Kelly:  There was an excellent review article by Wisner, et al, in the Aug
1996 American Journal of Psychiatry.  Sorry, I don't have the full
reference with me (I can get it for you if you can't find it in the
archives).  I just found two even more recent references:

Wisner KL, Perel JM, Findling RL, Hinnes RL. Nortriptyline and its
hydroxymetabolites in breastfeeding mothers and newborns.
Psychopharmacology Bulletin.  33(2):249-51, 1997.
The authors, who previously had not detected nortriptyline in breastfed
babies, report on two infants aged 10 weeks or less who were found to
have low concentrations of the metabolite, and 6 more dyads with babies 4
weeks of age, and one premature baby.  One infant had quantifiable
nortriptyline levels, and another had metabolites, but still the levels
were very low and no adverse clinical effects were noted.

Yoshida K, Smith B, Craggs M, Kumar RC.  Investigation of pharmacokinetics
and of possible adverse effects in infants exposed to tricyclic
antidepressants in breast-milk.  Journal of Affective Disorders.
43(3):225-37, 1997 May.
Ten dyads were compared with a bottle-feeding group (presumably with
mothers on tricyclics), and monitored for health and development for 30
months.  The breastfed infants got a daily dose of about 1% of the
maternal dose, very small amounts of the meds were detected in the babies.
No adverse effects nor developmental delays were noted.

There is now a good body of evidence that tricyclic antidepressants pose
little, if any, risk to breastfed babies.  We always need to remember all
the known risks of artificial feeding and balance them against the small
risk of the medication.  Hope this helps.  Alicia Dermer, MD, IBCLC.