Paroxetine during breast-feeding: infant weight gain and maternal adherence to counsel

The aims of the present study were to examine the weight gain in infants breast fed by mothers taking paroxetine and to assess the clinical implementation of the recommendations of the teratology service in our centre. A prospective cohort study design was used. The study group included 27 mothers who had taken paroxetine for at least 2 weeks while breast-feeding, 19 mothers who did not taken paroxetine and did not breast-feed their infants, and 27 mothers who breast fed their infants but did not take any drugs. Participants completed a detailed outcome questionnaire at 3 months to 1 year after the birth of their child. Additional infant data were obtained from specific follow-up forms routinely completed by the paediatricians and nurses at well baby clinics and paediatric services in Israel. Infant weight and developmental milestones at ages 3, 6, and 12 months were recorded. There were no statistically significant differences between the paroxetine group and control groups in mean infant weight at ages 6 and 12 months. The usual developmental milestones were reached in all groups. There were no reported adverse effects of paroxetine during lactation except for irritability in one infant. Mothers expressed satisfaction with the treatment.

paroxetine use during breast-feeding does not affect infant weight gain and rarely has adverse effects on the infant. Paroxetine may be an acceptable solution for depression in lactating women provided that they adhere to four important restrictions: use lowest dose (20 mg/day), preferable single bed-time dose, avoid combinations of drugs, and ensure close medical follow-up of the infant.