It’s rarely easy to seek help for a mental health challenge, and you should be proud that you are addressing your mental health by considering taking an antidepressant. Thankfully, Zoloft is considered safe to take while breastfeeding. In fact, it’s generally the first antidepressant a healthcare provider recommends to a breastfeeding parent. “Of all the SSRI [serotonin reuptake inhibitor] medications, Zoloft has the most widely recognized safety profile for breastfeeding,” says Daniel Roshan, MD, a high-risk maternal-fetal OB-GYN in New York City. “We would consider Zoloft generally safer than other similar medications for breastfeeding.”
What Is Zoloft?
Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) medication used to treat a wide variety of mental health disorders. In addition to treating depression, Zoloft is often used to treat obsessive-compulsive disorder, PTSD, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder. The way Zoloft works is by increasing the body’s levels of serotonin, a neurotransmitter made in the brain that balances your mood. Zoloft can be taken in pill or liquid form and is usually taken once per day. Often, healthcare providers start patients on a low dose of Zoloft and gradually increase as your body adjusts. It can take a few weeks for Zoloft to take full effect, and during this time, you may still be struggling with your mental health symptoms. It’s important to stay in touch with your doctor, and to have a plan for managing your mental health until the medication takes full effect. Side effects from Zoloft can include nausea, dizziness, digestive upset, headache, mood changes, weight gain, and sex drive changes. Any severe side effects should be reported promptly to your healthcare provider, including seizures, swelling, hives, difficulty breathing, rapid heartbeat, confusion, and abnormal bleeding.
Is It Safe to Take Zoloft While Breastfeeding?
No medication comes without risks, whether you are breastfeeding or not, but doctors generally consider Zoloft quite safe for breastfeeding parents to take. “Sertraline, or Zoloft, as it’s known by the trade name is readily the first-line choice of antidepressants for breastfeeding women,” says Kecia Gaither, MD, double board-certified in OB/GYN and Maternal-Fetal Medicine. The main reason that Zoloft is considered safe for breastfeeding is that very little of it passes into breast milk, Dr. Gaither explains. Because such small amounts of Zoloft are detected in breast milk, there is very little risk of side effects in your baby, she adds. Dr. Roshan agrees: “Zoloft is by far the most studied SSRI in breastfeeding moms and the risks are minimal.” In addition to having no known significant negative impacts on babies, Zoloft doesn’t impact milk supply, he assures. When babies ingest breast milk from parents who are taking Zoloft, there is either no Zoloft detected in their blood or very low levels of Zoloft detected. In some rare cases, preterm infants have more trouble metabolizing Zoloft and might have higher levels of it in their blood after breastfeeding. There have been very few reported side effects in babies who were exposed to Zoloft through breastfeeding. Among the side effects reported, none have been serious. Two cases of side effects have been documented: neonatal sleep myoclonus (sleep jerking or spasms) in a four-month-old, and agitation in a five-month-old. Importantly, Dr. Gaither reminds, postpartum mood disorders should be taken seriously. “The prevalence of postpartum depression affects about 21% of people in the US, and makes this diagnosis one of the more common complications of the [postpartum period],” she says. For Dr. Roshan, the decision to take Zoloft should be looked at as a risk/benefit analysis, with the risk of not treating a postpartum mood disorder more harmful than taking Zoloft while breastfeeding. “The benefit of treating postpartum or underlying antepartum depression far outweighs any possible risk associated with Zoloft use while breastfeeding,” Dr. Roshan contends. “The benefit is hopefully decreased symptoms of depression for mom and increased bonding and ability to care for the infant.”
Safety Precautions
Although Zoloft is considered a “first choice” when it comes to treating postpartum depression and other postpartum mood disorders, anytime you are taking medication, especially while breastfeeding, you need to monitor yourself and your baby for unusual side effects. You should also consult with a healthcare provider for how to take the drug, and in what dosage. Here are some safety precautions to keep in mind.
Monitor Your Baby for Side Effects
Before taking Zoloft, you should consult with your baby’s pediatrician about any possible risks. Again, although little to no Zoloft is usually found in breast milk, it’s possible that your baby could have a reaction. Your baby may be at higher risk for any complications if they are premature or have any other health vulnerabilities. Most babies will be cleared to breastfeed while their parents are taking Zoloft. But even if you’ve been given the okay to take Zoloft while breastfeeding, you should monitor your baby for any unusual side effects, and be in close touch with your baby’s pediatrician.
Monitor Yourself for Side Effects
As with any medication, you should monitor yourself for any reactions or unwanted side effects, Dr. Roshan recommends. Additionally, if you are just starting the medication, you should stay in touch with your doctor or mental health provider because you will still be dealing with mental health challenges as you wait for the medication to take effect. “Zoloft can take up to four weeks to reach a steady state in the body, meaning it can take about one month before the patient may feel relief from their symptoms,” Dr. Roshan warns. “It is important to communicate closely with the prescribing provider during Zoloft therapy.”
Start With a Smaller Dose
One way to mitigate any unwanted side effects is to start with a smaller dose of Zoloft and gradually increase the dose as your body gets used to it. This is the method that the Academy of Breastfeeding Medicine (ABM) recommends when a breastfeeding parent begins a course of Zoloft. For example, ABM recommends starting at a dose of 25 mg, staying on this for 5-7 days, and then increasing the dose to 50 mg per day. After that, dosage can be increased if needed. Of course, dosage and timing will vary from one breastfeeding parent to another and is something for you to discuss with your healthcare provider.
A Word From Verywell
Going through mental health challenges while caring for a baby can be a difficult experience. If you are considering taking an antidepressant to treat your symptoms, you may feel conflicted and worried about its safety. This is understandable, but you can be assured that taking Zoloft to treat depression or anxiety is considered very safe for your baby. Moreover, in most cases, not treating your mental health is a bigger risk to both you and your baby than taking Zoloft. Of course, every parent and baby is different, so you should discuss your particular health concerns with a healthcare provider and your baby’s pediatrician before taking Zoloft while breastfeeding.
