 Dr.
Jane Morton,
Clinical Professor of Pediatrics at Stanford University School
of Medicine, is an expert on nursing premature infants as well
as a
member of the Breastfeeding.com medical advisory board. Dr.
Morton has answered many of your breastfeeding questions.
Dr. Morton works one-on-one with new mothers at the
Lucile Packard Children's Hospital at Stanford University,
teaching moms how to breastfeed successfully. In 1997, Focus
Magazine named Dr. Morton one of the "Best Doctors in the
Bay Area," and she was again selected by her peers as one
of "Silicon Valley's Best Physicians" as reported in
The Sane Jose Magazine in 1999.
 What antidepressants are
safe for nursing moms?
| NAME: |
Dr. Doug Hasell (Pediatrician) |
| BABY'S NAME: |
Sara |
| BABY'S AGE: |
2 months
|
|
BIRTH WEIGHT: |
12 lbs 2 oz |
|
CURRENT WEIGHT: |
95% |
I
have a mother that has been diagnosed with depression and would
like medical treatment. She is exclusively nursing a healthy
baby that is thriving with height and weight at the 95%. My
first response to her question regarding antidepressants and
nursing was that Prozac would probably be a good choice.
Unfortunately, she was unable to tolerate Prozac in the past.
She would like to try St. Johns' Wort, and I wonder if there is
any data available on safety profile for nursing babies whose
moms are taking this, or if you recommend any other
antidepressants that are safe for nursing mothers to take. I
feel that this mother is doing such an excellent job at nursing
her baby it would worsen her outlook if she had to stop because
she needed to be on an antidepressant.
Thank you for your time.
Dear
Dr. Hasell,
This has been a difficult question for many of us. I believe
that the consensus is now that the benefits of the mother taking
Prozac or other like antidepressents, outweigh the potential
theoretical risks to the infant and the risk of not
breastfeeding at all.
There are a few interesting articles looking at Prozac, which
crosses the placenta, and the effect of the neurodevelopment of
the offspring preschooler. There was no significant impairment
in global IQ scores, language scores, temperament, mood, or
behavior problems in the children of mothers who took Fluoxetime
(Prozac) during pregnancy compared to mothers who did not (N Eng
Jnl Med, 336:258-62, 1997).
For the depressed mother, many times breastfeeding is one of the
most important positive experiences of her day. For her baby, we
need to remember the short and long-term benefits of
breastfeeding that formula surely does not come close to
providing. I have read that some pharmocologists believe that
Zoloft, for theoretical reasons, would be a better choice than
Prozac. But I think we have enough experience over the past
several years to know that there at least no major risks to the
baby whose mother uses either drug.
I would suggest for more information you call the following
resources: Dr. Tom Hale (fax: 806-354-5536); Dr. Ruth Lawrence
(phone: 716-275-4354); or Dr. Audrey Naylor at the Wellstart
Clinic (phone: 619-295-5192). You might also read the article on
Breastfeeding.com by Dr. Ruth Lawrence that discusses herbal
remedies for breastfeeding mothers, including St. John's
Wort.
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