I have a client who is currently BF her 3 1/2 year old daughter.  She
nurses 2-3 XD for less than 5 minutes each session.  This woman has been
diagnosed with chronic atypical major depression.  Her condition is to
the point of rendering her non-functional.  She is currently taking
Zoloft, 75 mg a day.  Both she and her doctor know that this is not the
appropriate medication for her.  They would like to try Prozac, but the
doctor(an M.D.)is not willing to prescribe Prozac because the patient
refuses to stop BF. She believes in baby-led weaning.  The client has
been willing to "sacrifice" herself up until this point for the benefit
of her daughter, but her condition continues to worsen.  The client now
feels comfortable exploring the alternatives because her daughter is
older and BF less in frequency and  quantity.

 The doctor has extremely limited knowledge of BF, but has stated that if
the patient can produce information that would intimate the relative
safety and efficacy of Prozac in this BF situation, the doctor would
reconsider her misgivings.

I am looking for an opinion on the safety of Prozac and BF in this
situation, preferably from a medical source.  If possible, please do not
address the preferred use of Zoloft(as it has already been used and found
to be ineffective) or Paxil(as it has been determined to also be
inappropriate for this client as she is not suffering from an agitated
depression.)  Information on other alternatives would also be
appreciated.Ilene Fabisch, IBCLC, LLLL
WIC Bfing Coordinator
Brockton, MA

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