Can Abilify Cause Low Milk Supply?

abilify and breastfeeding
abilify and breastfeeding

Lately I’ve been seeing some families who have an uncomplicated birth, their baby latches and feeds well….but their milk just never comes in.

Or it does come in, but their supply is very low.

There are a lot of reasons why a parent’s milk would never “come in” or would be low, but there is one reason that I am seeing more and more with the families that I work with. And surprisingly, many of the families, and even some medical providers, don’t know about this risk factor.

That is the medication aripiprazole, or Abilify.

Aripiprazole and Breastfeeding

Aripiprazole is an antipsychotic drug that is not commonly prescribed, but when it is, is often prescribed along with other medications to help treat depression. 

So how does Abilify impact supply?

In order to understand how it impacts supply, we need to understand how milk supply works to begin with.

How does milk supply work during lactation?

Milk supply is a supply and demand system. That means that the more milk that is taken out of the breasts, the more milk the body is told to make.

That’s why it’s so important to feed or pump frequently in the early days and weeks.

When a baby latches to your breast, or you pump, the stimulation of your nipple causes the release of prolactin, a hormone that is produced by your pituitary gland. 

Prolactin is the hormone that sends the message to your body that you need to lactate, or produce more milk. So nipple stimulation = prolactin = milk. 

Which means that if your prolactin levels are low, then your milk supply can be low, because your body is not receiving the message that it should make more milk. 

How does aripiprazole affect breastmilk?

What does this have to do with aripiprazole?

Well, aripiprazole actually lowers the level of prolactin in the body. In fact, because some other medications that treat depression can raise the levels of prolactin too high, one of the reasons Abilify can be prescribed to a parent is to lower the prolactin down to more normal levels.

For a parent who is breastfeeding, this lowering of prolactin levels can result in low milk supply, or milk not coming in at all.

In one case study, a parent who was taking medication for depression and was making a full milk supply was prescribed aripiprazole at eight days postpartum. Three days after taking the medication, the parent’s supply began to drop drastically until they were unable to produce milk at all. This parent was prescribed a low dose of aripiprazole, at 2 mg per day. 

In another case study, a parent was prescribed 2.5 mg aripiprazole shortly after her baby’s birth. In this case, the parent was on aripiprozole for two weeks, during which her supply dropped drastically. After two weeks, she was prescribed a different medication, and her supply was able to come back up after she stopped taking the aripiprazole. 

In yet another case study, a parent who was taking 10-15 mg per day of aripiprazole failed to have her milk come in at all after the birth.

Can you breastfeed while taking Abilify?

Well, first of all, if you are taking aripirazole and have concerns with low milk supply, or how it might potentially impact your supply when you give birth, talk to your prescribing provider about your concerns.

Never stop taking a medication without talking to your provider first!

Finding the right medication and dosage with antidepressants can be hard, and once you are on the right medication and dosage, it can be really difficult to change or adjust medications.

Your mental health is more important than your breastmilk. 

So if you and your doctor agree that stopping aripiprazole is not in your best interest, or is too risky for your mental health, then thinking more about your feeding plan with your baby is going to need to happen.

Breastfeeding isn’t an all or nothing act. You can have low milk supply and still be a breastfeeding parent. And there are some parents who are on aripiprazole who are still able to make a full milk supply.

What I would recommend:

  • Feed frequently at the breast and pump after feedings in the first few days to maximize your milk production.
  • Monitor your baby closely for signs of good feedings and for signs that they are getting enough at the breast.
  • Connect with an IBCLC to come up with a feeding plan that will work for you and your family.

And most importantly….remember what I said above. Your mental health is more important than your breastmilk. 

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