Antidepressants and Caring for your Baby

Around one in 10 women need to be treated for depression/anxiety during pregnancy. It is very important that mental health issues continue to be managed with medication or psychological treatments during pregnancy and beyond, to make sure you stay well and can care for your baby.

This leaflet has been written for parents who have taken antidepressant medication in pregnancy to treat anxiety and depression. These drugs are known as selective serotonin reuptake inhibitors (SSRIs), selective noradrenaline reuptake inhibitors (SNRIs) or atypical antidepressants. These groups of drugs include fluoxetine, sertraline, citalopram and venlafaxine and mirtazapine.

The information in this leaflet does not apply to the treatment of other mental health conditions – it applies only to people who have depression and anxiety and need to take SSRIs or SNRIs.

What effect will taking antidepressants have on my baby?

There have been many studies that have looked into this question, but it is very difficult to answer because each person’s situation is unique. There have been concerns in the past that taking antidepressants during pregnancy can cause heart problems or blood flow problems to the lungs. The latest evidence tells us that these risks are only very slightly increased compared to other babies. It is very important that you are well and able to care for your baby and that often means taking antidepressants, especially as there is an increased risk of depression and anxiety after having a baby.

Some babies may experience mild symptoms if they have been exposed to antidepressants during pregnancy. This is called Neonatal Adaptation Syndrome.

What is Neonatal Adaptation Syndrome?

The symptoms of Neonatal Adaptation Syndrome usually start within the first 72 hours of being born and may last for up to two weeks. The symptoms vary a great deal and include:

• crying
• restlessness
• poor sleeping
• jitteriness.

These symptoms can be managed by care such as holding and cuddling your baby and feeding more frequently.

It is important to note that babies cannot tell us when they are unwell, and these Neonatal Adaptation symptoms could be confused with a baby that is not well. It is important to discuss any of these symptoms with your midwife, health visitor or GP or seek medical attention out of hours.

The Healthier Together website provides you with information on how to spot if your baby is unwell and who to contact.

What to expect after delivery

Unless your baby needs immediate medical attention and admission to the Special Care Baby Unit, you and your baby will be cared for together on the post-natal ward. It is very important that Mum and baby are cared for together. You may be able to go home as soon as the midwives are happy with your and your baby’s health.

At home

After you have had a baby, it is important for you to seek help and advice from a healthcare professional if you feel low in mood, anxious or find yourself having unusual thoughts. You must contact your GP or speak to someone if you are feeling this way. Never feel worried about asking someone for help for you or your baby.

What can you do to help your baby settle?

Your baby may cry, be a bit jittery and want to be held and fed more than other babies and they may also find it difficult to settle to sleep even after a feed:

• stay calm
• attend to your baby quickly before they become too upset
• skin-to-skin contact or close cuddling will be soothing for your baby
• keep the room as quiet and dark as you can
• handle your baby gently – try not to ‘jiggle’ them
• a pacifier/dummy may help to settle them if they are not hungry
• avoid patting or touching your baby too much
• humming or gentle soothing music may help.

Here are a few useful tips that you may find useful when caring for your newborn baby:

• do not wake your sleeping baby
• avoid strong smells around your baby (perfume, cooking smells, cleaning products etc)
• do not smoke near your baby and change your clothes after you have smoked to avoid your baby coming into contact with harmful chemicals from smoking
• do not share a bed with your baby. Your midwife will talk to you about the safest sleeping position for your baby
• do not give your baby any medication unless advised by a doctor
• never worry about asking for help or advice – your midwife, doctors, neonatal staff and health visitor are always happy to offer you support and advice when you need it.

About this leaflet

Authors: Clare Hollingsworth, Paediatric Consultant and Katharine Hopkins, Advanced Neonatal Nurse Practitioner
Written: January 2023
Approved: March 2023
Review Date: March 2026
Edition: v1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk