When I first subscribed to Lactnet, I was interested in finding out more about the effects of Fluoxetine and the effects it had on breastfeeding infants. As of late, there has not been any discussion on this topic, so I went into the archives and was quite impressed with the information that is there.
     I found about the same information as what was discussed in the archives-little adverse effects on the infants. Dr. Hale (1996) lists the following as adverse effects: "nausea, tachycardia, hypotension, headache, anxiety, nervousness, insomnia, dry mouth, anorexia, visual disturbances and colic." One of the articles that I read, did discuss a below normal growth/weight curve. However, when responding during the interview, the 26 mothers' did not notice any unusual symptoms from their infants that could be attributed to Fluoxetine (Chambers, et al., 1999). Yet another study that was done did a Bayley Scales of Infant Development test on four infants who were breast fed by mothers taking Fluoxetine. All four infants showed a normal development and no neurological abnormalities (Yoshida, Smith, Craggs and Kumar, 1998). 
     Infants who are breastfeeding can be exposed to large amounts of Fluoxetine as was reported by a study that was completed with ten women who breastfed 11 infants (one mother had twins) (Taddio, Ito, Koren, 1996). Yet no adverse effects were reported by the mothers. This study also suggested that if mothers who take Fluoxetine wish to nurse, they should be advised to take the lowest therapeutic dose in order to reduce any exposure to the infant.  The information that I have found said that more studies are necessary for any long-term effects.  
     Once again, I am impressed with how Lactnet subscribers respond to the mailing that arrives each day. 

Valerie Hanson, Student Nurse
University of North Dakota
Reference:
     Chambers C. D., Anderson, P. O., Thomas, R. G., Dick, L. M., Felix, R. J., Johnson, K. A., Jones, K. L. (1999). Weight gain in infants breastfed by mothers who take fluoxetine. Pediatrics, 104(5):e61.

     Hale, T. (1996). Medications and mothers' milk. (5th ed.). Amarillo, TX: Pharmasoft Medical Publishing.

     Taddio, A., Ito, S., Koren, G. (1996). Excretion of fluoxetine and its metabolite, norfluoxetine, in human breast milk. J Clin Pharmacol 36(1), 42-47.

     Yoshida, K., Smith, B., Craggs, M., Kumar, R. C. (1998). Fluoxetine in breast-milk and developmental outcome of breast-fed infants. British Journal of Psychiatry, 172:175-179.

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html