To Maureen K.  concerning Prozac:

        I would suggest that you read a case report of an infant exposed to
Prozac via breastmilk(Lester, BM, et.al. J.Am.Acad. Child Adolesc.
Psychiatry 32:6, 1253-1255).

        In this report,  the infant suffered significant  GI problems such
as colic, increased crying, decreased sleep, increased vomiting, and watery
stools.  Upon examination,  the breast milk had high levels of prozac, and
more importantly,  the infants plasma levels were higher than the mom's,
and were equivalent to the adult plasma level at twice the dose(40mg/day).
In essence,  the extremely long half-life of this product produces
accumulation in the infant plasma at levels that exceed the adult range.

        In this report,  the symptoms rapidly disappeared when the infant
was formula fed,   and they returned when the infant was again breastfed.

        This is a thorough case report,  and I believe we should be
extremely cautious prior to recommending SSRIs in BFing moms.


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T.W. Hale, Ph.D.
Associate Professor of Pediatrics
Texas Tech University School of Medicine

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