Breastfeeding offers significant benefits to both infants and mothers, leading the World Health Organization to recommend exclusive breastfeeding for the first 6 months. The use of serotonergic antidepressants may influence lactation physiology and pose potential risks to breastfed infants. This chapter first examines how antidepressant use affects breastfeeding initiation and duration, emphasizing the role of a supportive environment in mitigating potential challenges. It then presents updated safety scores for antidepressants based on the 2021 “safety scoring system for the use of psychotropic drugs during lactation.” Among the evaluated antidepressants, sertraline, paroxetine, and mirtazapine received the highest safety scores, followed by citalopram, fluoxetine, fluvoxamine, and clomipramine. These findings are contextualized within major international guidelines to provide evidence-based recommendations for clinical practice.