Characteristics of breastfeeding newborns in the first month of life with in utero selective serotonin reuptake inhibitor medication exposure: a scoping review protocol

Abstract

Objective: The objective of this scoping review is to understand the extent and type of evidence in relation to the characteristics of breastfeeding newborns in the first month of life who have been exposed in utero to selective serotonin reuptake inhibitor (SSRI) medications. Introduction: SSRIs are the most commonly prescribed antidepressant medication in pregnancy. Up to 30% of newborns who are prenatally exposed to SSRIs demonstrate withdrawal signs. Poor neonatal adaptation syndrome represents a constellation of signs observed in these newborns. Little information has been studied regarding breastfeeding, as it relates to the impact of in utero SSRI exposure on the newborn. Parents have many questions regarding the safety of taking medications during pregnancy and breastfeeding. It is important for health care providers to collate evidence-based information and facilitate shared decision-making. We aim to identify the approaches researchers have used to investigate in utero SSRI exposure among breastfed newborns to determine knowledge gaps. Inclusion criteria: Primary peer-reviewed studies will be considered for inclusion according to the following criteria: newborns, 31 days of age or less, with in utero SSRI exposure in any trimester of pregnancy, who were breastfed or received breast-milk feedings. Methods: MEDLINE, CINAHL, Embase, LactMed, the Maternity and Infant Care Database, and ClinicalTrials.gov databases will be searched. JBI methodology will be used. Abstracts will be assessed for eligibility and full texts will be retrieved if they meet the inclusion criteria. Two reviewers will independently extract the data from identified studies using a data extraction form and the results will be summarized descriptively and in tabular format. Review registration: Open Science Framework osf.io/2bt39