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Prozac Used by Breastfeeding Mothers May Affect Baby's Weight

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Dec. 3, 1999 (Atlanta) -- Many women continue to use the antidepressant Prozac (fluoxetine) while they breastfeed, despite the concerns expressed by the American Academy of Pediatrics, the FDA, and the manufacturer of the drug. One likely reason: There's been little research to back up those concerns, until now.

According to a study in the November issue of Pediatrics, the use of Prozac by women while they are breastfeeding does not lead to any unusual behavior in their babies. However, the drug is linked with reduced growth in these infants.

"There may be an effect that you need to watch for in babies who are exposed to [Prozac] during breastfeeding," says lead author Philip Anderson, PharmD, with the department of pharmacy at the University of California, San Diego Medical Center. "To me, [the findings] ... make it a less desirable medication to use in mothers who are depressed and want to breastfeed."

In the study, 64 women who took Prozac during pregnancy between 1989 and 1997 were interviewed about frequency of any side effects. All of the women breastfed their babies, but only 26 continued to take Prozac while breastfeeding. Pediatric records were used to measure the babies' weight gain.

The infants of the mothers who continued to take Prozac were significantly lower in weight than infants who were breastfed by mothers not on the drug. Between two weeks and six months of age the average deficit in weight was just under 14 ounces. "[That's] not considered to be a real serious risk to the baby's health in terms of decreased weight gain," says Anderson. "But we are dealing with averages. And there are some babies at the far end of spectrum where the effect could be great enough to be of concern."

"There are other papers that have found kind of a pattern of side effects that seems consistent among a bunch of different case reports -- fussiness and colic, and agitation," says Anderson. "Those are hard to detect, since babies are fussy."

The weight loss experienced by the infants may be explained in several ways, according to the researchers. First, the drug may directly inhibit weight gain in infants who receive it through breast milk; weight loss is a commonly noted side effect of Prozac in adults.

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