Last update June 18, 2022
Very Low Risk
SSRI antidepressant with properties and uses similar to those of fluoxetine. Single daily dose oral administration.
It is excreted in human milk in an undetectable or clinically insignificant amount. (Schoretsanitis 2019, Pogliani 2019, Weisskopf 2017, Salazar 2016, Weissman 2004, Berle 2004, Stowe 2003 and 1997, Hendrick 2001, Dodd 2000, Kristensen 1998, Altshuler 1995)
Plasma levels in infants whose mothers take sertraline are usually very low or below the detection limit. (Wisner 2006, Stowe 2003 and 1997, Hendrick 2001, Dodd 2001, Epperson 2001 and 1997, Wisner 1998, Kristensen 1998, Mammen 1997, Altshuler 1995)
No short or long term clinical or developmental repercussions have been observed. (Pogliani 2019, Stowe 2003 and 1997, Hendrick 2003 and 2001, Kristensen 1998, Mammen 1997, Altshuler 1995)
There may be transient problems during the immediate neonatal period, such as antidepressant discontinuation syndrome or serotonin hyperstimulation, in term or preterm infants born with high plasma levels because their mothers were taking sertraline during pregnancy. (Müller 2013, Hale 2010)
Although less commonly than other antidepressants, sertraline can cause galactorrhea (Nebhinani 2013, Lesaca 1996), with (Petit 2003) or without (Trenque 2011, Sagud 2002, Gordon 1998) hyperprolactinaemia. There may also be a temporary decrease in milk production that improves with good hydration. (Holland 2000)
It is probably the safest antidepressant during breastfeeding.
Various medical societies and expert consensus consider the use of this medication safe during breastfeeding. (Hale, LactMed, Uguz 2021, Molenaar 2018, Mcallister 2017, Pinheiro 2015, Sriraman 2015, Orsolini 2015, Davanzo 2014 and 2011, Rowe 2013, Berle 2011 , Patil 2011, Amir 2011, Lanza 2009, ABM 2008, Gentile 2005, Weissman 2004, Rubin 2004, Gjerdingen 2003, Wisner 2002 and 1996, Nordeng 2001)
Women suffering from depression during pregnancy need more breastfeeding support due to their increased risk of problems and of early cessation of breastfeeding. (Grzeskowiak 2018, Leggett 2017, Venkatesh 2017, Gorman 2012)
We do not have alternatives for Sertraline Hydrochloride since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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