Urgent help needed RE antidepressants in breastfeeding

[ArtfulLimeUser]

My daughter is almost 3, I was on fluoxetine my entire pregnancy but was switched to sertraline to feed her.
she still has one breastfeed at night but I can’t cope with the anxiety on Sertraline so today my gp has agreed to put me back into fluoxetine but with ‘great caution’ the benefit outweighs the risk however I am nervous about initiating fluoxetine whilst still breastfeeding.
she has one breastfeed at night from one breast to go to sleep. It’s been a long journey feeding her as she has multiple allergies and was small for her age, so her consultant recommended me to feed until she was ready to stop.

has anyone else STARTED fluoxetine whilst breastfeeding
thanks

At her age it will be fine (perinatal psychiatrist here). We only really worry with neonates or in the first few weeks as fluoxetine takes a bit longer to clear out of the system than some other antidepressants and can build up in a very young or premature baby.

Hi, I'm not an expert and haven't experienced what you are going through but didn't want to r&r.

I can only talk about what I would do, firstly you have done amazing to get to three and still bfeeding, don't ever underestimate how great you have done, I know how much dedication it requires.

I fed my first until 2.5, but my second I had to stop at 18 months as I required medical treatment and I didn't feel that it was worth the risk.

I don't know about the risks with changing anti depressants, but if they are saying that the new one is too risky then I would stop feeding.

You being well is so important so I would definitely go back to the medication that works. Sorry not more help.

I hadn't seen this reply, just that you posted a while ago with no replies. This sounds much better than my post.

Good luck whatever you do.

Your health condition is the most important and you need the right medication to treat that. Breastfeeding is not essential, treating you is. Especially age 3!

From the Breastfeeding Network Drugs in Breastmilk service - "It is suggested that initiation in mothers of babies more than 4 months old would appear to be compatible with breastfeeding particularly if it has been shown to be effective for that woman in the past."

I would suggest reading the full fact sheets here https://www.breastfeedingnetwork.org.uk/factsheet/antidepressants/ and here https://www.ncbi.nlm.nih.gov/books/NBK501186/

Consider phoning the National Breastfeeding Helpline or emailing the links shown here www.breastfeedingnetwork.org.uk/drugs-in-breastmilk/ to speak with a volunteer pharmacist