This is a question from a *new* IBCLC an hour from here (isn't lactnet
wonderful?)

The mother of a 7 week old weaned at 2 weeks. She feels her postpartum
depression worsened after weaning, and now takes paroxetine, which has
helped greatly.  But she feels nursing is what she really needs, and would
like to rebuild her small-but-still-there supply.  Paroxetine is not
advised during breastfeeding.

My thoughts to her:
*Wean off the paroxetine as she weans onto breastfeeding.  At this point,
her milk supply is small and so is the baby's exposure.
*Talk up prolactin as a substitute for paroxetine, since the mother is
somewhat reluctant to give up a medication that she feels is working well
for her.  Describe the relaxing, mellowing role prolactin plays.
*Perhaps strike a balance between paroxetine and nursing if need be,
keeping her on a minimal drug dose.
*Point out that since she's known her baby for 7 weeks, she'll be better
able to judge any side effects than the mother of a newborn.

Other thoughts?  Alternate meds?

Thanks!  Diane Wiessinger, MS, IBCLC,  LLLL  Ithaca, NY