WWYD re: weaning to get back on meds or not

MickeyM04 · August 2014

I basically just do not know what to do, I am completely 50/50 on this and thought I would put it out there.

I generally am medicated for severe anxiety (heart palpitations, extremities tingling, shaking hands, lightheadedness, racing thoughts, etc.). When I got pregnant with DD, I got off my meds, and I did fine during pregnancy. Then I had some postpartum blues but those resolved after about 3 weeks and I was fine for awhile. In the past couple of weeks I have felt my anxiety starting to rear its ugly head again. When this happened with DS, I pushed myself to EBF for 6 months and I basically spent months 4.5-7 of his life (it took about a month to fully wean) miserable. Multiple panic attacks a day, losing a ton of weight because I was too nervous to keep anything down, etc. I promised myself I wouldn't let myself get to that point this time, because he did great on formula, I felt better on meds, etc. (The med I was on last time with DS was not approved for nursing - so I waited to wean him to get back on those meds.) Well I was on a different med when I got pregnant with DD. This one is safe while nursing. Or as safe as anything can be while nursing. I think it's in the same category as antibiotics but not the safest category that Tylenol is in. Psychiatrist, therapist, OB and pediatrician all say that I can continue nursing while on this medication, but they all say it's up to me. I am having a really hard time deciding what to do. Part of my anxiety is that I am absolutely terrified for DD to be getting anti-anxiety meds through my BM, even in low concentrations. I keep seeing all those TV ads running through my head, "Are you suffering from fertility problems/heart problems/etc. etc.? Did your mother take XYZ medication while she was pregnant with you or breastfeeding? If so, you may have a cause of action. Call the such and such law firm." And I am an attorney who works in the healthcare field so I know about all the things that can go wrong, that nothing is ever 100% safe, etc.

So I can't decide whether it would be best for DD to continue getting BM, even if that BM has my medication in it, or whether it would be best for her to be on formula, which of course isn't as good for her as BM (no antibiodies in it, not as easy to digest, etc.) but is definitely proven safe (other than of course the occaisonal recall and stuff like that, I don't think there's any dispute that formula is safe for a baby to consume). I feel like I'm damned if I do and damned if I don't. If I wean her and get her on formula, I'll feel bad that she's not getting "the best stuff." If I get back on my meds and keep nursing, I'll be paranoid that she's going to have adverse effects immediately or even like 20 years from now, and any time she seems "out of sorts" I'll wonder if it's the meds as opposed to just typical infant behavior.

So ladies, WWYD? I'm just at a loss and would like input and maybe a different point of view.

(Edited for spelling)

CNYBride05 · August 2014

I'd keep nursing, and take the meds. I did, actually, for the 1st few months. Anxiety is such a miserable thing

. ((Hugs))

MickeyM04 · August 2014

Thanks ladies. It's hard because every practitioner is framing it in terms of, "It is safe to nurse while continuing this medication," but I guess I'm more looking for whether it's safer to nurse on the medication or safer to use formula. If that makes sense. As someone who represents a lot of doctors and hospitals in litigation, I know that for example, every surgical procedure has risks, including bleeding, infection, and even death. But the procedure is still overall considered safe, and in many circumstances the risks of not having the procedure outweighs the risks of having it (like an appendectomy for appendicitis--obviously safer to get the appendectomy even with the attendant risks than to let the appendix burst). So to me when a medical professional says it is safe to do X, or take Y medication, I know that they aren't inherently saying, "There are no risks here." So I guess what would be nice to know is if the risks in nursing on the meds are greater than the risks in not nursing.

It's also complicated by the fact that, for example, I received formula from day 1 and I turned out fine (mental illness aside, LOL). Same with many of my friends, as we are of the generation where nursing wasn't what it is now. So in some sense I'm comparing two different animals...is it safer to be nursing on the meds or safer to be on formula and no meds. Like of course formula is safe. But do the benefits to breastfeeding over formula feeding outweigh the risks of breastfeeding while medicated. Last time it was easy, the med I was on wasn't compatible with nursing, and to top it off, I wanted to stop at 6 months anyway, so it wasn't a big deal to start weaning like a week before I had intended. Now the med is compatible and I'm 2.5 months out from my goal.

It's just hard in the profession that I am in and with my anxiety to figure out what I am most comfortable with. Especially because there are class action lawsuits out there now where women are now having fertility problems because their mothers took certain medications while they were pregnant. So yeah, sure, now we know that this med is considered safe, but what about 20 years from now. Putting babies to sleep on their stomach was also considered safe and now we know that SIDS has been reduced by 50% since back to sleep. So it's hard because the current state of information we have doesn't reassure me that all will be well in the future, if that makes sense.

eggmankate · August 2014

I second looking it up on LactMed--perhaps having the specific details about what studies indicate will give you a piece of mind. If you are still anxious can you discuss an anti-anxiety that has no transfer to the milk? I believe Zoloft is one of them.

I ran into a similar situation when I was hit with insomnia, but we found a med that trace amounts of medication may transfer to milk, but the benefits to my DD that I continued giving her breastmilk far outweighed any theoretical extremely unlikely risk of her taking in some trace amounts of medication.

cinderin · August 2014

I decided to bf while on a medication.

Formula feeding is not risk-free.

JulyMumma · August 2014

I just want to say first of all the being a mom is hard, right? Lots of decisions and lots of doubt especially in the early days, weeks, and first months.

When you think about it there is "risk" in everything we do - formula feeding, breast feeding, riding in a car, crossing the street, walking, etc. You have to decide what is best for you and your family.

If the doctors say it's fine to continue to BF, but you are so consumed with worry and concern that you are not enjoying it and not enjoying your baby - then stop. To me it's not worth the risk. We all know that babies thrive however they are fed. On the other side, if stopping BF is going to make you feel guilty or like a "failure" than maybe you should continue. Only you can decide. And of course you could do both.

Whatever you decide to do - your baby will be FINE. I would encourage you to Google the Fearless Formula Feeder. Lots of good infant feeding advice. Suzie (the woman behind the blog) is a mom and a LC, but supports choice for moms. You'll find lots of bf supporting, ff support, combo feeding support. I'm sure you'll find someone on her site going through a similar thing. Good luck and enjoy that baby of yours.

MickeyM04 · August 2014

Thanks ladies. I think you are right, there are risks to everything. Formula is not totally risk free either and I have to decide what will make me feel sane and happy because obviously DD will be fine regardless. There may be more benefits to one over the other or more risks to one over the other, but as long as she is fed, she will thrive, right?

I think the thing I'm hung up on is the long term risks of the medication. I know short term she will likely be fine but the long-term risks of BFing on medication largely have not been studied yet, because a lot of these meds are newer, and BFing is a lot more widespread now than it was when we were kids, 30 years ago. I would love to see studies of people who were nursed while their mothers were medicated and who are now 20, 30, 40 years old. As far as I can see, those studies don't really exist. I don't know if Zoloft or Lexapro (what I would be taking) or Paxil or whatever were even on the market back then. It frustrates me (I did look on Lactmed) when I see all these case studies or studies or whatever where it's like so and so's mother was on X medication and at 7 weeks/16 weeks/20 weeks, baby was doing fine. I am like, yeah but what about 5 years down the road, 10? 20?

I did wean my son at about 6 months and by 7 months he was on 100% formula and he has turned out just fine. He doesn't have asthma or food allergies or seasonal allergies and he's not dumb or not bonded with me or anything so I know she will be fine either way she's fed, I just have to I think decide what I want to do. Thanks for everyone's input, I do appreciate it very much!

(Edited for clarity)

Myaflowers · August 2014

I second what AmyG said about Dr. Hale. Call Infant risk or ask about your situation on their web forum. I asked about a medication for myself, and Dr. Hale answered within the day. I have chosen to stay on my meds and breast feed. I'm not sure specifically about Lexapro, but many of the meds are undetectable in the breast milk, and you have to consider the half life and peak plasma levels, as AmyG mentioned. If Lexapro isn't OK, Zoloft definitely is. I wouldn't give up breastfeeding because of taking a medication. I have anxiety, too, and I know it's hard to make these kinds of decisions. I'm sure your LO will be just fine either way!

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WWYD re: weaning to get back on meds or not

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