Susan,

Thank-you for you very detailed and informative piece on antidepressants.  I
receive quite a few call every year on this topic and have found that the
most common medication that is being recommended here is prozac.  Gerald
Briggs did a talk a year ago on the topic of drugs.  His concern with this
type of drug was long term effects on brain development and that there is no
way of knowing at this time what the outcome will be for the infant whose
mother is taking this drug.  I think another concern has been the
inappropriate dispensing of the drug with incomplete (or entirely no)
follow-up in the way of therapy to resolve underlying issues.

What are some ways that you would discuss this issue with a mother you were
working with?  I find it difficult at best because I feel there are so many
unknown factors when we deal with these types of complex cases.  Obviously we
refer the mother to appropriate HCPs but they often are not terribly
supportive of the breastfeeding relationship.  When the mother who is already
depressed is faced with conflicting information about whether to continue
breastfeeding or wean it seems to add to her depression.

Any physician's or pharmacists out there who can comment on this issue?

Denise Parker, BA, IBCLC