This sheet is about exposure to etanercept in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is etanercept?

Etanercept (Enbrel®) is a medication that has been used to treat some autoimmune diseases, such as rheumatoid arthritis, ankylosing spondylitis, psoriasis, psoriatic arthritis, and juvenile rheumatoid arthritis. Etanercept is called a tumor necrosis factor (TNF) inhibitor because it binds and blocks TNF. TNF is a substance in the body that causes inflammation in the joints, spine, and skin.  

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.  

For more information, please see the MotherToBaby fact sheets on rheumatoid arthritis at https://mothertobaby.org/fact-sheets/rheumatoid-arthritis/, ankylosing spondylitis at https://mothertobaby.org/fact-sheets/ankylosing-spondylitis/, and psoriasis/psoriatic arthritis at https://mothertobaby.org/fact-sheets/psoriasis-and-pregnancy/.   

I am taking etanercept, but I would like to stop taking it before getting pregnant. How long does the drug stay in my body?

The time it takes the body to metabolize (to process) medication is not the same for everyone. In healthy non-pregnant adults, it takes about 3 to 4 weeks, on average, for most of the etanercept to be gone from the body. 

I take etanercept. Can it make it harder for me to get pregnant? 

Studies have not been done to see if etanercept can make it harder to get pregnant. Etanercept is being studied to see if it might help to improve the success rates of certain fertility treatments. 

Does taking etanercept increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. One study found that 337 people treated with etanercept during their pregnancy did not have a higher chance of miscarriage compared to similar groups of people who were not treated with etanercept in pregnancy. Another study found no increase in miscarriage was reported in 417 people exposed to etanercept or another TNF inhibitor during pregnancy.  

Does taking etanercept increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like etanercept, might increase the chance of birth defects in a pregnancy. 

Most studies do not show an increased risk of birth defects from using etanercept during pregnancy. Several small studies and one larger study of over 2,000 pregnancies found no increased risk. A few studies did find a higher rate of birth defects, but no specific pattern of birth defects was noted. Also, it is unclear if the defects were due to the medication or the underlying disease. One study found a small increase in risk with TNF inhibitors overall, but it did not compare to similar people not using the medication, so the cause of the increase reported is not clear.   

Does taking etanercept in pregnancy increase the chance of other pregnancy-related problems?

A study looking at 495 pregnancies exposed to TNF inhibitors (140 exposed to etanercept) found a small increased chance of preterm delivery (birth before week 37) when looking at all the TNF inhibitor medications. However, the study did not compare these pregnancy outcomes to those who had similar medical conditions but were not taking TNF inhibitors. This study cannot determine if the problems reported were due to the medications or the diseases being treated. Another study including 2,116 people who reported using etanercept during pregnancy did not find an increased chance of pregnancy complications.  

Three studies found that people with rheumatoid arthritis, chronic inflammatory arthritis, or psoriasis were more likely to have preterm delivery and have babies with lower birth weight than people who did not have these medical conditions. This was true for the people with medical conditions who used etanercept and those who did not. This makes it hard to know if the autoimmune conditions themselves or use of another medication besides etanercept increased the chance for these issues.   

More etanercept is thought to cross the placenta during the second and third trimesters than in the first trimester of pregnancy. Limited information looking at the use of etanercept in the third trimester has not shown increased risks to the fetus.  

Does taking etanercept in pregnancy affect future behavior or learning for the child?  

Studies have not been done to see if etanercept can affect future behavior or learning for a child exposed during pregnancy.   

Can my baby receive vaccines before one year of age if I take etanercept later in pregnancy? 

Since etanercept might suppress the immune system of the person taking it, there is a theoretical (not proven) concern that the same thing could happen to the baby if they are exposed during pregnancy. If someone has a weakened immune system, they may be more likely to develop an infection from a “live” vaccine. Live vaccines contain a small amount of live virus. In the United States, rotavirus is the only live vaccine routinely given in the first year of life. Inactivated vaccines do not contain live virus, so they cannot cause the disease they protect against. Most people can get inactivated vaccines in the first year of life.  

Talk with your child’s healthcare provider about your exposure to etanercept during pregnancy. They can talk with you about the vaccines your child should receive and the best time for your child to receive them. 

Breastfeeding while taking etanercept:

Etanercept is not well-absorbed from the gut. It is expected that any etanercept that gets into breast milk would most likely pass through the baby’s body without getting into their bloodstream. Information on 10 people taking etanercept while breastfeeding suggests that the levels of etanercept in breast milk are very low. Two of these reports looked at the amount of etanercept in the baby’s blood from breast milk and the lab test could not measure any etanercept in their blood. One of the infants was followed to 3 years of age and no harmful effects were reported.  

A small study looked at 5 infants exposed to etanercept through breastmilk and compared them to breastfeeding infants of people who had the same medical conditions but were not taking a TNF inhibitor medication. The study found no differences in the infants’ growth, development, response to vaccinations, or illnesses in the first year of life.  

A national registry of patients with rheumatic disease treated with drugs like etanercept was conducted in Spain. Three infants whose mothers were taking etanercept were breastfed (extent not stated) with no mild or severe adverse events reported in the infants. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes etanercept, could it affect his fertility or increase the chance of birth defects?

Two small studies reported that men taking etanercept for spondylarthritis (SpA) had the same sperm quality as men with SpA who were not taking a TNF inhibitor. This suggests that etanercept would not affect men’s fertility (ability to get a partner pregnant). In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.

This sheet is about exposure to midazolam in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is midazolam?

 

Midazolam is a medication that has been used to help patients relax, be calm, and sleep before medical procedures, dental work, or surgeries. It has also been used to treat seizures and anxiety. Two brand names for midazolam are Versed® and Seizalam®. Midazolam is in a class of medications called benzodiazepines. MotherToBaby has a general fact sheet on anxiety at https://mothertobaby.org/fact-sheets/anxiety-fact/.    

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. 

I take midazolam. Can it make it harder for me to get pregnant?

 

Studies have not been done in humans to see if taking midazolam could make it harder to get pregnant. In an experimental animal study, midazolam did not affect fertility (ability to get pregnant). 

Does taking midazolam increase the chance of miscarriage?  

 

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if midazolam could increase the chance of miscarriage. 

Does taking midazolam increase the chance of birth defects?

 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at published data to try to understand if an exposure, like midazolam, might increase the chance of birth defects in a pregnancy.  Studies have not been done in humans to see if midazolam can increase the chance of birth defects. Animal studies did not find a higher chance of birth defects with exposure to midazolam. 

Does taking a benzodiazepine increase the chance of birth defects, such as cleft lip and palate? 

 

Some of the first studies that looked at the use of other benzodiazepines in pregnancy suggested a slight increased chance of cleft lip and/or cleft palate (opening in the upper lip and/or the roof of the mouth) if taken during the first trimester. Since these early reports, there have been other studies and reviews that have not found an increased chance of birth defects with the use of benzodiazepines during the first trimester. 

Does taking midazolam in pregnancy increase the chance of other pregnancy-related problems?

 

Studies have not been done to see if midazolam can increase the chance of other pregnancy-related problems such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). 

If used near the end of a pregnancy, will midazolam cause symptoms in my baby after birth? 

 

The use of midazolam as part of a C-section can cause temporary symptoms in newborns such as trouble breathing soon after birth. Not all babies exposed to midazolam will have this issue. There have been reports of use of midazolam during C-section without problems for the newborn. C-section itself can cause temporary breathing problem in the baby.  

Does taking midazolam in pregnancy affect future behavior or learning for the child?  

 

Studies have not been done to see if midazolam can increase the chance of behavior or learning issues for the child.  Animal studies have reported that midazolam, in combination with other medications for general anesthesia, might affect the developing brain. Based on this, the US Food and Drug Administration (FDA) has suggested that midazolam be avoided for use as general anesthesia and sedation during the third trimester of pregnancy for surgeries not related to delivery of the baby. If needed for a C-section, the baby would be exposed only for a short period of time; this has not been associated with learning issues. For more general information on anesthesia, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/general-anesthesia-pregnancy/.  

Breastfeeding while taking midazolam:  

 

Midazolam has not been well studied for use while breastfeeding. Small amounts of midazolam can get into breast milk after single intravenous (IV) doses. If midazolam is given as part of general anesthesia (including for C-section), or as a single dose, breastfeeding can be restarted as soon as the mother is ready to nurse and once any side effects, such as feelings of sleepiness, have passed. Some professional organizations recommend delaying breastfeeding for at least 4 hours after midazolam is used during a procedure. If more than one IV dose is given during breastfeeding, watch the baby for sleepiness (hard to wake for feeding), low energy, or poor suckling. If you suspect the baby has any symptoms, contact the child’s healthcare provider. Be sure to talk with your healthcare provider about all your breastfeeding questions.  

If a man takes midazolam, could it affect fertility or increase the chance of birth defects?

 

Studies have not been done to see if midazolam could affect men’s fertility (ability to get a partner pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/. 

Please click here for references.

North American Antiepileptic Drug (AED) Pregnancy Registry: There is a pregnancy registry for women who take antiepileptic medications, such as midazolam. Please see the registry website for more information: https://www.aedpregnancyregistry.org/introduction/.

National Pregnancy Registry for Psychiatric Medications: There is a pregnancy registry for women who take psychiatric medications, such as midazolam. For more information you can look at their website: https://womensmentalhealth.org/research/pregnancyregistry/.

This sheet is about using herbal products in pregnancy and while breastfeeding. This information is based on available research studies. It should not take the place of medical care and advice from your healthcare provider.

What are herbal products?

Herbal products are considered dietary supplements. They are not the same as medication. In the United States, dietary supplements cannot be sold for the purposes of treating, diagnosing, preventing, or curing disease. They come in many forms, such as teas, infusions, caplets, dried extracts, and tinctures.

People often forget to tell their healthcare provider(s) that they use herbal products, but it is important to let all your healthcare providers know about all herbal products, supplements, and other over-the-counter products that you use.

Dangerous side effects have been reported for some herbal products. Herbal products can also affect how prescribed medications or anesthesia work. Be sure to ask your healthcare provider if the supplement you are considering would be helpful for you before starting the use of any herbal products.

Herbs can also be used in food preparation. When used in moderation, herbs used in preparing food are not expected to be of concern.

Are herbal products different from using prescription or over-the-counter medications?

Yes. The Food and Drug Administration (FDA) regulates herbal products differently than prescription medications. Very few herbal products have scientific proof that they work at all or in the way stated on the product label. Also, there are no standards for ingredients and strength. Be mindful of product claims such as “works better than [a prescription drug],” “totally safe,” or has “no side effects.” Keep in mind that the term ‘natural’ doesn’t mean a product is free from harmful effects.

Many herbal supplements have not been evaluated for use in pregnancy or breastfeeding. Herbal products could contain high amounts of ingredients that can be of concern in pregnancy or while breastfeeding. Some herbal products might contain contaminants such as metals (lead, arsenic, mercury), pesticides, other chemicals, or microorganisms (e.g. fungi or bacteria). They might contain other ingredients not listed on the label. Tinctures and liquid products can contain alcohol. Alcohol should be avoided in pregnancy. Levels of active ingredients in herbal preparations will depend on the growing and harvesting conditions, plant parts used (e.g. root, stem, flower, and/or bark), and the way they are made into supplements.

I take herbal products. Can it make it harder for me to get pregnant?

Some herbal supplements have been shown to cause changes in hormones that are important for getting pregnant. Other products have been suggested to increase the chances of getting pregnant.

I just found out that I am pregnant, should I stop using herbal products?

Most herbal products have not been well studied during pregnancy, so it might not be known how they could affect a pregnancy. A woman who is pregnant or planning a pregnancy should talk with their healthcare providers about their herbal products and why they are using them. There might be other therapies for which more information on using during pregnancy is available.

Does taking herbal products increase the chance of miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Some products have been shown to cause hormone imbalance or uterine contractions that could lead to pregnancy loss.

Does taking herbal products increase the chance of birth defects?

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like herbal products, might increase the chance of birth defects in a pregnancy.

There is limited information on the use of most herbal products during pregnancy. Products that contain more than 1 ingredient are very hard to study for how they could affect a pregnancy. Other concerns with using herbal products during pregnancy include interactions between herbal products and other medications and possible harmful substances in herbal products that are not noted on the label.

Does taking herbal products in pregnancy increase the chance of other pregnancy-related problems?

Some products have been shown to bring on labor, changes in hormones, or uterine contractions. Read the label on the product and discuss each ingredient with your healthcare provider.

Does taking herbal products in pregnancy affect future behavior or learning for the child? 

For many herbal products, studies have not been done to see if they can increase the chance of behavior or learning issues for the child.

Breastfeeding and herbal products:

There is little information on use of herbal products while breastfeeding. Read the label on the product and discuss each ingredient with your healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a man takes herbal products, could it affect fertility or increase the chance of birth defects?

Some herbal products might affect men’s fertility (ability to get a woman pregnant). Herbal product ingredients should be looked at carefully before using. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Please click here for references.

This sheet is about having hepatitis C in pregnancy or while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is hepatitis C? 

Hepatitis C is a type of liver disease caused by infection from the hepatitis C virus. Hepatitis C virus is often called “HCV”. People can have acute (short-term) or chronic (long-term) hepatitis C.  

Acute hepatitis C happens in the 6 months after someone is exposed to HCV. Some people have no symptoms, while others might have some or all of the following symptoms: dark colored urine, red colored stool (poop), feeling tired, joint pain, nausea, stomach pain, fever, and jaundice (yellowing of the skin and eyes).  

Chronic hepatitis C is a long-term condition that happens if HCV stays in the body long-term. Chronic hepatitis C can cause liver failure and liver cancer. Not everyone who is infected with HCV will get chronic hepatitis C. 

How do you get hepatitis C?

Hepatitis C is mostly spread through blood or other bodily fluids that contain blood. Sharing items infected with HCV (such as needles, razors, nail clippers, tattoos or body piercing equipment) or coming in contact with HCV-infected body fluids through sex, blood donation, or a workplace exposure (like a hospital) can cause a person to get hepatitis C.  

How can I find out if I am infected with hepatitis C?

To find out if you have hepatitis C, your healthcare provider will take a blood sample to see if you have HCV antibodies (proteins made by your immune system after an infection). If you are found to have HCV antibodies, then you will be tested for an active HCV infection.  

The American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC) have recommended that everyone who is pregnant get testing for hepatitis C. If you have been diagnosed with hepatitis C, it is important to talk with your healthcare provider as soon as possible about treatment options.  

People who have hepatitis C might not feel or look sick. It is important to get treatment for hepatitis C infections as soon as possible to prevent chronic hepatitis C and other complications.  

Can hepatitis C be passed to the fetus during pregnancy or at the time of delivery?

Hepatitis C can be passed to the fetus when someone has an active HCV infection. It can happen during pregnancy or at the time of delivery.  

When a woman passes an infection to the fetus in a pregnancy, it is called vertical transmission. Vertical transmission can happen at any time in pregnancy, but it is usually more likely to happen when the woman has the infection closer to the time of delivery.  

Some children who get HCV infections during pregnancy will get rid of the virus on their own. Others will have HCV but will not have symptoms of an infection (asymptomatic). Some children will develop symptoms of hepatitis C including hepatomegaly (liver larger than expected), fever, diarrhea, and nausea.  

I have hepatitis C. What should I talk about with my healthcare team before I get pregnant? 

It is important to talk to your healthcare team (including your obstetrician, primary care provider, and hepatologist) about plans for treating your condition before and during pregnancy, during delivery, and after delivery. If possible, talk with your healthcare team before getting pregnant. If your pregnancy is unplanned, contact your healthcare providers as soon as you find out you are pregnant.  

Things to talk about with your healthcare team include: 

• Ways to monitor your pregnancy and your hepatitis C symptoms. 
• Any medications or vitamins you should take during pregnancy.  
• Getting any necessary vaccines before and during pregnancy. Many vaccines can be given in pregnancy. For more information, please see the MotherToBaby fact sheet on vaccines at https://mothertobaby.org/fact-sheets/vaccines-pregnancy/. 
• Any other questions or concerns you have. 

I have hepatitis C. Can it make it harder for me to get pregnant? 

In a study of 27,000 women with HCV infections, there was an increased chance of infertility (trouble getting pregnant) when someone had an HCV infection.  

Does having hepatitis C increase the chance of miscarriage? 

Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if hepatitis C increases the chance of miscarriage. In 1 study of 36 women with HCV infections, there was no reported increased chance of miscarriage. In another study with 100 women with HCV infections, an increased chance of miscarriage was reported.  

Does having hepatitis C increase the chance of birth defects? 

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like hepatitis C, might increase the chance of birth defects in a pregnancy. It is not known if hepatitis C can increase the chance of birth defects.  

Does having hepatitis C increase the chance of other pregnancy-related problems? 

Studies have reported that having a hepatitis C infection during pregnancy can increase the chance of preterm delivery (birth before week 37), low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth), babies who are small for gestational age (measuring smaller than expected for their age), pre-eclampsia (high blood pressure and problems with organs, such as the kidneys), which can lead to seizures (called eclampsia), and infants spending more time in the neonatal intensive care unit (NICU).  

Does having hepatitis C in pregnancy affect future behavior or learning for the child?   

One study reported a possible link between having a hepatitis C infection and an increased chance of a child having a neurological (brain) condition, including problems with feeding, cephalohematoma (gathering of blood under the scalp), seizures, bleeding in the brain, and problems getting enough oxygen. Having these symptoms might affect behavior or learning in the future.  

What screenings or tests are available to see if my pregnancy has birth defects or other issues?

Prenatal ultrasounds can be used to screen for some birth defects. Ultrasound can also be used to monitor the growth of the pregnancy. Talk with your healthcare provider about any prenatal screenings or testing that are available to you. There are no tests available during pregnancy that can tell how much effect there could be on future behavior or learning. 

Breastfeeding while I have hepatitis C:

HCV does not usually pass into breast milk. Most women can continue to breastfeed while they have hepatitis C. The CDC recommends that breastfeeding should be temporarily stopped if someone has nipples and/or areolas that are cracked and bleeding. However, it is not known if HCV can pass from the mother’s blood to the nursing infant through dry or cracked nipples. The CDC has a page on breastfeeding with hepatitis C here: https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/hepatitis-b-c.html. Be sure to talk to your healthcare provider about all your breastfeeding questions.  

If a man has hepatitis C, can it affect fertility or increase the chance of birth defects?  

Hepatitis C infection can lower the amount of sperm made, change the shape of the sperm, and lower sperm motility (how well the sperm moves). Having hepatitis C might also lower testosterone levels. These changes might affect men’s fertility (ability to get a woman pregnant). Studies have not been done to see if hepatitis C in men could increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references. 

This sheet is about exposure to venlafaxine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider. 

What is venlafaxine? 

Venlafaxine is a medication that has been used to treat depression, panic disorder, social phobia, and anxiety. It has also been used to treat attention deficit hyperactivity disorder (ADHD), binge eating disorder, bipolar disorder, diabetic neuropathy, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder, and tension-type headaches. Venlafaxine is sold under the brand name Effexor XR®.  

Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.  

A return of symptoms (relapse) is possible after stopping this medication. If you plan to stop this medication, your healthcare provider might suggest that you slowly lower the dose instead of stopping it all at once. Stopping this medication suddenly can cause withdrawal symptoms. It is not known what effect, if any, withdrawal can have on a pregnancy.  

I take venlafaxine. Can it make it harder for me to get pregnant?  

It is not known if venlafaxine can make it harder to get pregnant. There are a few reports of women having higher levels of the hormone prolactin while taking venlafaxine. High levels of prolactin can stop ovulation (part of the menstrual cycle when an ovary releases an egg). Stopping ovulation can make it harder to get pregnant. 

Does taking venlafaxine increase the chance of miscarriage?  

Miscarriage is common and can occur in any pregnancy for many different reasons. One study suggests that taking venlafaxine might increase the chance of miscarriage, while other studies have not. Research also shows that depression itself might increase the chance of miscarriage. This makes it hard to know if it is the medication, untreated or poorly treated depression, or other factors (age, health, medical conditions, other medications used) that can increase the chance of miscarriage.  

Does taking venlafaxine increase the chance of birth defects?  

Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like venlafaxine, might increase the chance of birth defects in a pregnancy. While some studies suggest that taking venlafaxine during pregnancy could possibly increase the chance of birth defects, several large studies have not found a higher chance of birth defects. If there is an increased chance of birth defects above the background risk with use of venlafaxine in pregnancy, it is likely to be small.  

Does taking venlafaxine in pregnancy increase the chance of other pregnancy-related problems? 

Some studies suggest a higher chance of preterm delivery (birth before week 37) when venlafaxine is used in pregnancy, while other studies do not. However, research has also shown that when depression is left untreated during pregnancy, there could be an increased chance of pregnancy complications. This makes it hard to know if it is the medication, untreated or poorly treated depression, or other factors that can increase the chance of these problems. For more information, please see our fact sheet on depression at https://mothertobaby.org/fact-sheets/depression-pregnancy/.  

One study found a higher chance of developing gestational diabetes in women taking venlafaxine during pregnancy, while a second study did not. For more information on gestational diabetes, see our fact sheet here: https://mothertobaby.org/fact-sheets/diabetes-pregnancy/.  

I need to take venlafaxine during my pregnancy. Will it cause withdrawal symptoms in my baby after birth?  

The use of venlafaxine during pregnancy can cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal and can include jitteriness, increased muscle tone, irritability, changes in sleep patterns, tremors, seizures, trouble eating, and problems with breathing. Most of the time these effects are mild and go away on their own. Some babies might need to stay in the hospital for several days to help manage the symptoms. Not all babies exposed to venlafaxine will have these symptoms. It is important that your healthcare providers know you are taking venlafaxine so that if symptoms occur, your baby can get the care that is best for them. 

Does taking venlafaxine in pregnancy affect future behavior or learning for the child?  

It is not known if venlafaxine can increase the chance of behavior or learning issues for the child. One study found no difference in IQ or behavioral problems in 4-year-olds who had been exposed to venlafaxine in pregnancy compared to children whose mothers had depression but were not treated during pregnancy. A second study found a small increase in the chance of autism spectrum disorders in children exposed to venlafaxine during pregnancy. However, it is not clear whether this was related to the medication, the condition being treated, or other factors.  

Breastfeeding while taking venlafaxine: 

Venlafaxine passes into breast milk. Side effects in children who are nursing have sometimes been reported. If you suspect the baby has any symptoms (being more sleepy or irritable than usual, poor feeding, trouble with gaining weight) contact the child’s healthcare provider. If there is a concern, the child’s healthcare provider can check the amount of medication in the infant’s blood.  

Some older product labels for venlafaxine recommend women who are breastfeeding not use this medication. Newer labels suggest weighing the benefits of taking venlafaxine and the benefits of breastfeeding your child against the risks of an untreated mental health condition. Be sure to talk to your healthcare provider about all your breastfeeding questions. 

If a man takes venlafaxine, could it affect fertility or increase the chance of birth defects? 

Studies have not been done in humans to see if venlafaxine could affect male fertility (ability to make healthy sperm) or increase the chance of birth defects. There are a few reports of higher levels of the hormone prolactin while taking venlafaxine. High prolactin levels in men might affect fertility. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.  

Please click here for references.