The catalyst was a post on Babycenter.com that was emailed to me in my weekly , "How to be a better mother" email from Babycenter. It talked about the "delayed onset of breastmilk in mothers who took SSRIs". That hit me in a more personal way than most headlines. I read the article and it was flawed and DANGEROUS! Do you know what happens if you suggest to a fragile new mother, who is prone to depression (by the fact that she's on SSRIs to begin with) that she stop taking her pills? It's called Postpartum Depression and it's not pretty. So, I wrote to the kind folks at BabyCenter.com. Here's my note:
I have to wonder whether or not your posting of content from the Health Day news service ismerely interesting and attention grabbing. It is perhaps ill advised. I have noticed that the health day reports rarely cite any concern over study methodologies. A particular example is the one pager suggesting that use of SSRIs is associated with delayed onset of breast milk. Since so many mothers and expectant mothers are already weary of taking ANY medication for fear it will affect their child, the decision to continue on an anti-depressant medication is one that can be truly heart wrenching. While the mothers and mothers to be know that they are already at increased risk for post partum depression and other complications, they also know that the effects of some of these medicines aren't known. In a population predisposed to depression and the concomitant symptoms of increased feelings of guilt and anxiety, they may decide to cease or reduce medication. This study implies that a woman who takes SSRIs will have less success in breast feeding because the delayed onset of milk may require early formula feeding. Here is the rub, did this study control for maternal age at time of the birth, dosage of the SSRI, length of time on the SSRI, the version of the SSRI (some have much longer half lives than others? What about c section vs. vaginal birth? What about duration of labor and additional interventions? A HUGE influence on milk production is the mother's overall hydration level. Were these mothers monitored for their hydration levels? Furthermore, what was the control group? How was the SSRI variable isolated? Since none of these answers can be made in a short one pager, I must assume that, no, they probably weren't. Basically, this article will just make the decision to continue anti-depressant therapy (a decision that rightly belongs between a woman and the prescribing doctor when ALL factors of her situation are considered) even more difficult. If ONE woman falls victim to post partum depression as a result of the reporting in this story, it is one too many. Not ONCE in the article NOR in the "what can you do" section was the danger of discontinuing an anti-depressant without the supervision of a LICENSED medical professional mentioned. For a site that claims to be a place for mothers, I have to wonder how such a relevant issue went unmentioned.
Stat Girl (name edited, of course)
San Francisco, CA
Mother to Stat Baby (I'm actually going to start calling her that) - 8 months
Here's the response:
Hi Stat Girl,
Thank you for emailing BabyCenter with your thoughtful note. You make some good points - I will forward your email to our news editors. Thank you for your interest in BabyCenter!
NO FURTHER COMMUNICATION, EVER. Even after I wrote again:
Thank you for forwarding my concerns. I am a bit trobled that there has been no additional response to my letter. Is it normally the policy of babycenter.com to simply reply "thanks for writing?". I have looked for any updates on PPD and have not seen much. However, I have noticed more coming from the wire service Reuters (which is at least a reputable news source). I am encouraging the new mothers who I know to read the reporting of studies via babycenter.com with a high degree of skepticism. Furthermore, in a survey that I was asked to take for babycenter.com, the survey seemed to be asking my degree of confidence in the information provided by the site. If your goal and value proposition is to be "the authority on the web for all matters baby-related", I have to question whether or not your content team is aware of what such a goal entails. If you are simply serving as a lead source for diapers.com, then I suppose catchy headlines are all that matters. For example, today's email blast has a link to an article about VBAC. It says, "Vaginal birth after C section may be safe." VBAC is VERY common. VBAC after multiple cesarians being safe, however is newsworthy. Making the lead link, "Vaginal birth after multiple C sections may be safe", seems like a more appropriate headline and does not imply that VBAC in general has heretofore been considered unsafe. I imagine that the click-through rate would be lower though.
Thank you again for reading my thoughts and passing them on.
MORAL OF THE STORY: This is my small way to save us from this kind of psychological warfare. That may seem hyperbolic, but that's how it feels to me.