Most mothers and babies I have followed have done fine with fluoxetine,
at least in the short term.  Fluoxetine does get into the milk in
greater than the "rule of thumb" 1%, at least 3% and likely more of the
total maternal dose getting into the baby.  Whether the maternal dose is
20 or 40 mg does not make that much difference to what the baby gets,
but there are now safer (for the baby) SSRI antidepressants, such as
sertraline (Zoloft) and I would say that perhaps this would be the way
to go in general for all mothers requiring antidepressants.  Paroxetine
(Paxil) would be a good second choice.

Prozac if necessary, but not necessarily Prozac.

Jack Newman, MD, FRCPC