While it's not completely contraindicated, Prozac is not the first
choice when a mom can have a choice of such meds.  As I understand
it, once your body becomes acclimated to one med, it isn't a good
idea to change, as it will take time again before the new one
reaches full effectiveness.  Sometimes moms have been able to be off
the Prozac during pregnancy in which case I will suggest she ask her
doctor if she needs to resume medication could she try Zoloft or
Paxil which don't have the same concerns.  Of course I tell her only
her doctor knows her case fully and would know if there are reasons
she shouldn't change, but I want to empower her to discuss
alternatives with him/her.
As I understand it, the biggest concerns are fussiness and colic in
the baby.  If these become a problem, she could reevaluate the med
and the breastfeeding.  The disadvantages of not being breastfed
would (at least in most cases) be greater than the theoretical
concerns of being breastfed with the med.  I think of the possible
effects of any med on an infant as being in one of two categories:
behavioral/temporary or physiological/long term.  If the side
effects are strictly in baby's behavior, they would go away once
either the medication or the breastfeeding stops.  On the other
hand, it would be a greater concern if the possible side effects
involve long term changes in baby's organs or their functioning
which would not change with withdrawal of the med or the
breastfeeding.
I have known several moms who have nursed while taking Prozac.  One
had a baby that seemed fussy a lot.  She tried many dietary changes
and concluded that if she eliminated a number of foods, he did much
better.  It was only later that she mentioned she was on Prozac.  It
may or may not have been a factor in his behavior.
Winnie

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