Am posting this inquiry to the list to get more info for a mom of
twins, VLBW (26wk gest).  I am the LC for a large level 3 NICU. I prefer
not to give any more identifying info to prevent problems.
   This mom has been pumping for over a month and has an excellent milk
supply.  Her self esteem is low (today she said "this is the only thing
I'm good at" as she was pumping).  She has had a history of depression
and prior to her pregnancy was on an antidepressant and was once on
lithium.  She recently told me all this in confidence and said her
husband felt she should go back on 'something' so she would be better
able to take care of these twins when they come home. One twin is still
fairly unstable on and off a vent.  The other has been off the vent and
is stable but not consistently tolerating feeds.
   She asked me what I knew and/or felt about antidepressants and
breastfeeding.  I told her that many physicians felt they were
contraindicated during breastfeeding, but some felt some might be OK.  I
did caution her that her babies doctor is very conservative.  I said he
might feel that none were/are acceptable especially while these kids are
still preterm.
   She wanted me to recommend a specific drug, but I told her that was
between her and her Psych doc.   She started on Zoloft today and sure
enough the babies doc told her she should stop pumping.  She said he
told her she would be experimenting with her babies brains even if she
waited until they were term to use the milk she is currently producing.
He showed her the info on zoloft in the 98 Briggs,et.al. I had showed
her the info from the new 'Hale book'.
   She is very upset and would like more info.  I tried to tell her they
were her babies and it is her decision, but she doesn't feel strong
enough to oppose him at this point.  He wants me to tell her she must
stop pumping because the drug doesn't have long term studies proving it
safe.
   Any opinions Dr Jack or Nancy or anyone ????????
                                              TIA...Becky B RNC IBCLC

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