Paxil and Breastfeeding

There is not enough information about the use of Paxil (paroxetine) during breastfeeding however studies suggest that small amounts of this medication are excreted into the human milk. Because of the potential for side effects on the breastfed child, healthcare providers should consider the possible risks and benefits of taking this medication while breastfeeding. If you are taking Paxil and are planning to breastfeed, be sure to consult your healthcare provider.

Healthcare providers would recommend continuing this medication if the perceived benefits outweigh the potential risks and side effects. In most cases, the benefits to the mother of using antidepressant drugs outweigh the possible risks.

What Studies Say

A number of studies suggest that in women who took Paxil while breastfeeding, the amount of Paxil in the blood of the breastfed infant is either very low or undetectable. The most recent published in the Journal of Clinical Psychiatry in 2004 has failed to show any potential harm on infants exposed to Paxil through the breast milk. It affirms earlier studies that indicate that breastfeeding women may safely take selective serotonin reuptake inhibitors (SSRIs).

The amount of paroxetine passed through the breast milk is negligible enough to not cause serious side effects in the breastfed child. In fact, there have been no reports of harm on infants exposed to these medications through breastfeeding. Perhaps, the only situation where breastfeeding should be avoided is when the infant is premature or has been diagnosed or suspected for hepatic immaturity. These conditions can affect how the drug is metabolized in the body. In addition, premature infants are thought to be more vulnerable to the harmful effects of medications.

Recommendations

Consult your healthcare provider about Paxil use during breastfeeding. Each patient is different, and your healthcare provider can give you appropriate recommendation that best suits your situation. Your healthcare provider will consider your condition and the safety of your child before making any decision.

• If your healthcare provider believes that taking Paxil is necessary, he or she may recommend ways on how to minimize the amount of the medication that gets into the breast milk.
• Your healthcare provider may prescribe the lowest effective dose of Paxil. In addition, timing or scheduling the feedings can help minimize exposure to this drug, often in older infants.
• If possible avoid breastfeeding during the peak times of the medication, usually within 8 hours after taking the drug. Studies conducted on a similar medication - sertraline (Zoloft) - have shown that this approach can reduce the infant’s exposure to the drug by up to 20%. Discuss with your healthcare provider other ways of minimizing exposure of your infant to drug.
• It is also important to monitor your child for any side effects. Contact your healthcare provider if you notice any changes in your child after breastfeeding.