MelG replied: "What a load of crap that you can't take antidepressants and bf!! Especially with older infants you'll be fine. Take a look at this- it's based off of Dr Thomas Hale who is a great authority on bfing and medications: Highlights were that: The effects of an untreated depressed mom on the infant are significant and hazardous; but the marginal effects of any medication usually are less hazardous than those effects. Treating a mom with postpartum depression (PPD) is much preferable to not treating, since a baby has a better outcome generally (as measured by Bayley scores, measuring interaction skills and speech and language development) when being cared for by a non-depressed parent. PPD is significantly more dangerous compared to depression outside of postpartum; PPD patients are sometimes more likely to commit suicide, and need to be treated with due haste. Waiting to wean before starting medication is not a sound option. Also, weaning in order to treat is not a good choice due to the loss of the positive effects of breastfeeding. The rate of depression in the general population in an individual's lifetime is between 3% and 17%. However, in the postpartum population depression is about 15%, and is often more severe. For example, it moves to psychosis more frequently. In all studies thus far, any negative effects of medication usually occur in the first 30-60 days postpartum, so breastfeeding beyond that and taking medication is usually fine. Babies exposed in utero can suffer "discontinuation syndrome" (a.k.a. withdrawal effects) but sometimes this is misdiagnosed as a reaction to the continued medications in mom's milk, when really the milk transfer rate for many of the SSRIs is negligible. SSRI improvements over older drugs The SSRI family of antidepressants is significantly improved over older antidepressants as follows: Not addictive No associated buzz Mild withdrawal or "discontinuation syndrome" in some patients More rapid onset as compared to older tricyclics Side effects generally wane over time Reported 60%-70% response rate in patients. SSRI sequence of effects The sequence of effects for SSRIs is as follows: Sleep and anxiety normalize within the 1st week Motivation, interest, hopefulness and appetite return within 2nd and 3rd week Mood and libido may improve after (libido may worsen) Specific drugs Specific drugs discussed: Prozac is the only drug "cleared by the FDA" for use during pregnancy. A mother on Prozac during pregnancy may wish to change drugs before birth or immediately after, or titrate the dose down in the last trimester since the existing blood plasma level in the newborn fetus plus the drug transfer through milk may lead to toxicity. Its effects on the breastfed infant have been reported in infants 2 months old or less. Zoloft is the "best drug choice so far". It has a low, low transfer rate to breastmilk (17-173 ug/liter) in mothers taking up to 150 mg/day. In one excellent study of 11 mother/infant pairs, the zoloft was undetectable in 7 of the 11 breastfeeding infants' serum and minimal in the other infants. In two other studies of one and three mother/infant pairs respectively, zoloft was undetectable in the plasma of all 4 infants. A theoretical concern with Zoloft is that some babies may not gain weight as rapidly or as well when breastfed by moms on Zoloft; so weight gain should be monitored and dosage tweaked as necessary. Paxil has low blood plasma levels in the mother, and a low transfer rate to human milk. It was undetected in the blood plasma of 7 of 8 breastfed infants in one study, all 16 of the infants in a second study, and all 24 of the infants in a third study. For babies exposed to paxil in utero, there is evidence that withdrawal may occur 24-48 hours after birth. Celexa has a 4.3-16 nanogram/kg blood plasma level, but transfer rate is higher via milk. Use with caution and watch infant for side effects (per Hale, "There have been two cases of excessive somnolence, decreased feeding, and weight loss in breastfed infants."). Effexor is a popular drug for treating depression in Australia. It is less popular here in the USA due to reported side effects. Effexor can also be used in breastfeeding mothers if it is efficacious. It may be effective against hyperactivity. It is an SSRI and NRI. St. John's Wort is a weak SSRI. It also stimulates liver enzymes and may enhance the metabolism of other drugs. German varieties are found to be the most pure in independent testing; other brands may have contaminates and not be very pure. Documented drug-drug interactions have been found; the action of St. John's Wort on the liver can accentuate the metabolism of many drugs. For example, St. John's Wort may reduce the efficacy of birth control pill regimens, although this has not been documented. Bupropion has a high milk to plasma ratio, and is excellent for"