There is an excellent review of phenothiazines (stelazine is one of that group of antipsychotics) by McElhatton P. The use of phenothiazines during pregnancy and lactation. Reproductive Toxicology, 1992, Vol.6, pp.475-90. They cite case reports mostly with other phenothiazines such as chlorpromazine and haloperidol, where the levels in breast milk were negligible and no adverse effects were noted. They also note that in none of the follow-up studies (some up to 10 years of age) of children exposed during pregnancy or breastfeeding were any physical or mental developmental problems noted. They caution, however, that there are really not enough data and that the potential for accumulation of these drugs exists. The AAP lists these as "use with caution" due to unknown long-term effects. Whenever drugs of this type are used during breastfeeding, the baby needs to be watched for sedation, lethargy, irritability or changes in feeding or sleeping patterns. Another possible action is to check levels in mother's milk and draw blood levels on the baby if the milk contains detectable levels. Of course, when possible, it is best to dose the drug immediately after a feeding, preferably prior to baby's longest sleep times. Hope this helps. If you want a copy of this article, e-mail me. Alicia. [log in to unmask]