Breast feeding and anxiety medications

[BekahDee00]

Hi! I'm a mother of three and am currently breast feeding my 6 month old, very healthy, son :) I took 10-20mg of Prozac throughout my pregnancy and my doctor has recently increased my dosage to 50mg as a result of anxiety. I've read so many different articles concerning the usage of Prozac while nursing and am wondering what side effects, if any, are possible. Will the increase in my dosage have any adverse effects?

Additionally, I have been experiencing heart palpitations as a result of anxiety. My physician recommended that I begin taking 25mg of Atenolol for this symptom. He also suggested taking only half a dose due to my heart rate and blood pressure which is average to low. Will Atenolol have any adverse effects on my son and will there be any interactions with the Prozac?

[copeace]

Hello,

Dr. Hale rates the medications by risk. L1 medications are the most compatible with breastfeeding. The scale goes to L5. The L5 medications are the medications that should be avoided while breastfeeding.

Prozac is rated an L2. At 50 mg/day, you are still within the normal dosage. The infant will receive anywhere from 1.6 percent - 14.6 percent of your dose. Studies have shown this medication is probably compatible with breastfeeding.

Atenolol is rated an L3. Unfortunately, Atenolol is one of the few beta-blockers that produces significant adverse effects in breastfed infants. The infant should be closely observed for bradycardia, weakness, hypotension, cyanosis, and tiredness. The infant’s pediatrician should be told you are taking this medication so the infant can be monitored appropriately.

There are a couple of beta-blockers that are more compatible with breastfeeding. Please call us at the InfantRisk Center at 806-352-2519 and we can discuss this with you further. We are open Mon-Fri from 8am-5pm, CDT.

Colleen

Colleen Peace, BSN, RN
TTUHSC, InfantRisk Center

[BekahDee00]

Thank you for the advice concerning atenolol. I have decided against taking it due to the possible risks to my 6 month old. I have researched metoprolol and am planning to ask my physician about changing my prescription. What information do you have on metoprolol?

[copeace]

Metoprolol is rated an L2. About 1.4 percent of your dose will get into the breastmilk. Metoprolol is probably compatible with breastfeeding. Although no pediatric adverse effects have been seen in several studies, observe for hypotension, weakness, and bradycardia in the breastfed infant. Although the levels in the breastmilk are probably too low to be clinically relevant, clinicians should use metoprolol during lactation under close supervision.

I hope this information is helpful. Please feel free to call us at the InfantRisk Center at 806-352-2519 if you have any further questions. We are open Mon-Fri from 8am-5pm.

Colleen

Colleen Peace, BSN, RN
TTUHSC, InfantRisk Center

[Feraralive]

Sorry, what you mean?

[BekahDee00]

I know of individuals that take valerian root in order to deal with anxiety in a more natural way. Is this type of herbal medication safe while breastfeeding?

[copeace]

Hi BekahDee00,

Valerian root is most commonly used as a sedative/hypnotic. The toxicity of valerian root appears to be low, with only minor side effects reported. However, the valepotriates, an important chemical group present in the root of this plant, have been found to be cytotoxic, with alkylating activity similar to other nitrogen mustard-like anticancer agents.

Unfortunately, we don’t have any human studies on valerian root. For this reason, we would not recommend you take this supplement while breastfeeding. We don’t know how much of the supplement would get into the breastmilk, nor do we know the effects it might have on the infant.

If you have any further questions, please call us at the InfantRisk Center. Our number is 806-352-2519. We are open Mon-Fri from 8am-5pm, CDT.

Colleen Peace, BSN, RN
TTUHSC, InfantRisk Center

[copeace]

Hello Feraralive,

I'm unsure of what you didn't understand. Please explain. Was it the information I posted about the Metoprolol? It is probably compatible with breastfeeding but should only be used with close supervision.

Colleen