Some maternal medications are associated with lower levels of protein and fat in breastmilk, according to a study. published online Jan. 7 in JAMA Network Open,
Essi Whaites Heinonen, MD, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues compared macronutrient levels in milk samples from mothers treated with long-term medications to samples from untreated healthy and disease-matched control (DMC) mothers in a cross-sectional study. Of 3,974 samples from unique individuals, 310 were from mothers treated with one of four categories of medications, 151 from DMC mothers with the same underlying disorders, and 73 from healthy untreated mothers; 150 of these samples were excluded.
The researchers found that mean protein levels were 15 to 21% lower in samples from exposed mothers versus those from healthy mothers (0.92, 0.85, 0.88, and 0.85 versus 1.08 g/100 mL for 63 exposed to selective serotonin reuptake inhibitors (SSRIs), 63 to monoclonal antibodies, 33 to steroids, and 20 to other anti-inflammatory drugs (ADs) versus 64 samples from healthy mothers, respectively).
For SSRIs and steroids, the adjusted differences were significant. In samples from mothers taking other ADs, mean fat and energy were 10 to 22% lower than that seen in samples from healthy and DMC mothers. The adjusted differences were only significant for fat compared with DMC mothers.
“We conclude that as the mean macronutrient levels were within normal range in all exposure groups, these results should not affect the breastfeeding recommendations for mothers treated with antidepressants and anti-inflammatory medications, and the growth of their breastfed infants should be monitored as per clinical routine,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.
More information:
Essi Whites Heinonen et al, Macronutrients in Human Milk Exposed to Antidepressant and Anti-Inflammatory Medications, JAMA Network Open (2025). DOI: 10.1001/jamanetworkopen.2024.53332
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