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A recent study published on January 7 in JAMA Network Open has revealed that some maternal medications may result in lower levels of protein and fat in breastmilk. The research, led by Essi Whaites Heinonen, M.D., Ph.D., from the Karolinska Institutet in Stockholm, examined the impact of long-term medication use on macronutrient composition in breastmilk.
The study compared milk samples from mothers on specific medications to samples from healthy and disease-matched control (DMC) mothers. In total, 3,974 milk samples were analyzed, with 310 coming from mothers taking medications in four categories: selective serotonin reuptake inhibitors (SSRIs), monoclonal antibodies, steroids, and other anti-inflammatory drugs (ADs). The remaining samples were from healthy untreated mothers or DMC mothers, though 150 samples were excluded for various reasons.
Findings indicated that protein levels in breastmilk were 15 to 21% lower in mothers on SSRIs, steroids, or other anti-inflammatory medications compared to healthy mothers. Specifically, mothers on SSRIs had protein levels averaging between 0.85 and 0.92 g/100 mL, significantly lower than the 1.08 g/100 mL observed in healthy mothers. Steroid use also showed a similar reduction in protein content, with a significant difference between the two groups.
In addition to protein, fat and energy content were found to be 10 to 22% lower in the milk of mothers using other ADs, compared to both healthy and DMC mothers. However, the differences were only significant in fat levels when compared to DMC mothers.
Despite these findings, the authors of the study stressed that the macronutrient levels in all exposure groups remained within the normal range, suggesting that these changes are unlikely to significantly affect breastfeeding recommendations. They emphasized that the growth of infants breastfed by mothers on antidepressants and anti-inflammatory medications should continue to be monitored according to clinical routine.
The study’s authors also disclosed potential ties to the pharmaceutical industry.
For further details, the full study can be accessed in JAMA Network Open.
Source: Heinonen, E.W., et al. “Macronutrients in Human Milk Exposed to Antidepressant and Anti-Inflammatory Medications,” JAMA Network Open (2025). DOI: 10.1001/jamanetworkopen.2024.53332
