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Fluoxetine (Prozac) and breastfeeding a 17 month old

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  • Fluoxetine (Prozac) and breastfeeding a 17 month old

    I'm considering (in conjunction with a psychiatrist) going on Prozac, but I am concerned about long-term effects on my 17-month-old daughter. I read a study saying that because of its long half-life, Prozac is the least ideal between Zoloft, Paxil, and Prozac. I tried Zoloft but had bad side effects. I was on Prozac for 10+ years before TTC, so I will presumably tolerate it better. But I'm concerned that there may be long-term effects, such as learning disabilities, etc. as my daughter grows. Can you put my mind at ease or share any information on that? My daughter typically nurses three times a day, at morning, nap, and bedtime. She doesn't nurse overnight anymore--would I significantly decrease the risk if I were able to take the medication at night, giving my body the night to metabolize it?

    Also, I have trouble sleeping. Is there anything I can take on bad nights that won't affect my daughter when she nurses in the morning? I currently take Advil PM as needed, but was warned it could be bad for my liver/stomach.

    Thank you so much. I want to feel better, but I have toughed it out so far because I am worried about the long-ranging effects. I should note that she is still quite sensitive to caffeine, even though I read that typically peaks at 6 months. So she may be more sensitive than most.

  • #2
    scarlett106,

    Prozac is rated an L2-limited data-probably compatible. The amount that transfers into breast milk is 1.6-14.6% of your dose. The half-life is 2-3 days. You really cannot work around this medication as far as time because of the long half-life, you will have what they call a level or steady state. We say it is probably safe to continue breastfeeding as long as your infant is not symptomatic. Monitor your infant for sedation or irritability, not waking to feed/poor feeding and weight gain.

    Paxil is an L2-limited data-probably compatible. The amount that transfers is 1.2-2.8% of your dose. Paxil and Zoloft are one of the lowest transfers into breast milk as far as SSRIs. This medication however is not recommended in pregnancy so if you are going to have more children this is not the best option. Monitor your infant for sedation or irritability, not waking to feed/poor feeding and weight gain.

    Here are a few articles you could read.

    [url]https://www.ncbi.nlm.nih.gov/pubmed/22299006[/url]

    [url]https://www.ncbi.nlm.nih.gov/pubmed/15367050[/url]

    Sandra Lovato R.N.
    InfantRisk Center
    806-352-2519

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