Is it safe to take Fluvoxamine while breastfeeding?(3+tips)

In this article, we will discuss if fluvoxamine is safe to take during breastfeeding. We will take a look at the research studies on fluvoxamine and breastfeeding and explore several factors that may affect the transfer of fluvoxamine into breast milk. We will also discuss the safety precautions that should be taken by breastfeeding mothers. 

Is it safe to take Fluvoxamine while breastfeeding?

Yes, fluvoxamine is safe to take while the mother is breastfeeding. It passes into breast milk in insignificant amounts and fluvoxamine plasma levels in infants are typically undetectable.

However, since there have been few studies on fluvoxamine use during breastfeeding, no effects on the infant’s short or long-term physical and psychomotor development have been documented (1).

So, a healthcare provider should be consulted so that the possible benefits of the medicine for the mother can be evaluated against any possible risks for the baby. 

What does research suggest?

A clinical study involving 50 nursing mother-infant pairs revealed that all infants exposed to fluvoxamine while nursing had undetectable serum drug concentrations and that the minimal exposure was not linked to any negative side effects in infants.

The study’s findings suggest that fluvoxamine may be an effective therapeutic choice for depression in nursing mothers (2). Published literature indicates the use of fluvoxamine during lactation in 14 mother-infant pairs. 

Maternal doses of up to 300mg/day produced minimal levels of the medication in milk, and no adverse effects were expected in breastfed infants, especially if the baby was older than two months (3).

Which factors affect fluvoxamine’s transfer into breast milk? 

Several factors can affect the passage of fluvoxamine into breast milk. Some of these factors are (4,5): 

Lipid solubility:

Being a lipid-soluble medication, fluvoxamine tends to concentrate in the hind milk, which has a higher fat content than the fore milk. Overfeeding an infant can lead to foremilk/hindmilk imbalance, resulting in inconsistent quantities of fluvoxamine in breastfed infants.

Dose:

Fluvoxamine dosage can affect the drug’s concentration in breast milk. Fluvoxamine is more likely to pass into breast milk if you have taken a higher dose.

Timing of dose:

The timing of the dose of fluvoxamine in relation to newborn feeding can influence the amount of medication passed into breast milk.

Age of infant:

Premature infants, neonates, and infants who are medically fragile or have poor kidney function are most vulnerable to medication exposure through breast milk.

Breastfeeding frequency:

The amount of fluvoxamine in breast milk can vary depending on the frequency of breastfeeding. While more frequent nursing may help lower the levels of the drug in milk, irregular breastfeeding could increase it.

Maternal disorders:

Maternal disorders that may affect medication clearance, such as poor liver or kidney function, may result in higher peak levels of the medication in the blood, which may result in increased transfer of the drug into milk.

How to know if the baby is affected by fluvoxamine intake?

Although most cases of mothers using fluvoxamine while breastfeeding have not been associated with harm to the baby, some reports of diarrhoea, vomiting, restless sleep, and agitation in infants have been reported.

So, breastfed babies exposed to fluvoxamine should be closely monitored for symptoms of diarrhoea, drowsiness, altered feeding patterns, or frequent crying (6). It is important to teach mothers how to distinguish between a typical baby’s behaviour and a negative medication response. 

Get in touch with your child’s healthcare professional if you have observed any behavioural changes in your infant.

What safety precautions should breastfeeding mothers consider when taking fluvoxamine?

The safety recommendations for nursing mothers who take fluvoxamine involve carefully evaluating the potential benefits and risks. The following are some of the precautionary measures (7,8):

Consultation with a healthcare provider:

Consult a healthcare professional before starting or discontinuing fluvoxamine during nursing. Talk about the advantages and disadvantages based on your health state, the severity of your mental illness, and your baby’s age and health.

The doctors will conduct an in-depth risk-benefit assessment. They will compare the benefits of treating the mother’s mental health issue with the possible risks of the infant being exposed to the medication.

Monitoring for side effects:

Healthcare professionals will monitor the mother and the child for any possible side effects or adverse reactions, as well as any changes in the mother’s emotional state and the baby’s overall health. Close monitoring is especially important during the first few weeks of treatment.

Breastfeeding routine:

It is occasionally advised to take the dose just after breastfeeding to minimize newborn exposure. Keep up a consistent and regular breastfeeding schedule. This may lessen the amount of drug present in breast milk.

Educating the mother:

Healthcare professionals should educate mothers about the potential positive and negative effects of fluvoxamine as well as any known side effects. They should also be informed about the health benefits of breastfeeding.

This allows the mother to make wise decisions. Family, friends, and medical professionals should support and urge them to keep taking their medicine, understanding the value of effective breastfeeding results for both the mother and the child.

Why do breastfeeding mothers need fluvoxamine?

Many women experience postpartum depression, which can be dangerous for both the mother and the child. In addition to the risk of maternal suicide, depression can make it difficult for a mother and a child to form an emotional connection. 

Children of depressive mothers may experience behavioural issues, delayed cognitive development, and difficulties with attachment. Treating your depression will enhance your productivity and quality of life (9). 

Therefore, your physician may prescribe you antidepressants such as fluvoxamine (Luvox), sertraline (Zoloft), or paroxetine (Paxil), etc.

Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) used off-label for the treatment of various mental disorders, including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and panic disorder.

Conclusion:

In this article, we have discussed that fluvoxamine is safe to take while breastfeeding. It passes into breast milk and the level of the medication in the breast milk is so low that no adverse effects are to be expected in the breastfed infant.

However, in my opinion, both the mother and the baby should be monitored occasionally to avoid any problems. Doctors should be consulted so they can evaluate the risks and benefits associated with fluvoxamine during breastfeeding.

References