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Subject:
From:
Linda Tandy <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 30 Jul 2001 14:44:34 -0500
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Greetings!  We have a 3.5 month old baby being seen in our follow up home
visit program due to poor state regulation in the NICU.  The mother has a
very significant mental illness history, and has been on antidepressents
since the age of 13.  She is now 27.  She feels that her current combination
of meds has "saved her life," and she won't consider making a change.  At
the same time, she is very committed to breastfeeding.  She took the
following meds during her pregnancy and continuing lactation:

Nortriptyline 50 mg @ hs
Zoloft 100 mg  qd
Buspar 15 mg qd

Baby was born at term with good apgars.  This baby continues to show poor
state control and state modulation.  Was seen on home visit today, and the
nurse stated the baby now has poor tone.  Baby will lay on her back, and
won't bring her hands up to midline.  She is starting to show a
developmental delay.  We have referenced both Briggs and Hale regarding
these meds, however the home visit nurse wants to be sure the meds the
mother is taking aren't a part of the problem.  I know both the
Nortriptyline and Zoloft have long half lives- any possibility this baby
could be building up a toxicity?  We really are glad the mother wants to
continue with breastfeeding, and is committed to it.  Any ideas?  Thanks so
much!
Linda


Linda J. Tandy, MSN, RN, CCM, IBCLC
Clinical Nurse Specialist
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