there is no right answer here. For some, medication is invaluable in the treatment process, for others it may help, and for some yet it’s simply not an option for a variety of reasons. Regardless of where you stand on the idea of medication, I highly believe in two things: First, that medication should only be taken when needed. This determination is best made between you and your primary care doctor or a psychiatrist, and I am happy to be included (with a proper release of information) in the determination process. Second, medication is most effective in conjunction with therapy.

Medication can be an important part of treatment for PMAD, though can sometimes carry stigma in the parenting community. Is medication safe? Is it necessary? Can it be taken while breastfeeding?

To begin, is medication safe? The short answer is yes, but it comes with some considerations. Yes, medication is safe to take, as long as you have your doctor or psychiatrists approval and follow the proper dosing and directions for taking it and as long as you are on the correct medication for your needs. Be mindful of any side effects, particularly an increase in suicidal thoughts, and report them to your primary care doctor, psychiatrist, or therapist.

Is medication necessary? The short answer is: It can be. Some people need medication for serious or severe mental illnesses and it can be life saving. Some people respond well on medication and struggle when off of it and find that this improvement in symptoms greatly improves the quality of their functioning and thus consider it necessary.

Can medication be taken while breastfeeding? The short answer is: Generally yes, but…. Google “can I take antidepressants while breastfeeding” and you will get pages and pages of answers, some contradicting one another, most opinion pieces from individuals. When working with breastfeeding clients taking medication I always recommend checking with your primary care doctor on the impact of medication and breastfeeding. It is not a simple yes or no answer when it comes to taking antidepressants while breastfeeding. It is generally considered safe to take most of the commonly prescribed antidepressants while breastfeeding because the level of medication transmitted through breastmilk is low. The other consideration given is the impact of the mother’s mental health when not taking the medication. The symptoms and level of functioning of the mother may be severe when not on medication, and thus any potential risk in taking the medication while breastfeeding may be outweighed by the need for the medication. Some medications have also been found to have lower transmission rates via milk and may be worth considering over medications with higher transmission rates (for a great article written by Kathleen Kendall-Tackett on anti-depressant use in pregnant and breastfeeding women, see here

Always check with your primary care doctor when it comes to starting any medication, whether breastfeeding or otherwise (I can’t state this enough). Medication can be an important component of treating PMAD and for some women it’s the best, right, or most successful choice, but it’s important to talk with a medical professional to determine if it will be of benefit to you, should it be an option you wish to consider. I will always be available to coordinate care with primary care doctors when requested by clients, and believe in fully supporting the clients I work with in their decisions for treatment.

Wishing you wellness!

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