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

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Postpartum depression (PPD) is agonizing. It strikes you at a time when you are supposed to be immersed in the intoxicating experience of giving birth to a new life. Instead of getting overwhelmed with joy every time the little one seeks you, you feel tired, anxious, irritated and exhausted. Instead of getting carried away by the touch of her tiny fingers and soft cheeks, you find ways to avoid her.

Thankfully, the condition is curable. PPD is usually treated using medication such as Prozac but because it coincides with breastfeeding you need to make sure the drugs do not harm the baby.

Here, MomJunction tells you about the use of Prozac while breastfeeding and its likely effects on you and the baby. In the end, we also explain how you can get relief from PPD the natural way.

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.

[ Read: Zoloft While Breastfeeding ]

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 Prozac’s safety 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 ingredients of the medication 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 higher or lower dosages.

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

Also avoid conventional medicines such as anti-convulsants, theophylline-containing drugs, anti-reflux medication and lithium, when you are on fluoxetine while breastfeeding.

Side Effects Of Taking Prozac While Breastfeeding

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

  • Vomiting
  • Colic
  • Decreased sleep
  • Irritability
  • Decrease in weight
  • Diarrhea

[ Read: Is Paroxetine Safe During Breastfeeding ]

In the Yale study, out of the 11 infants, one has seen a decline in platelet 5-HT, coupled with measurable plasma fluoxetine level in his blood. 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 examined 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 breastmilk within the first six hours of ingestion. But you need not have 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, track his weight regularly to make sure that he is growing normally.

These worries about the drug effects on the baby arise because of your medication for PPD. What if you make additional efforts to come out of the situation as quickly as possible?

[ Read: Is It Safe To Take Alprazolam While Breastfeeding ]

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.

On the bottom line, like professor Epperson says, women need to “weigh a range of factors, including the severity of the postpartum depression, their response to the anti-depressant, and their commitment to breastfeeding” before they take fluoxetine or any other SSRI.

Have you been through this situation in your life? Do give our readers some tips out of your experience.

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