Is It Safe To Take Prozac (Fluoxetine) While Breastfeeding?

check_icon Research-backed

Image: iStock

IN THIS ARTICLE

The medication Prozac while breastfeeding is known to treat postpartum depression (PPD), a physical, emotional, and behavioral change that pregnant women experience after the delivery of a newborn. For example, a mother may feel tired, exhausted, irritated, and anxious about taking care of their child. As a result, she may seek escape from the responsibilities of a newborn. However, this temporary change can be treated with some medications and tips. The most commonly suggested by medical professionals to treat PPD is Prozac. But a few mothers may hesitate to take medications while nursing due to the possible effects on the baby. In this post, we answer this query and discuss Prozac, its usage, and its effects on breastfeeding. We have also included a few natural remedies to help deal with PPD.

What Is Prozac?

Doctors often prescribe Prozac to treat severe depression and anxiety. The medication helps overcome obsessive compulsive disorders (OCD) and eating disorders such as bulimia and anorexia. The generic name of the medicine is fluoxetine. It belongs to the popular class of antidepressants, or Selective Serotonin Reuptake Inhibitors (SSRI).

Norfluoxetine is the long-acting, active metabolite of Fluoxetine. Apart from Prozac, other fluoxetine drugs include Symbyax, Prozac Weekly, Sarafem, Selfemra, and Rapiflux.

Is Prozac Safe While Breastfeeding?

You may take a low dosage of Prozac to deal with depression or panic disorder after childbirth. However, monitor any changes in the behavior of your infant.

The average amount of Prozac that mixes with your breastmilk is relatively higher than other SSRIs. Hence, most doctors opt for Zoloft or Paxil instead of Prozac.

Now, what does research say about the safety of Prozac while breastfeeding?

Researchers at the Yale University School of Medicine studied 11 mother-infant pairs when the mothers were on 20 to 40mg of fluoxetine on a daily basis. The study has concluded that there are “no meaningful changes” in platelet 5-hydroxytryptamine receptors (5-HT) transport in infants (1).

The lead author of the study, and assistant professor of psychiatry and obstetrics and gynecology at Yale School of Medicine, Neill Epperson says: “Ten of the 11 infants experienced little or no decline in blood serotonin concentrations after exposure to fluoxetine through breast milk.”

Serotonin is a chemical produced in the brain and is said to influence mood, appetite, sleep and other behavioral issues (2).

Doctors could detect the drug in the serum of breastfed infants. However, less than 10% of the drug found in the mother’s blood gets into the breastfed baby.

Talk to your doctor about some safer alternatives to fluoxetine.

Safety Tips

Stick to the prescribed dosage of Prozac during breastfeeding.

Do not take SSRIs or other antidepressants in conjunction with any other drug, as it could lead to complications.

Avoid conventional medicines such as anticonvulsants, theophylline-containing drugs, anti-reflux medication and lithium, while taking fluoxetine and breastfeeding.

Side Effects Of Taking Prozac While Breastfeeding

Common side effects in mothers are: sweating, anxiety, abnormal dreams, nervousness, dry mouth and nausea (3). Some other side effects are:

In the Yale study, out of the 11 infants, only in one a decline in platelet 5-HT, coupled with measurable plasma fluoxetine level was seen. Researchers assume that this was due to the exclusive breastfeeding by the mother, who was on high plasma drug level.

“However, the observations may be coincidental, and the infant experienced no discernible adverse effects,” the report says.

Another study that measured the weight gain in infants (4) when the mothers were on fluoxetine, observed reduced growth in the babies. This could be of concern in babies who are already having a low weight gain.

Both the study reports agree that further research is required to determine the adverse effects of SSRIs.

These observations could raise doubts of whether or not to use Prozac when breastfeeding.

Should The Mother Stop Breastfeeding When Taking Prozac?

The drug gets to its peak in the breast milk within the first six hours of ingestion. But you don’t need to discontinue breastfeeding.

In fact, breastfeeding is good if the mothers have taken SSRI during the third trimester of pregnancy because breastfed infants are less prone to poor neonatal adaptation than formula-fed babies.

However, monitor the baby’s behavior for fussiness, colic or sedation. Also, measure his weight regularly to make sure that he is growing normally.

These worries are because of your medication for PPD. What if you make additional efforts to come out of the situation naturally as quickly as possible?

Natural Ways To Get Rid Of Postpartum Depression

Overcome your depression with some support from non-medical ways:

  • Maintain a healthy diet and get enough rest.
  • Practice relaxation exercises or go for a walk in the park.
  • Speak and share your feelings with your partner or close friends and family.
  • Try stress-relieving techniques such as yoga, meditation, and good music.

Any medication such as Prozac while breastfeeding may raise concerns for your baby’s health. Since you undergo several physical and emotional changes postpartum, you may be prescribed medications and therapy. However, as said by professor Epperson, before taking fluoxetine medicines and SSRIs, women should “weigh a range of factors, including the severity of the postpartum depression, their response to the anti-depressants, and their commitment to breastfeeding.” Therefore staying aware of the drug and consulting your doctor about safer alternatives provides better management.

Frequently Asked Questions

1. Can depression affect your milk supply?

Mental health issues such as stress and anxiety may increase levels of certain hormones such as cortisol and affect your milk supply (5). Postpartum depression (PPD) additionally interferes with breastfeeding. Women with unaddressed PPD may not breastfeed or do it for shorter durations than women who are not clinically depressed. PPD may also affect the immune properties of breast milk (6).

2. Can Prozac decrease milk supply?

Women on Prozac may encounter a delayed onset of milk production, which may cause initial feeding difficulties. However, this delay did not significantly impact their feeding (7).

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Maternal Fluoxetine Treatment in the Postpartum Period: Effects on Platelet.
    https://e-lactancia.org/media/papers/FluoxetinaBF-Pediatrics2003.pdf
  2. Breastfed Infants Show Little Effect when Moms Take Anti-Depressant.
    https://news.yale.edu/2003/11/24/breastfed-infants-show-little-effect-when-moms-take-anti-depressant
  3. Fluoxetine.
    https://medlineplus.gov/druginfo/meds/a689006.html
  4. C D Chambers et al; Weight gain in infants breastfed by mothers who take fluoxetine.
    https://pubmed.ncbi.nlm.nih.gov/10545587/
  5. 4 factors that can decrease breast milk supply – and how to replenish it.
    https://utswmed.org/medblog/decrease-breast-milk-supply/” target=”_blank” rel=”follow noopener noreferrer”> https://utswmed.org/medblog/decrease-breast-milk-supply/
  6. Psychological Distress in the Mother May Affect Levels of Immunoglobulins in Breast Milk.
    https://womensmentalhealth.org/posts/psychological-distress-mother-may-affect-levels-immunoglobulins-breast-milk/
  7. C D Chambers et al; Weight gain in infants breastfed by mothers who take fluoxetine.
    https://www.ncbi.nlm.nih.gov/books/NBK501186/
The following two tabs change content below.

Dr. Dur Afshar Agha

(MS)
Dr. Dur Afshar Agha is a consultant pediatrician with decades of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association. She has also completed her Post Graduate Program... more

Shivali Karande

Shivali holds a bachelor’s degree in pharmacy and a master’s in management. After working for nearly five years in the market research sector, she discovered her passion for writing and started freelancing. Her knowledge about medicines and biology, coupled with her experience in research, helps her write well-researched, informative, and evidence-based articles. For MomJunction, she writes articles on health and... more