Breastfeeding dilemma

adifrog

I've been on a couple of medications for Crohn's disease for years.  One of them is a biologic (Humira) that I administer through an injection every two weeks.  I met with my GI specialist back at the beginning and he told me to stay on both medications through pregnancy because a flare up would be more harmful to the baby than the meds.  This morning I called to check on breastfeeding while taking these drugs because I don't recall us talking about it and I just wanted to make sure it's safe before beginning.  Turns out it's not--he said I can't breastfeed for the three days following the shot, but the remaining days are safe because the meds aren't as potent at that point.

Obviously, I will consult my OB and come up with a plan at my appointment on Tuesday, but for now I'm a bit crushed.  I really had to psych myself up to breastfeed in the first place (I come from a long line of non-BFers) and then I'm surprised by this.  I think I can get to a point eventually where I have enough milk pumped to cover those three day gaps, but that will not happen for a while.  Has anyone been in/know anyone who's been in this kind of situation?  Is it possible to do mostly breast milk and then a few days of formula when they're so small?  Will we be able to get into a rhythm if I have to start and stop every two weeks?  Thanks for any advice you can share.  

AnnikaD20

You will definitely have to pump a lot on the days you can't breastfeed to keep your supply up. As far as getting a stash ready vs. supplementing with formula, that will depend on how successful you are at pumping, but it seems like it should be doable.

You may want to look more into the meds though. It's extremely rare that you will actually need to stop breastfeeding due to meds. A lot of doctors are untrained in breastfeeding safety and just look in their copy of Physicians Desk Reference, which only contains manufacturer info and not any of the tons of independent research that's been done (and drug companies usually just rubber stamp "not for pregnant or breastfeeding women" on everything rather than testing it.)  The National Institute of Health and the breastfeeding meds helpline run by Dr. Hale have much more accurate info. Linky below.

https://kellymom.com/bf/can-i-breastfeed/illness-surgery/med-risks/

Good luck with whatever you find out.

adifrog

Thank you AnnikaD20!

mojomama6

I agree that most doctors simply say no to breastfeeding, since they have no training there, but the three day rule sounds slightly more thought out than a rubber stamp no. I would certainly look into  it a lot more before taking up any sort of start/stop breastfeeding routine. 
That said, if it is necessary to stop and start, make sure you're pumping and dumping on your "days off"- as often as your baby eats plus as often as you're pumping to build a stash for that time, or you could very rapidly lose your supply. 

allisshiney

I would really look into the safety of the shots and probe further. I'm in Canada and here 2 great resources are kellymom.ca contacting Dr. Jack Newmans office. He is a leading bfing expert. A lot of doctors will be very cautious (not a bad thing) but in the end you can still breast feed

allisshiney

I would really look into the safety of the shots and probe further. I'm in Canada and here 2 great resources are kellymom.ca contacting Dr. Jack Newmans office. He is a leading bfing expert. A lot of doctors will be very cautious (not a bad thing) but in the end you can still breast feed

adifrog

I've been on the drug for 7 to 8 years, about two years shy of when it was first approved.  There are still so few studies with concrete evidence, and of course the drug company wants to avoid liability and says "don't BF, just in case."  I'll continue to research and consult doctors and LCs to make sure we come up with a plan that's safe but effective.

seasidesweete

Once the baby is here it is typically the pediatrician a decision not OB. Check with the ped to see if it is ok. As for the period where you can't BF, is there a milk bank near you?  If you aren't able to build enough of a stash before you need your injections you could do that. FX for a healthy supply and that you are able to BF through this. 

emgee27

I would definitely second the advice to not start/stop as that disrupts supply and demand. If you really end up not being able to use that 3 days of milk, then dump but don't stop pumping. 

Hopefully you get a more thorough answer with more research on the safety of everything!

amaniupendo

You can definitely mix the Bf and the formula feeding. Supplement as needed and pump and dump if necessary. BF doesn't have to be all or nothing. Good luck!