Cymbalta or Xanax and Breastfeeding

I have a diagnosis of major depression and took Wellbutrin when I was pregnant and breastfeeding. From the reading I did when it was first prescribed to me, Wellbutrin is usually what they will switch you too when you need meds when pregnant or breastfeeding. I thinks it's category B. It works well for me and may be worth looking into. Good luck with everything!

I went through the same thing. In the end, after LOTS of research and discussion (with doctors, nurses, lactation specialists and of course, my husband) I decided that my daughter deserved a mommy who wasn't a basket case all the time. So I stayed on my meds both while pregnant and during breastfeeding.
The research on this topic is confusing, even to medical professionals, but overall, it seems as if taking a low-dosage of most anxiety meds is OK while breastfeeding. Not ideal, of course, but not a substantial health threat to the baby. In such cases, it is also important to remember that when the person in need of anxiety medication is also the primary caregiver to an infant, this becomes more of a question of weighing risks than trying to achieve ideals.
Taking care of an infant is stressful and exhausting even under the best conditions -- if the caregiver is suffering from untreated anxiety/depression the child could easily come to harm because of his/her caretaker's inability to cope in such a stressful situation. Anxiety causes panic, and panic causes irresponsible decision making. Not what you want when taking care of a completely vulnerable little baby. And feeling overwhelmed leads to depression and emotional withdrawal. Again, not safe around a baby.
It wasn't easy to stand up for myself on this issue -- there are always lots of people who will tell you that being a good/responsible mother means being a total martyr, always putting your needs (even medical needs) aside -- but I honestly believe that without my anxiety meds, I would not have been able to make it through the first year of my daughter's life.
She is now a happy, healthy, normal, thriving 2 1/2 year- old, with a sane, involved mommy who truly enjoys raising her. I think that's the greatest gift a parent can give. I know I made the right decision for us.
I can't tell you what to do, but I want you to know that you're not alone. My advice would be to do as much research as you need to make what you feel is an informed, responsible decision. Then trust yourself.
Good luck hanging in there -- I won't lie and tell you it all evens out eventually, but I will say that it's worth the trouble!!!
And as for the bold letter warnings all over the prescription paperwork? In my opinion it's just a legal thing that allows the pharma companies to cover their butts in case of some weird situation.

Which doctor prescribed the meds? When I nursed my son and wanted to go back on fluoxetine, the OB referred me to the Pediatrician who strongly advised against it. I chose not to use either medication.

Category C means that it hasn't been approved by the FDA. There may be studies on it, but likely they would have the FDA approval if they really wanted it (for Cymbalta).

Category D (Xanax) - means that there is evidence of fetal risk but that benefits may outweigh the risk.

Having worked in the pharmaceutical industry for a LONG time and knowing these categories well, I'd not personally expose my child to it. I, too, have anxiety and depression. I had to find other ways to work through it in order to nurse.

If the symptoms are really severe, and you need the meds, have comfort that you've done an amazing thing by giving your child 6 months of breast milk. I had to stop nursing my daughter at 12 weeks to go on chemo. I nursed my son for a full year. It was better for my child to have a mother than to have my milk. I'm guessing it's better for your child to have you well than to have your milk, too.

Good luck.
I'd ask the pediatrician and your pharmacist for more clarity.

Category D or C are pregnancy categories and not lactation categories-

I am going to get on Cymbalta while breastfeeding myself soon and Xanax can also be taken while breastfeeding.

The warnings you saw on the medicine are on ALL medicines and is just a CYA move by the pharmacy and drug companies and not a true reflection of the drug's safety during pregnancy or breastfeeding.

Drugs are almost always passed on to a child at a much greater rate in utero than while breastfeeding.

Cymbalta is listed as an L3 (safe) but has limited information about it. Some does get into the breastmilk but the baby would get 0.141% of a dose and it appears that the amount of drug that does get into the milk is not able to be absorbed by the baby. Based on that I'd say that it seems much closer to an L2 (safer).

Xanax is an L3 as well but for a baby of 6 months of age and who is also getting supplemented with solids/formula it should be fairly safe to take on a regular basis.

If you have further questions about medications that are safe for breastfeeding check on Kellymom.com, search within in the the book Mother's Milk & Medications by Thomas Hale on Amazon.com, or check Dr. Thomas Hale's Breastfeeding & medications forums. Dr. Thomas Hale is the world's leading expert on lactation pharmacology and if he says a medicine is safe to take while breastfeeding it is.

http://neonatal.ttuhsc.edu/discus/messages/43/8008.html - Discusses using Xanax and Zoloft while breastfeeding. Zoloft is considered the safest antidepressant for breastfeeding mothers to take. His main concern was the addictive properties of the Xanax for the mother but as long as the Xanax is short term until the Cymbalta kicks in, and only for emergencies after the short term period there shouldn't be a problem.

Considering how important breastfeeding is for both your health and the health of your baby more doctors really should support and try to preserve breastfeeding relationships as much as possible. Yes a well mother is important but too often women are given bad information about nursing and medication. Plus there are a wide variety of medications safe for nursing mothers who need treatment for anxiety and/or depression.

http://neonatal.ttuhsc.edu/lact/medicationforumspage.html - Dr. Hale's breastfeeding & medication forums
http://www.kellymom.com/health/meds/aap-approved-meds.html - Short list of AAP approved medications to take while BFing
http://www.kellymom.com/health/meds/antidepressants-hale1... - About anti-depressants and nursing

well I am breastfeeding my second child and she is now 3 months old and with her and my first I was on Fluoxetine which is generic for Prozac 20 ml for my 1st and 10ml for my second child and both of my girls our awesome. I have only been told to take Prozac or Zoloft while breastfeeding and during pregnancy by my obgyn. I have tried to not take it and I just can't do it. I have to much depression and anxiety to be a mom/wife and also be happy to raise my family not to be on it. You do what you have to do to, but my advice I have never heard to take other than what I told you. I would be scared! Fluoxetine is a category B I am pretty sure. Good luck

I've never taken either of those but I used Wellbutrin XL during and after my pregnancy with no problems. I even breastfed my daughter for a year. My OBGYN said that it was fine. I'm not sure which doctor is telling you that those are ok but if you're not comfortable with that answer, call another doctor especially your OBYGN.

You have to do what is best for you. I had to stop breastfeeding my twins at 2 weeks, because of a heart issue. I needed to take 2 meds, and the doctor advised me to stop BF'd. At this point I had to do what was best for me, so I could take care of my babies.

I had to stop cold turkey, so it was very hard and emotional for me, but I had no other choice. Breastfeeding is great for your baby, but it is more important that you are are able to take care of her.

I realize the date is from 2 years ago but my son is also 6 months old and my doctor just recently prescribed Cymbalta to me as well (I am also on Klonopin for the anxiety). I would really love to know what your experience has been while nursing on Cymbalta. I also supplement due to my milk production decreasing while I went back to work and also stress. Thanks for any feedback!!

Updated

I realize the date is from 2 years ago but my son is also 6 months old and my doctor just recently prescribed Cymbalta to me as well (I am also on Klonopin for the anxiety). I would really love to know what your experience has been while nursing on Cymbalta. I also supplement due to my milk production decreasing while I went back to work and also stress. Thanks for any feedback!!

Hi sweetie! So sorry to hear about your depression and your doctor's complete lack of understanding! If it were me, I'd do one of two things: stop breastfeeding earlier than scheduled, or hang in there until you were ready to stop and then take the meds. The thing is, though, as much as we love breastfeeding for the bonding, your baby has gotten quite a lot of the benefits of it already at age 6 months and your health is very important too. Plus your baby will benefit from a mommy that feels good and isn't struggling with depression anymore. Just my two cents. I've not struggled with depression personally but remember my mom struggling with it. In this case, I'd say the best thing for baby was mommy being healthy. Unless of course you can find an alternative treatment that's not category C or D... maybe you could tell your doctor, "look, I'm not comfortable with category c. It has to be A or B, period."

Anyway, prayers coming your way for healing and help with this decision.
God bless!

I second was Alicia Z. said. There tends to be a bias against breastfeeding in prescribing medications. Any issue is a question of considering risks and benefits, and risks get over-emphasized in breastfeeding and medications. That's why there's warnings on most anything about taking it during breastfeeding. From what Alicia said, those medications sound safe enough for breastfeeding, especially in the case of an older baby. Older babies are more mature & can metabolize drugs better. They also are getting solids/other supplements or at least close to that stage.

I too have suffered with these issues. I considered taking meds while breastfeeding my son (now 11 mos and weaned), and both my doctor and pediatrician said ABSOLUTELY NOT. (MOstly about the Xanax) I wasn't to the point of not being able to live like that at the time, so I just kind of suffered with the A&D. I have to tell you, I think there's a point (and it sounds like you're there) where you have to make yourself the priority. If you feel like you really need the meds, Wean your baby, know you gave your baby 6 great months (a lot more than some people can do!), and get on those meds!!! You will be a better mom for it. Good LUCK! I know this totally sucks.

The best breastfeeding website out there is www.kellymom.com. It is grounded in science and the data. Plug in the names of the drugs and it will tell you if they are safe by the "Hanes" guide- the doctor that compiled all the info. If the drugs are not considered safe, they will have a list of those that are. Depression, anxiety are serious issues with Mom's and breastfeeding is so important. I would hit this website and if you still have questions, contact a lactation consultant personally. Mine is on speed dial and I've been nursing for 7 months now. Good luck. You are a good mommy!

perhaps consider an "Alternative" medical route to alleviate your symptoms. Cranio Sacral Therapy/ Myofascial Release are very successful ....
also the Young Living Oils, Peace and Calming and the blend, Joy.
Much is documented on post partum emotional issues as a result of the dural tube/coccyx/pelvic floor imbalance after childbirth......
B. Gettel OTR/L CHT CCH
Eclectic Body Work
Tucson

Here is my best advice. You have given your beautiful baby life and love, and have even breast fed for 6 months, and that is great. I have four kids, and wanted to be that mom, but I was not able to breast feed. At first I really beat myself up about this, but I realized that the most important part of breastfeeding was the bond that moms form with their kids, and I cultivated that bond in other ways. My kids are now 12, 9, 8 and 5 and we are incredibly close. If you need support from another mom, I am here for you. I have been through this very issue. I recommend taking the meds, bottle feeding, and being happy and joyful with your child in the million other ways you can be once you have tackled the depression issues. My heart goes out to you, and I am here.