Code Blue to Blue's Clues

Every time I tweet about my Antidepressants and Breastfeeding: Are They Compatible? article, I inevitably find myself attacked by some pharmawacko. They have no medical background except for being able to look up things in the FDA's MedWatch database, and they use blogs as their evidence to refute my article. I researched everything I wrote and referenced only Dr. Thomas Hale, the leading expert on medications and breastfeeding, the American Academy of Pediatrics and the United States National Library of Medicine's LactMed database when discussing a drug's relative safety.

I never claim that a medication is 100% safe, and neither do my expert sources. Hell, not even oxygen is 100% safe (ask Stevie Wonder). However, there are medications that are considered relatively safe and there is no reason for breastfeeding mothers to turn to formula just so they can remain sane. The pharmawackos mention the very, very rare cases where an infant has been harmed by a medication. While these cases are terribly sad and unfortunate, in the statistical scheme of things, they are insignificant.

I wonder if I would get the same reaction if I had written about high blood pressure medications and breastfeeding. Part of me says that I wouldn't. The social stigma surrounding mental illness and the utterly fucked up idea that mental illness isn't real or can just be dealt with without medications still prevails. I encountered that idiotic belief a lot while I was pregnant. Doctors would refuse to prescribe antidepressants to pregnant mothers I knew from online forums. I'm sure those same doctors wouldn't refuse to prescribe high blood pressure medications or diabetic medications because that would amount to negligence and malpractice. So why is it acceptable to refuse treatment for a mental illness? Doctors are even more reluctant to prescribe antidepressants to breastfeeding mothers even though the risk to the infant is much smaller than to the unborn fetus.

The misinformation abounds, and it is perpetuated by these pharmawackos. Yes, a medication sounds dangerous if you mention that 100 infants have suffered adverse reactions. Maybe it's an American psychosis to be unable to put things into perspective, I'm not sure. But when you put those 100 infants into perspective and realize that there are many tens or hundreds of thousands more that are totally fine, it doesn't seem so risky after all. Since we thrive on shock news reporting where a 10 minute TV spot on one person that experienced one incredibly rare thing sends the nation into an uprising, these pharmawackos accomplish their mission. A little bit of misinformation, sprinkled with a dash of hysteria and mixed with a big bunch of militant shock tactics makes a nasty dish.

So if we believe the pharmawackos' [completely erroneous] claim that antidepressants are unsafe for breastfeeding mothers and their infants, what options are mothers left with? Mothers can go without treatment until their babies wean, which could be years depending on the child. Mothers could purchase breast milk from a milk bank. Or mothers could feed their babies formula. To me, all three of those are incredibly poor options.

Anyone who's ever lived with a person with an untreated mental illness knows that everyone in the house suffers, not just the ill person. Post-partum depression and psychosis are potentially deadly for mother and baby. They also interfere with the mother-child bonding process. So the mother who is determined to do what's best for her baby, which is undoubtedly breastfeed, and everyone close to her will have to suffer for months or years until the baby weans. Hmm...that doesn't sound so great does it? No.

Ok, well, mothers who want to breastfeed but have to take antidepressants could purchase milk from a milk bank. Not only is this prohibitively expensive, it takes milk away from babies who really need it, like preemies. Not a good choice either.

The third option is formula. Now some people may think that's a perfectly fine and acceptable alternative to breastfeeding, but it's simply not. That's right, formula is NOT an acceptable alternative to breast milk. It's a passable substitute at best. If you could have the choicest filet mignon or the cheapest ground beef mixed with gristle, you'd choose the filet mignon. Yes, there are rare situations where mothers cannot breastfeed due to insufficient glandular tissue or they must take a medication that is totally incompatible with breastfeeding, and then formula feeding is the better choice since letting a baby starve is not okay. But for the vast majority of women and their babies, breastfeeding is the absolute best option. Nature's perfect baby food is superior to lab-generated artificial formula.

Taking medication is NOT an absolute contraindication to breastfeeding, no matter what the pharmawackos say. The benefits far, far outweigh the risks, not only of the medications themselves, but also the risk of formula feeding.