I have a dilemma. I have a 5 week-old baby that I have been exclusively breastfeeding. I have begun to show symptoms of post-partum depression %26amp; have also been very anxious. I had ppd with my other child too %26amp; it got very bad before I would accept help. I was convinced that I was a terrible mother %26amp; that he was better off without me. It would break my heart if I had to stop bfeeding in order to take meds. I know some meds are considered safe, however, my dummy psychiatrist refuses to give me anything because ';he doesn't feel comfortable with it';. So then basically he is putting me in a position where I have to decide to either suffer w/ the ppd %26amp; do the right thing for my baby or to stop bf %26amp; take the meds. What should I do? I am so heartbroken already.If you are pro-breastfeeding I need your advice?
Get a second opinion. See your obstetrician, he/she probably knows more about the subject than a psychiatrist and treats women in the same situation all the time. Zoloft is considered extremely safe while breastfeeding; millions of breastfeeding mothers have used it.If you are pro-breastfeeding I need your advice?
I had PPD with each of my sons and had successful and healthy breastfeeding relationships with each of them. (thrush problems aside! lol)
Definately see your OB rather than this psychiatrist. I am sorry that this man is being uneducated about this issue. See your OB and be sure to discuss your options and other health issues and reactions to medications that you have had. Each patient will have different meds. I was on Lexapro and Welbutrin. The combination worked best with my body chemistry. Both were safe for me and baby. I hope that you soon find a solution to you PPD. Hugs!!!
I took Zoloft on the recommendation of my old OB who was one of the authors of the study at Case Western University that confirmed the safeness of nursing mothers using it. My milk never had it in it! I was taking 100mg then 150mg and it never was passed into my milk. I would see an OB for this because they tend to read the news that relates to their patients and are usually better equiped to deal with PPD.
I am so sorry! I breastfed all of my children. Although I never had PPD, I did end up with severe depression later on. I am now completely recovered - thank God!
I guess I would talk to your OB/Gyn - who can also prescribe antidepressants. I agree that it's best to use a psychiatrist, but you're dealing with newborn baby and nursing and hormones too. I don't know myself what is safe/unsafe to take. I believe others have had meds and continued to nurse. You would only want to if you were absolutely assured it would be okay and extensive testing has been done with that drug and nursing.
The worst case scenario - you have to stop nursing in order to get better. It's not the end of the world. Your baby has already been nursed for the most important stage - newborn to now! You did it! If you had to put the baby on formula, it would not be as beneficial as breastmilk, that's true - but it would not be all bad. You need to focus on getting the help to make you feel better - there is NOTHING more important than your babies having their mom and their mom being healthy!
Call around. Get lots of opinions. Ask your pharmacist too about what he/she thinks/knows about the subject. Then you will be able to make the best decision you can!
You're trying to be the best mom you can be - that's all we can do! I'm not perfect, neither is anyone else. If one mom can breastfeed and one can't - it doesn't make the nursing mom more worthy or special. Life isn't perfect, so all we can do is do our best and move forward. I think the worst thing would be ignoring symptoms and letting ppd get stronger.
It's possible that increasing your excercise level, taking your prenatals, eating super healthy will help balance you out too, without meds. Maybe there's a hormone based treatment that would help? PPD is probably caused directly from the decrease and imbalance of hormones. You can breastfeed while on some low dose birthcontrol pills - I wonder if that would help? I would be asking my OB about it if it were me.
Excercise always made me MUCH improved. Watch funny movies and LAUGH a lot. Laughter is one of the most healing things we have to fight depression.
I hope it all works out the way you want it to - I hope you can concentrate on how beautiful your baby is and how blessed your children are to have YOU as their mom! You're irreplaceable in their eyes! Best Wishes!!!
Go see a different doctor. There are many PPD drugs that are safe to take while breastfeeding. Call an lactation consultant and your OB they will both be able to point you in the right direction. You don't have to stop breastfeeding so you can receive treatment.
And i agree your psychiatrist is a dummy, i think he needs to go back to medical school.
Get a different psychiatrist, or take him the research if he's too lazy to look it up himself.
There are lots of medications that you can take while breastfeeding. Anecdotally, half of my friends have used depression meds while nursing. You're right, you can make the decision to keep nursing AND get yourself taken care of.
If this guy is unwilling to help you, then he needs to get out of your way. Get a second opinion. You might have to educate HIM if he won't help you. Don't forget, you are his boss, you employ him, you pay him, he needs to work with you to accomplish your goals. If he can't support nursing, which is the BEST for the baby AND you, then you should consider someone else. Frankly, since nursing releases prolactin and oxytocin, two proven hormones that relax you and make you happier, I'm surprised he doesn't do EVERYTHING in his power to make sure you keep nursing.
Essentially, Zoloft and Paxil seem to be the safest choices with the lowest transfer in milk. Lithium is one of the dangerous choices. If your doctor won't listen to you, send him the link to the Kelly Mom site or encourage him to pick up a book specifically dealing with medications and nursing moms (like ';Clinical Therapy in the Breastfeeding Patient, Medications and Mother's Milk, Drugs during Pregnancy and Lactation.) All of those books are pro-breastfeeding books that detail what drugs are OK and which aren't.
Here is the list I got from Kelly Mom and linked below.
Specific drugs discussed:
* Prozac is the only drug ';cleared by the FDA'; for use during pregnancy. A mother on Prozac during pregnancy may wish to change drugs before birth or immediately after, or titrate the dose down in the last trimester since the existing blood plasma level in the newborn fetus plus the drug transfer through milk may lead to toxicity. Its effects on the breastfed infant have been reported in infants 2 months old or less.
* Zoloft is the ';best drug choice so far';. It has a low, low transfer rate to breastmilk (17-173 ug/liter) in mothers taking up to 150 mg/day. In one excellent study of 11 mother/infant pairs, the zoloft was undetectable in 7 of the 11 breastfeeding infants' serum and minimal in the other infants. In two other studies of one and three mother/infant pairs respectively, zoloft was undetectable in the plasma of all 4 infants. A theoretical concern with Zoloft is that some babies may not gain weight as rapidly or as well when breastfed by moms on Zoloft; so weight gain should be monitored and dosage tweaked as necessary.
* Paxil has low blood plasma levels in the mother, and a low transfer rate to human milk. It was undetected in the blood plasma of 7 of 8 breastfed infants in one study, all 16 of the infants in a second study, and all 24 of the infants in a third study. For babies exposed to paxil in utero, there is evidence that withdrawal may occur 24-48 hours after birth.
* Celexa has a 4.3-16 nanogram/kg blood plasma level, but transfer rate is higher via milk. Use with caution and watch infant for side effects (per Hale, ';There have been two cases of excessive somnolence, decreased feeding, and weight loss in breastfed infants.';).
* Effexor is a popular drug for treating depression in Australia. It is less popular here in the USA due to reported side effects. Effexor can also be used in breastfeeding mothers if it is efficacious. It may be effective against hyperactivity. It is an SSRI and NRI.
* St. John's Wort is a weak SSRI. It also stimulates liver enzymes and may enhance the metabolism of other drugs. German varieties are found to be the most pure in independent testing; other brands may have contaminates and not be very pure. Documented drug-drug interactions have been found; the action of St. John's Wort on the liver can accentuate the metabolism of many drugs. For example, St. John's Wort may reduce the efficacy of birth control pill regimens, although this has not been documented.
* Bupropion has a high milk to plasma ratio, and is excellent for use in smoking cessation programs. It may reduce the milk supply but as yet this is undocumented.
* Lithium use by the breastfeeding mother is dangerous to the breastfed infant.
* Valium use by the breastfeeding mother entails a greater risk of infant sedation, and may perhaps increase the risk of SIDS.
* Tricyclics - many have significant side effects in mothers including dry mouth, constipation and other anticholinergic symptoms. Thus they are not overly popular with patients. Generally, tricyclics have a poor transfer to milk with the exception of Doxepin, which has a higher transfer rate. Long-term effects are unknown.
Talk to your ob/gyn right away. They will be able to recommend something for you. Good for you for asking for help right away. As a mom, you think you need to ';suck it up'; and deal but that is not true. If you are not healthy, you cannot take good care of your children. Try to stick to bf as long as you can BUT if you have to stop or need to stop for your own sanity, please do not feel like a failure. You need to do what is best in your own life, not listen to other people who put pressure on you. Good luck.
I can understand your dilemma there are never any fair choices some days but here is what I would do....
Your baby is safer with your mental health taken care of first so that should be your major priority.
Next you have a couple of options....you can give yourself 2 very well supervised weeks to just pump and pump and then start meds and your baby will benefit by having your breast milk which can last another 6 weeks or you can check with your local LeLecheLegue on where to find a breast milk bank and you can continue to give your baby breast milk although it's not yours.
Also if you are looking to simulate the entire process they do have a bag that you can wear that has a straw that goes down to your nipple that the baby then suckles from you but gets the healthy bagged milk. You would need to be sure that you totally no longer make milk to try that as any of your meds will harm the child.
Please keep in mind millions of babies have NEVER been nursed and they are doing great, You need to first keep your children safe then figure out how to feed them.
good luck
Maybe you should try counseling and talking it out as opposed to taking medications. There are alot of things you can do in that regard. It's good that you know you are at risk. It's a shame you're experiencing symptoms again. If you can't work through it with counseling then you may have to go on medication and switch the baby to formula. Either way you need to do what is best for yourself and your baby and realize that your baby has reaped many benefits of your 5 weeks of breastfeeding. Many babies never get breastmilk at all and go straight to formula. So you've already given your baby a head start in that way. If you're up for it you could even pump and save some breastmilk for when you go on medication. That way you could continue giving the baby breastmilk. The symptoms and risks of ppd can be deadly. So take care of yourself and your little one and that's the best thing you can do.
