Breastfeeding and Antidepressants
My hands crumpled together. Fingers heavy in my palm, twisted together in misery and emptiness.
I stared across the doctor’s office.
My eyes burnt with tears, blurring the figures in front of me.
I searched my mind for an answer, for a feeling, for anything that would stop the wave of uselessness and unease.
I craned my neck and searched in hope for the face of my husband, who stood by me.
His hand lay heavy on my shoulder, grounding me to that moment. Looking into his eyes I let go of my last shred of dignity, I welled up with fear. Letting the failure wash over me, relinquishing to the ugly truth that lay at the core of me, I said:
‘I don’t want to fail at this as well’
My GP’s office, June 2016.
What didn’t I want to fail at? Breastfeeding. Why was this an ugly truth for me? Well, at this point in my life I truly believed I had failed as a mother. That I had no worth, that I had nothing to offer my five-month-old son. That I was no better than those who abused or starved their children.
For those who haven’t guessed yet, I suffered from Post Natal Depression.
Depression is a wide and varied subject, an illness that can manifest itself in many different dark and manic forms. I won’t bore you all with that, but if you have never suffered or never come across it in your life, it is hard to explain. My husband observed that it wasn’t when I was sad or upset that worried him – the emotions many people associate with depression. Instead, it was when I had no emotion at all. As if I wasn’t there. That scared him. The only way I can describe it – and I must stress this is from my point of view only – is wholly and truly believing you are worthless. That you have nothing to offer, that your existence is a mistake.
Now apply that logic to the care of an innocent new-born.
Imagine how utterly awful I truly felt.
Babies are supposed to bring joy. You have been lucky enough to get pregnant – which is a privilege, not a right – you have a healthy child, and yet you cannot be happy. It’s a hard thing to swallow.
But I digress. I don’t want to talk about PND, there are lots of articles and support in that regard.
I want to talk about breastfeeding and drugs.
I took antidepressants.
I did not want to take them. I wanted to be ‘strong’. Now I think of how utterly idiotic that sentence is. ‘Strong’ does not mean ‘deal with it on your own.’
I got to a stage that when I did end up at the doctors office – tears dribbling down my face, fear paralysing my body – I would have done anything to not feel how I did. I was utterly, hopelessly desperate. I would have sold my left arm to be happy. I wanted to love my child, I wanted to look at him and actually feel ‘these sleepless nights are all worth it’ but when I looked at him I had not one emotion. Nothing. That was terrifying.
So, I took the drugs. Even if they had been placebo I didn’t care. I knew I had a baby and a husband (and a business) that relied on me. But as you know from the beginning of this piece, I wanted to continue breastfeeding.
This is the point where I tell all those who haven’t had a baby that breastfeeding is a horrible, beautiful, painful, amazing, insanely clever and terribly hard process. (If anyone can describe it better I doth my cap to you).
I knew that I wanted to give breastfeeding my best shot. I didn’t put any pressure on myself – and I stress no woman should – I took it each day at a time.
It is hard. Everyone chats about birth. Birth was a doddle. Breastfeeding made birth feel like a Sunday lunch at my Nan’s. More people should talk about the difficulty of breastfeeding. Its painful, it’s a team effort; except your team mate still thinks they are living inside you, and also can’t communicate, its exhausting and its all on you. No one else can feed the baby, or pump, just you.
I honestly thought I wouldn’t be able to do it. I put everything I had into it. Even when my nipples scabbed over and I was hospitalised for 3 days due to mastitis (an infection in your milk ducts) I soldiered on. Trust me it’s a battle.
I got to five months of breastfeeding before I admitted my true feelings, or lack of. I will add that by five months I was a pro. I would whack out the boob anywhere, my son and I were the dream team. I would class it as my only success in mothering at this point in time.
So, when my doctor looked me in my puffy eyes, and said ‘you will have to stop breastfeeding’ in order to take the antidepressants, something deep down in me snapped.
‘I don’t want to fail at this, as well’
Because this was the one and only thing I believed I had contributed to my son’s life, and now I was being told it had to end. No. I wouldn’t. I couldn’t. I didn’t want to fail, again.
Looking back my doctor (I say ‘my’ doctor, I had never seen her before this appointment) she did not give me an alternative or discuss my feeding choice, she simply told me I should give up breastfeeding. If I had not had such a strong attachment to breastfeeding I would have given it up, gladly. I find this sad. Sitting like a broken doll in that office, I was incredibly vulnerable. In that moment someone should have asked me what I would like to do. Support should have been offered to reach my goal regardless if it was bottle or breastfeeding. The fact that the go to answer was ‘just put him on a bottle’ makes me angry and upset for all the women out there who haven’t reached their own goals because they weren’t given the love and tools to reach it. If I had stopped, the affect on me would have been detrimental.
With this in mind, my husband and I made a decision. I would take the antidepressants…and breastfeed.
This was not taken lightly. I spent four days researching into antidepressants and breastfeeding. Actually – any drug and breastfeeding. It may surprise you to hear that there is little to no research into this. For obvious reasons, you can’t subject a new-born to an unknown. Fair enough. I looked at alcohol and nicotine’s affect on breast milk, on food’s affect on breastfeeding, anything that may help me reach the decision. It was patchy.
When I returned to my GP we discussed what choices of drugs I had. Sertraline was our agreed drug of choice – being the only antidepressant that has any research on it in regards to breast milk. I was placed on 100mg a day.
I won’t lie, I was afraid of the effect it would have on my son. After digging through piles of research, and discussing it with my doctor, I still couldn’t confirm that it would go into my breast milk, and if it did, what effect, if any, it would have on my baby. Mad isn’t it!
But I made my decision and I stuck to it. I took my pills, I breastfed my child and I went on and did a course of CBT (cognitive behavioural therapy) as well.
I was afraid of the effect it would have on me too. Selfishly. But the whole process was enlightening. I can safely say I love my son, I relish spending time with him and I don’t recognise the person I was at that time.
I am not perfect, I still have days where the fog drops back down over me and I feel lost, again. But now I know how to deal with it. I have learnt how to tackle my emotions and understand why I have got to this point.
I still take Sertraline. I am on perhaps 50mg twice a week now. This a year and four months on from the day I started. My journey has not been linear, I tried to drop down to 25mg, and it didn’t work for various reasons. I also forgot renew my prescription and ran out of drugs over my husband’s birthday weekend. I am ashamed to say I had a major relapse and crashed. It was stupid and irresponsible. I hurt the one person who was holding me up. I learned the hard way.
I also only just finished breastfeeding my son at 21 months old. I am incredibly proud of this. I never actually believed I would get to two weeks let alone almost 2 years. My son is a happy, health, tantrummy and difficult toddler. Completely standard for an almost two-year-old. I can’t know the effect on him, if any, and I can’t know what my mental state would have been had I not taken the antidepressants or had I stopped breastfeeding. I believe I made the right decision for my family, for us to continue and become the unit we are today.
All a parent can do is make the decision that is right for your family. Every situation is different, but I want mums to know that taking antidepressants doesn’t make you weak, you are strong for taking a step towards recovery; the way you feed your child does not denote the worth of your care; and always remember that YOU are just what your baby needs.
Please, if you feel like you can’t cope, feel worthless or in any way find the change of becoming a mother – or father – difficult, please please please talk to someone. Promise me.
And if you breastfeed and you need/want/have to take any drugs relating to a mental or physical disease or injury, just make sure you inform yourself and your family, so you can make the right decision for you.
I don’t regret taking antidepressants and I don’t regret continuing to breastfeed. I have a better relationship with my son, and I am a better mother, wife, daughter, sister and friend because of it. Arm yourself with knowledge and run into the war of parenting with a pack of baby wipes handy at all times.
***If you would like more information on the safety of taking antidepressants or any other medication while breastfeeding, check out these websites: https://www.breastfeedingnetwork.org.uk/drugs-factsheets/ and https://www.breastfeeding-and-medication.co.uk/useful-links ***