From the Guidelines
Zoloft is generally considered safe during lactation, with minimal risk to the infant, as the amount of medication that passes into breast milk is very small, typically less than 10% of the maternal daily dose normalized for weight. According to a study published in Pediatrics in 2012 1, sertraline, the active ingredient in Zoloft, is minimally excreted in human milk, providing the infant with less than 10% of the maternal daily dose. The study also notes that the ratio of infant to maternal plasma concentrations for sertraline is generally low, although some variability has been reported.
Key Considerations
- The American Academy of Pediatrics suggests that mothers on treatment with an SSRI, such as Zoloft, who desire to nurse their infant should be counseled about the risks and benefits 1.
- Untreated maternal depression can have negative effects on infant development and the mother-infant relationship, making continued treatment with Zoloft during lactation a reasonable option for many women.
- Monitoring the infant for unusual sleepiness, feeding difficulties, or irritability is recommended, although these effects are rare.
Clinical Guidance
- No special dosing adjustments are needed specifically for lactation, and the typical adult dosage ranges from 50-200 mg daily.
- Clinicians should be aware of the potential for clinical signs of drug toxicity or withdrawal in infants over the first week of life and arrange for early follow-up after the initial hospital discharge 1.
- The decision to use Zoloft during lactation should be made in consultation with a healthcare provider, taking into account individual benefits and risks.
From the FDA Drug Label
are breast-feeding or plan to breast-feed. Some sertraline may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking sertraline. The FDA drug label does not answer the question.
From the Research
Zoloft Safety During Lactation
- Zoloft, also known as sertraline, is considered relatively safe to use during breastfeeding 2, 3, 4.
- Studies have shown that sertraline is present in low levels in breast milk and is considered a preferred agent for treating depression during lactation 5, 3, 4.
- The American Academy of Pediatrics and other organizations have classified sertraline as a medication that is usually compatible with breastfeeding 6.
- However, it is recommended to start with low doses and slowly increase the dose, with careful monitoring of the newborn for adverse effects such as irritability, poor feeding, or uneasy sleep 4.
- Women taking sertraline should be advised to breastfeed and continue the medication, with the target dose being the lowest effective dose 4.
- It is also recommended to avoid breastfeeding at the time when the antidepressant milk concentration is at its peak, if feasible, to reduce child exposure to the medication 4.