Prozac-Laced Breast Milk May Slow Infant Growth

http://www.healthscout.com/cgi-bin/WebObjects/Af?ap=55&id=86918

Not likely to cause other side effects



By Nicolle Charbonneau
HealthSCOUT Reporter

THURSDAY, Nov. 4 (HealthSCOUT) -- Moms who took a widely prescribed
antidepressant while breast-feeding can take comfort in the results of a new
study.

According to a report in the current issue of Pediatrics, the infants of
breast-feeding mothers on Prozac appear to fall slightly behind the normal
growth curve, but the difference is clinically insignificant. Based on a few
case reports, Prozac's manufacturer, Eli Lilly and Company, had suggested
that it not be used during breast-feeding, but the authors of this report
had found that women didn't always follow this advice.

Epidemiologist and lead author Dr. Christine Chambers says that in her
group's 1996 New England Journal of Medicine article, they found that
mothers who used Prozac until late in their pregnancy tended to have babies
with a slightly lower than normal birth weight.

But questions remained about exposure to Prozac through breast milk. So in
this study, Chambers and her colleagues at the University of California, San
Diego, interviewed 64 women who had taken Prozac (also known as fluoxetine)
during a pregnancy between 1989 and 1997.

Twenty-six of the women had exclusively breast-fed their child for at least
two weeks while taking the drug, while the remaining 38 mothers exclusively
breast-fed but stopped taking the medication. Chambers and her colleagues
looked at pediatrics records to find out how much the infants weighed at
birth, measured the infants' weight again between two weeks and six months
of age, and asked the mothers about any side effects.

Smaller, but not to worry

After adjusting for birth weight, since their previous study showed that
mothers who took Prozac in late pregnancy had lower weight babies, the
researchers still found a "significant" difference in the post-natal weight
of infants who were breast-fed on the drug, says Chambers.

"It's statistically significant, but there were not an excess number of kids
who were off the growth curve," she says.

So while this growth curve was statistically lower, it was not enough to be
of clinical concern. "It seems like it would be clinically important if you
had a child where there were growth concerns," says Chambers. "Say you had a
child who was born prematurely, or was low birth weight to begin with, or
was exhibiting failure to thrive. That would be a consideration."

None of the mothers reported other side effects like those that had turned
up in the case studies.

Previous studies have determined that roughly 10 percent of the mother's
dose of Prozac finds its way into the baby, although that can vary depending
on the size of the infant. But Chambers can't confirm that Prozac itself is
definitely behind this lower growth curve.

"It could be that mothers who are depressed enough to need medication might
breast-feed their infants in a different way," she says. "It may affect
content of the milk, or the quantity of milk."

In another development, a Food and Drug Administration panel has recommended
that Prozac be approved to treat premenstrual syndrome.

What To Do

For more information on exposures that may affect a developing fetus, check
out the Organization of Teratology Information Services. To find out about
Prozac, visit the Mayo Clinic Health Oasis or Prozac's manufacturer site,
Eli Lilly and Company. For anything you ever wanted to know about
breast-feeding, contact La Leche League International.

This HealthSCOUT article from the FDA answers some common questions about
the safety of Prozac.

Cindy Curtis,RN,IBCLC
mailto:[log in to unmask]
http://www.erols.com/cindyrn

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