Antidepressants During Breastfeeding

  • Salvatore Gentile
  • Maria Luigia Fusco


Despite the severe repercussions of maternal depression on the infants’ well-being, women are often reluctant to seek treatment for postpartum depression, with fear of adverse events for the infant playing an important role in such considerations. However, the pharmacological approach to postpartum depression often represents one of the most effective options in a number of clinical conditions. Therefore, the necessity exists to establish the safety of antidepressants in the breastfed infant. The aim of this chapter was to discuss the main criteria that should be considered in the risk/benefit assessment of antidepressant treatment in lactating women. In accordance with the Breastfed Infant-Antidepressant Safety Index classification, sertraline and paroxetine should be considered as first-line medications in women who need to start antidepressant treatment during the postpartum period and wish to continue breastfeeding. Among TCAs, nortriptyline also shows reassuring information; however, primiparous women taking SSRIs are more likely to experience delayed secretory activation. Hence, the decision to start or to continue antidepressant treatment in lactating women should be taken on individual basis, after a careful evaluation of the severity of maternal symptoms and weighing the risk for the mother-infant dyad of exposure to mood symptoms against the risk for the baby of being exposed to antidepressants.


Antidepressants Breastfeeding Pregnancy Safety SSRIs Women’s mental health 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Salvatore Gentile
    • 1
  • Maria Luigia Fusco
    • 2
    • 3
  1. 1.Department of Mental Health, ASL SalernoMental Health Center Cava de’ Tirreni - Vietri sul MareCava de’ TirreniItaly
  2. 2.Developmental PsychologistMental Health InstituteNaplesItaly
  3. 3.Developmental PsychologyPost-graduate School of Psychotherapy (SIPGI)NaplesItaly

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