Not *all* medications are safe for breastfeeding.  And it would not be
correct either to say that *all* antidepressants are safe for
breastfeeding.  Zoloft is probably safe.  Prozac is less safe.  In all
cases we try to get information which will tell us which medication is
*safest*.  Probably "safe" is not the best word here either.  What we
should be asking is this question:

"Which is the lesser of two evils--Exposing the baby to extremely
small amounts of a drug but the baby continuing to get the benefits of
breastmilk, or exposing the baby to formula and its known risks?"  The
answer is, in my opinion, almost always:  It is safer to continue
breastfeeding with that drug in the milk.  But it is a weighing of
benefits and risks, not an absolute.  Unless there is an absolute
right answer, incidentally, the mother has the right to decide, based
on adequate information, whether to continue or not with the
breastfeeding.  Not the prescribing physician, nor I can force her to
stop or continue breastfeeding.  I find it interesting that many of
those that are most eloquent in promoting "choice" in infant feeding
decisions are the first to tell mothers they *must* stop breastfeeding
for this or that reason (usually trivial).

It should be pointed out that, occasionally, even tiny amounts of
drugs can cause serious side effects.  But this is not a reason to say
that formula is safer, in general.

Jack Newman, MD, FRCPC