Most breastfed infants nurse without showing meaningful effects from their mothers taking 20-40 mg of the anti-depressant fluoxetine (Prozac) daily, according to a study by Yale researchers.
Postpartum major depression affects about 10 percent of women. Prozac belongs to a class of anti-depressants known as selective serotonin reuptake inhibitors, which are the most commonly prescribed class of anti-depressants for post-partum depression.
The researchers based their findings on 11 breastfed infants before and after their mothers took Prozac for eight weeks. The infants were four weeks to 12 weeks of age during the study.
"Ten of the 11 infants experienced little or no decline in blood serotonin concentrations after exposure to fluoxetine through breast milk," said Neill Epperson, M.D., assistant professor of psychiatry and obstetrics and gynecology at Yale School of Medicine and lead author of the study in this month's Pediatrics journal.
A decline in blood serotonin levels would have suggested that the infants received enough of the drug through their mother's breast milk to affect brain serotonin function. Serotonin is a chemical in the brain that is believed to influence mood, appetite, sleep and other aspects of behavior and cognition.
Epperson said her advice to women who are thinking of breastfeeding and taking an anti-depressant is to weigh a range of factors, including the severity of the postpartum depression, their response to the anti-depressant, and their commitment to breastfeeding.
She said the infants are being evaluated for any impact of their exposure to anti-depressants on motor and cognitive development.
Co-authors included Peter Jatlow, M.D., Kathryn Czarkowski, and George Anderson, all of Yale.
Citation: Pediatrics, Vol. 112, pp. e245-e249 (November 2003)
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