From the Guidelines
Wellbutrin (bupropion) can be considered safe for use during breastfeeding, as the available safety data in the perinatal period suggests a low risk of adverse effects on the infant. When making a decision about using Wellbutrin during breastfeeding, it's essential to weigh the benefits of treatment for the mother against the potential risks to the infant. According to a recent study published in the American Journal of Obstetrics and Gynecology in 2024 1, the consensus is that the magnitude of documented risks associated with medication use during breastfeeding is very low, and treatment should not be stopped if it's required for the daily functioning of the breastfeeding person.
Some key points to consider when using Wellbutrin during breastfeeding include:
- The amount of bupropion that passes into breast milk is relatively small, with infants receiving approximately 2% of the weight-adjusted maternal dose
- Most healthy, full-term infants have not shown adverse effects when their mothers take Wellbutrin while breastfeeding
- Mothers should monitor their infants for potential side effects such as irritability, poor feeding, or unusual sleepiness
- The lowest effective dose should be used, and the medication can be taken immediately after breastfeeding to minimize infant exposure
It's also important to note that bupropion may not be as efficacious as stimulants for the treatment of attention-deficit/hyperactivity disorder (ADHD), but it can be a suitable alternative for individuals requiring treatment for co-occurring depression, as suggested by the study 1. Ultimately, the decision to use Wellbutrin during breastfeeding should be made on a case-by-case basis, taking into account the individual circumstances and medical history of both the mother and the infant.
From the FDA Drug Label
Data from published literature report the presence of bupropion and its metabolites in human milk (see Data). There are no data on the effects of bupropion or its metabolites on milk production. Limited data from postmarketing reports have not identified a clear association of adverse reactions in the breastfed infant The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for bupropion hydrochloride extended-release tablets (XL) and any potential adverse effects on the breastfed child from bupropion hydrochloride extended-release tablets (XL) or from the underlying maternal condition In a lactation study of ten women, levels of orally dosed bupropion and its active metabolites were measured in expressed milk. The average daily infant exposure (assuming 150 mL/kg daily consumption) to bupropion and its active metabolites was 2% of the maternal weight-adjusted dose. Postmarketing reports have described seizures in breastfed infants. The relationship of bupropion exposure and these seizures is unclear.
Key Points:
- Bupropion and its metabolites are present in human milk.
- There is limited data on the effects of bupropion on the breastfed infant.
- The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for bupropion.
- Postmarketing reports have described seizures in breastfed infants, but the relationship to bupropion exposure is unclear.
Answer: The use of Wellbutrin (bupropion) during breastfeeding is not entirely clear, but the available data suggest that it may be present in human milk and could potentially cause adverse effects in the breastfed infant, such as seizures. However, the benefits of breastfeeding should be considered along with the mother's clinical need for the medication. Therefore, caution is advised when using bupropion during breastfeeding, and the decision to use it should be made after careful consideration of the potential risks and benefits 2.
From the Research
Wellbutrin during Breastfeeding
There are no direct studies provided on the use of Wellbutrin (bupropion) during breastfeeding.
- The available studies discuss the general safety of various medications during breastfeeding, emphasizing the importance of weighing the risks and benefits for both the mother and the child 3, 4.
- Some studies highlight that few medications are absolutely contraindicated during breastfeeding, and most can be used with careful monitoring of the infant for adverse effects 3, 5.
- The safety of specific medications, such as sertraline, has been studied, indicating that it is one of the safest antidepressants during breastfeeding, with recommendations to start with low doses and monitor the newborn for adverse effects 6.
- For analgesics, safety considerations during breastfeeding have been assessed, with recommendations for the use of certain drugs like paracetamol (acetaminophen) and ibuprofen, emphasizing the importance of using the lowest effective dose and avoiding breastfeeding at times of peak drug concentration in milk 7.
- However, without specific studies on Wellbutrin (bupropion), it is not possible to provide a definitive answer on its safety during breastfeeding based on the provided evidence.