Prozac and breastfeeding
I suffer from depression and have been taking fluoxetine for years. Weighing the risks vs. my mental health, I continued to take it throughout my pregnancy without issue. I have now been breastfeeding for nine months and have developed some concerns. My son, born in May 2010, has started sleep-crawling. He seems to sleep poorly, crying and whining often in his sleep, and several times a night he will sit up and start crawling around on the bed, without waking up. I know that the fluoxetine affects my own sleep, causing me to have restless-legs on occasion and sleep less deeply and thus feel less rested much of the time. It suddenly struck me tonight that there was a strong possibility that the fluoxetine that passes into the breast milk was doing a similar thing to my son. I donâ€™t want to suddenly stop breastfeeding because I donâ€™t know whether the baby would be susceptible to SSRI discontinuation syndrome and/or whether that could harm him. I am currently taking 50mg a day.
I have my BA in psychology and studied the effects of fluoxetine during pregnancy prior to deciding to continue taking it; however, I never considered the ramifications of the effects during breastfeeding, as I didnâ€™t think I would be able to breastfeed much at all, or for this long. My lactation consultant assured me that it would be fine.
My biggest concern is the possibility that the fluoxetine in my breast milk is affecting the seratonin levels in my son's brain and may be not only disturbing his sleep short-term, but also affect his own ability to produce seratonin himself. I know that it's a chicken/egg situation (which came first, predisposition to depression genetically, or was it introduced), but since he is now nine months old, I think weaning him might be the best solution. I'm just not sure whether I should decrease the breastfeeding slowly in order to minimize any adverse affects on the baby.
In response to your concerns about the discontinuation of breastfeeding, I would strongly suggest that you slowly decrease breastfeeding in order to minimize any adverse effects on the baby.
For instance, if you are currently breastfeeding six times a day, then you might want to only breastfeed 5 times a day for a few days, then 4 times a day for a few days, and continue this trend for a couple of weeks. As you gradually stop breastfeeding, your milk supply will decrease accordingly.
Please observe your infant for any behavioral changes during this time (such as irritibility or excessive crying). If you have any concerns regarding your child’s behavior, contact your peditrician immediately.
If you have any further questions, please call the InfantRisk Center at 806-352-2519 Mon-Fri 8-5pm (CST).
Colleen Peace, BSN, RN