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Weight gain in infants
breastfed by mothers who take fluoxetine.
Chambers
CD, Anderson PO, Thomas RG, Dick LM, Felix RJ, Johnson KA, Jones
KL.
Departments of Pediatrics, University of California, San
Diego, California 92103, USA. chchambers@ucsd.edu
OBJECTIVE:
Despite the manufacturer's recommendation that fluoxetine not be used by
women while breastfeeding, many women choose to do so. There is little
information available in the literature to suggest that this practice is
or is not safe. The purpose of this study was to examine weight gain in
infants who are breastfed by mothers who take fluoxetine, compared with
weight gain in infants who are breastfed by mothers who do not take any
psychotherapeutic medication. A secondary goal was to assess the
frequency of reported side effects in infants who are breastfed by
mothers who take fluoxetine. METHODOLOGY: A retrospective cohort study
design was used. Subjects were identified from an ongoing pregnancy
outcome study conducted through the California Teratogen Information
Service and Clinical Research Program. A total of 64 women were
interviewed who had taken fluoxetine during a pregnancy between the 1989
and 1997; 26 of these women breastfed their infants and continued to
take the medication, and 38 breastfed their infants but did not take the
medication. Postnatal weight gain was taken from pediatric records, and
the frequency of side effects was measured by maternal response to the
interview questionnaire. RESULTS: Using linear regression analysis, the
infants who were breastfed by mothers taking fluoxetine demonstrated a
growth curve significantly below that of infants who were breastfed by
mothers who did not take the drug. The average deficit in measurements
taken between 2 weeks and 6 months of age was 392 g (95% confidence
interval: -5, -780). Using a repeated measures analysis of covariance
for those infants with more than one postnatal weight measurement
available, the difference between the two groups was similar,
approximately 1.2 standard deviations (P =.005). In response to
interview questions regarding side effects, no mother who breastfed her
infant while taking fluoxetine reported any unusual symptoms that could
be attributed to the medication. CONCLUSIONS: These data do not suggest
that women who breastfeed while taking fluoxetine are likely to note
unusual behavior in their infants that they consider related to use of
the medication. However, although there was no excess of infants in the
fluoxetine group with postnatal weight measurements >2 standard
deviations below the mean, these data indicate that breastfeeding while
taking fluoxetine is associated with reduced growth that may be of
clinical importance in situations in which infant weight gain is already
of concern.
PMID: 10545587 [PubMed - indexed for MEDLINE]
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