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Subject:
From:
Alicia Dermer <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 4 Apr 1995 23:09:07 -0400
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Hi, everyone:  In reply to the question regarding slides for presentations
on breastfeeding, I have some beautiful slides as part of an instructional
program from Georgetown University.  I don't know if slides available
separately, but you might try them: Georgetown University Hospital, National
Capital Lactation Center, 3800 Reservoir Rd NW, Washington, DC 20007.  One
of my LC colleagues said it sometimes works to just ask some of your patients
if they would consent to be photographed.
As for zoloft, I have no personal experience, and the UCSan Diego drug
information line had no really good data on this, but no contraindication.
Still, at least with prozac the level in breast milk has been measured at 10%
of the maternal dose; with zoloft, we don't even know whether it gets into
breast milk.  The problem with drugs such as the SSRI's and other
antidepressants is that we don't know the long term effects, and that's why
the AAP committee in Jan. 1994 Pediatrics put such meds on its "use with
caution" list.  With a premature baby, there is a potential concern due to
its vulnerable nervous system.  This unknown risk of course has to be weighed
against the known benefits of breastfeeding to premature infants and
long term maternal and child health benefits.  Since we have no way to
compare the two, there is no easy answer here.  As in all difficult
situations, the parents may need to be provided with as much information as
possible and make their own decision.  If this mother has been on zoloft
throughout her pregnancy, she must be aware that the baby has had seven
months of exposure, probably at higher levels than would be in her breast
milk. Good luck, Alicia.

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