Dangers of not treating depression

Here are some interesting facts about not taking anti-depression. Although this article, and I in previous post, have stated the dangers of not treating depression. Always be careful of the medications and other materials that are taken while breastfeeding.

“Here are some things to consider with anti-depressant use in pregnancy: Women are 5 times more likely to relapse when anti-depressants were discontinued during pregnancy. The effect of untreated depression during a pregnancy can include negative obstetric and neonatal outcomes. There is evidence that uncontrolled maternal depression can cause fetal growth restriction, low IQ, and can even effect future language development. Only really high doses of SSRIs have been showed to cause fetal malformations (in rats-simply because you cannot do those tests on humans). Switching medications or lowering dosage is not recommended if current treatment is working. However, treating depression with medication for the first time during a pregnancy is particularly difficult as emotions during pregnancy may be labile. However, all medications have side-effects and risks. A baby born to a mother who has been taking SSRIs (especially after 20 weeks gestation) is more likely to experience withdrawal from the medication. One of the greatest risks of SSRI withdrawl is neonatal persistent pulmonary hypertension (PPHN). PPHN symptoms in the newborn are as follows: jitteriness, mild respiratory distress, rapid breathing, weak cry, poor muscle tone, etc. However, these symptoms tend to resolve soon after birth. There may be an increased risk of miscarriage with first-trimester anti-depressant use, however it could not be ruled out that this was not also an effect of the depression itself. It is recommended that the SSRI, Paxil (paroxetine) should be avoided during pregnancy possibly due an increased risk of fetal heart defects and PPHN.”

American Pregnancy Association article on depression medication

 Pregnancy is supposed to be one of the happiest times of a woman’s life, but for many women this is a time of confusion, fear, sadness, stress, and even depression. About 10-20% of women will struggle with some symptoms of depression during pregnancy, and a quarter to half of these will suffer from major depression. Depression is a mood disorder that affects 1 in 4 women at some point during their lifetime, so it should be no surprise that this illness would also touch women who are pregnant. But all too often, depression is not diagnosed properly during pregnancy because people think it is just another type of hormonal imbalance. This assumption can be dangerous for the mother and the unborn baby. Depression is an illness that can be treated and managed during pregnancy, but the first step, seeking out help and support, is the most important. What is depression during pregnancy? Depression during pregnancy, or antepartum depression, is a mood disorder just like clinical depression. Mood disorders are biological illnesses that involve changes in brain chemistry. During pregnancy, hormone changes can affect brain chemicals, which are directly related to depression and anxiety. These can be exacerbated by difficult life situations, which can result in depression during pregnancy. What are the signs of depression during pregnancy? Women with depression usually experience some of the following symptoms for 2 weeks or more: Persistent sadness Difficulty concentrating Sleeping too little or too much Loss of interest in activities that you usually enjoy Recurring thoughts of death, suicide, or hopelessness Anxiety Feelings of guilt or worthlessness Change in eating habits What are possible triggers of depression during pregnancy? Relationship problems Family or personal history of depression Infertility treatments Previous pregnancy loss Stressful life events Complications in pregnancy History of abuse or trauma Can depression during pregnancy cause harm to my baby? Depression that is not treated can have potential dangerous risks to the mother and baby. Untreated depression can lead to poor nutrition, drinking, smoking, and suicidal behavior, which can then cause premature birth, low birth weight, and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby. Your purchase supports the APA What is the treatment for depression during pregnancy? If you feel you may be struggling with depression, the most important thing is to seek help. Talk with your health care provider about your symptoms and struggles. Your health care provider wants the healthiest choice for you and your baby and may discuss options with you for treatment. Treatment options for women who are pregnant can include: Support groups Private psychotherapy Medication Light therapy If your symptoms are severe, your health care provider may want to prescribe medication immediately. There are medications that have been used during pregnancy without adverse affects. Discuss with your health care provider what he/she feels is safest for your baby but still beneficial to you. If you do not feel comfortable talking with your health care provider about your feelings of depression, find someone else to talk with. The most important thing is that someone knows what you are dealing with and can try to help you. Never try to face depression alone. Your baby needs you to seek help and get treatment.

Mothers Act

Please look at this website. The government is trying to pass a bill that would approve a mandatory anti-depression pill to pregnant women who are not depressed to prevent post pardum depression!! http://www.naturalnews.com/022789_drugs_MOTHERS_Act_expectant_mothers.html

Transmission of medication from mother to baby

When a mother takes a medication such as an anti-depressant medication, there is a risk that the drug will be transfered to the infant through the breast milk. The amount of drug that is excreted into the milk depends on many factors. Transfer into human milk occurs when the concentration in maternal plasma is high. Information about absorption and when peak levels of a medication will occur are available. Nursing mothers are usually encouraged to take medications after nursing to avoid nursing when the medication is at its peak.  Drugs with a a low molecular weight pass easily into milk. Heparin is a large molecule compound and never passes into breast milk so it is safe for breast feeding mothers to use. Drugs with low protein binding capabilities do not bind to proteins in the mothers circulation and therefore pass easily into milk. One of the most important factors to consider in the transfer of medications to breast milk is the oral bioavailability. The drug must be easily absorbed in the mothers gut in order for it to reach her blood circulation and then cross into her milk. The baby also must absorb the medication from the mothers milk. Some drugs are destroyed in the infant’s gut or fail to be absorbed through the gut wall. Drugs enter milk primarily by diffusion. They pass from the maternal plasma through capillary walls into the alveolar cells lining alveolus. Medications must generally pass through both lipid membranes and the alveolar cell to penetrate milk. The most critical factor for drug penetration into a mothers milk is the level of the mothers plasma level. When the plasma level of a mother rises the concentration in milk increase as well. Drugs enter and exit milk mainly as a function of the mother’s plasma level (Hale, 2006). All medications are metabolized in the liver. Preterm or young infants have immature liver function which can delay the breakdown of medications and keep high circulating levels of drug

Anatomy of breast milk

Alveoli are grape like clusters of cells inside the breast that produce breast milk in response to the action of suckling from the infant. These alveoli encompass thin tubes called ducts that carry milk from the alveoli to the nipple. The areola is the dark area of skin around the nipple. Montgomery glands located on the areola produces natural oils to keep the nipple clean. When the infant suckles at the breast, a hormone response releases the milk from the alveoli into the ducts and is transfered to the infant through 4-9 openings in the nipple. The hormone responsible for this action is oxytocin. The sucking action of the infant in the process of feeding stimulates the hormone prolactin which stimulates milk production. Each time the infant nurses there is a surge of prolactin. The more often a baby nurses the higher the baseline level of prolactin. Four weeks after birth, there is a natural decline in prolactin levels and the production of milk is then based on supply and demand. The more often and completely the breast is emptied of milk, the more rapidly the breasts will produce milk. The production of milk is a fine balance between hormones and frequency of feedings, which is regulated by the infant.

Depression medications

Anti-depression medication rates are surprisingly high in mothers who are pregnant or have recently had newborns. Newborns who have been exposed to depressant medication while in the womb are exposed to a much higher dose of the medication than those who are exposed while breast feeding. This is because the drug is transported through the blood which has a direct line to the baby in the womb. The top three anti-depressant medications that are recommended are zoloft, paxil, and luvox. These are considered better because they have a lower excretion dose into the mothers breast milk with fewer side effects. The three non-reccomended depressants are celexa, lexapro, and Prozac. These have longer half lifes and create a higher dose that transfered to the baby.

It is hard to know these days which medications are safe, especially for breast feeding mothers. The medications that breast feeding mothers ingest can severely harm their babies. A safe way for mothers to know if the medication they are taking is harmful or dangerous to their baby is to visit this website toxnet.nlm.nij.gov. Once at this website click into lacmed on the left hand side. There you can search any type of medication and it will give you research, symptoms, and precautions. One negative about this website is you must know the real name of the medication not just the brand name. This is a great way to protect your newborn child.