----- Original Message -----
From: "Tony Knox" <[log in to unmask]>
To: "Lactation Information and Discussion" <[log in to unmask]>
Sent: Monday, July 30, 2001 11:29 PM
Subject: Re: Re: Case consult: Antidepressents and bf


> The effects sound like a toxicity unfortunately.
> Buspar is not yet established as safe in lactation and definitely enters
BM.
> Nortryptyline enters BM - albeit in small quantities.
> Zoloft not established as safe in lactation.
>
> All of the above can cause diverse and dangerous effects on CNS and
> cardiopulmonary systems. If BF on Zoloft it is critical to have
> paediatrician assessing the baby - serum levels may be needed in a series
> [which is clearly painful and upsetting all round].
>
> The bottom line may be that if BF is to continue then the drugs may need
to
> be altered - and that might be worse for the baby [and the mum] than
opting
> for artificial feeds. It is her call - but she must be counselled about
> serious risks associated with BF and these drugs.
>
> Tony Knox
> ----- Original Message -----
> From: "Linda Tandy" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Monday, July 30, 2001 8:44 PM
> Subject: Re: Case consult: Antidepressents and bf
>
>
> > 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
> > [log in to unmask]
> >
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