I am a breastfeeding counselor with the Massachusetts WIC Program.  This
is my first time on LACNET, so please bear with me!  My Coordinator
suggested that I use this medium for help with a situation a client has
asked me for help with.

I have a longtime client with whom I have developed a close, trusting
relationship.  She confided in me that she is having mental difficulties.
 She has been diagnosed with Panic/Anxiety Disorder.  Her doctor would
like to investigate antidepressants (Zoloft, Paxil) to aid in her
recovery, since depression often goes hand in hand with her disorder and
she has shown symptoms.  The client is open to this, but the doctor(a
psychiatrist) insists that she stop breastfeeding altogether immediately.
 She refuses to do so.  She is currently on Klonopin, and is happy with
the results.  She has not seen any side effects in her nursing child, he
is 14 1/2 months, 29 lbs, and is only nursing at naptime and bedtime for
a couple of minutes until he falls asleep.

I can't understand why the doctor would allow her to breastfeed on
Klonopin and not on Zoloft or Paxil as well.  The info that I have is
sketchy at best, but does not indicate that these drugs, even in
conjunction, are completely contraindicated while breastfeeding.  I would
appreciate any type of info regarding these drugs and breastfeeding,
either on an individual basis, or prescribed together.  Also, would
Zoloft or Paxil be the best choice for anxiety coupled with depression?

Wendy Godfrey, Breastfeeding Peer Counselor
Massachusetts WIC Program




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