You should have the patient sign a " permission to use photograph for
educational purposes" form before taking photo. --Beth Williams

On Tue, 4 Apr 1995, Alicia Dermer wrote:

> Hi, everyone:  In reply to the question regarding slides for presentations
> on breastfeeding, I have some beautiful slides as part of an instructional
> program from Georgetown University.  I don't know if slides available
> separately, but you might try them: Georgetown University Hospital, National
> Capital Lactation Center, 3800 Reservoir Rd NW, Washington, DC 20007.  One
> of my LC colleagues said it sometimes works to just ask some of your patients
> if they would consent to be photographed.
> As for zoloft, I have no personal experience, and the UCSan Diego drug
> information line had no really good data on this, but no contraindication.
> Still, at least with prozac the level in breast milk has been measured at 10%
> of the maternal dose; with zoloft, we don't even know whether it gets into
> breast milk.  The problem with drugs such as the SSRI's and other
> antidepressants is that we don't know the long term effects, and that's why
> the AAP committee in Jan. 1994 Pediatrics put such meds on its "use with
> caution" list.  With a premature baby, there is a potential concern due to
> its vulnerable nervous system.  This unknown risk of course has to be weighed
> against the known benefits of breastfeeding to premature infants and
> long term maternal and child health benefits.  Since we have no way to
> compare the two, there is no easy answer here.  As in all difficult
> situations, the parents may need to be provided with as much information as
> possible and make their own decision.  If this mother has been on zoloft
> throughout her pregnancy, she must be aware that the baby has had seven
> months of exposure, probably at higher levels than would be in her breast
> milk. Good luck, Alicia.
>