Production and regulation of serotonin is related to a woman's ability to produce milk. SSRIs may have an impact on serotonin regulation in the breast, which would affect the secretion of milk.
The study examined the effect of SSRI use on milk production in 431 new mothers. Women who were taking SSRIs began lactating an average of 85.8 hours postpartum. Those not taking SSRI medications had an onset of lactation of 69.1 hours postpartum. Delayed lactation onset is defined as 72 hours or more after birth.
Only eight of the women were taking SSRIs. Researchers acknowledged that the small size of the study necessitates further research before specific recommendations can be made.
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The good news, according to researchers, is that even those women who experienced delayed lactation eventually produced breast milk and were able to breastfeed their babies. However, researchers note that those women had access to support networks that other women may lack, including lactation consultants.
"Mothers taking serotonergic drugs may need additional support to achieve their breastfeeding goals," the study concluded.
Paxil is in FDA pregnancy category D because it may cause heart defects or serious life-threatening birth defects in infants. Women who are pregnant, thinking about becoming pregnant or breastfeeding should not stop taking their medication until consulting their doctor.