Breastfeeding on medication

[MaryMary007]

Hi all

Just looking for some advice on breastfeeding on medication. I'm trying for another baby my youngest in 4 now and I had Post natal psychosis 3 weeks after her birth I was breastfeeding her successfully at the time

I.m currently on a maintenance low dog of olanzapine 2.5mg antipsychotic and 200mg sertraline anti depressant I'm on these as I had a relapse of psychosis 2 years ago

I really want to breast feed if I'm lucky enough to get pregnant again my psychiatrist has advised I stay on this medication as I'm high risk

I was wondering if maybe I could do a morning feed only as I take my medication at night

Any advice appreciated x

[jessieh APP]

Hi MaryMary007,

Thanks ever so much for writing. I thought I'd get in touch as I have some experience of feeding while on medication. I mix fed with bottle and breastfeeding for around 6 months after having PP, I'll admit I didn't find it easy, it can be possible though.

I wondered if you've seen this guide from APP, as you might find it useful: app-network.org/wp-content/...

Did you get a chance to talk to your psychiatrist about your medication while breastfeeding? I'd definitely recommend discussing with them. The APP guide has a section about medication and a link to the Choice and Medication website that has advice on specific medications - you could take a look at your medications and see what it says: choiceandmedication.org/ncmh

I had PP 'out of the blue' when my son was a couple of weeks old. I was admitted to hospital and had 2 weeks apart from him, followed by 3 months in a Mother and Baby unit (MBU). I had been desperately keen to breastfeed, though I really struggled. While apart from my son I had a breast pump, and then staff at the MBU supported me to try feeding again when we were back together. I still found it difficult and in reality I think my son would have been just as happy without me doing so! He was bottle fed at night by staff and then when I came home by my partner. I did a feed once/twice a day and that suited me, I tried pumping still and did feel sad when at 6 months my son showed little interest in breastfeeding, so I stopped then. I was on a combination of 2 medications at first for a month - Clonezepam and Olanzapine. I then continued with just olanzapine for 1 year.

So I know that it can be possible and that staff can be supportive. There are options for mix feeding, if you think that might work for you. I guess the main thing is to be prepared, either way, and so that you don't feel disappointed and feel like you have some control if you don't find it possible.

I hope that this helps you with finding some sources for advice and I'm very happy to talk further.

Jessie xx

[swylie]

Hi I just wanted to say that I'm 30 weeks pregnant after being very poorly after my last son 5 years ago.

I don't have any experience of medication and breastfeeding but I'm likely to be put on meds once I've had baby and have been thinking about breastfeeding.

So thank you for your post as I wasn't aware of the online resources, I've book marked them so I can use them.

Thank you for posting and I hope you are well and have a healthy future pregnancy.

[BronSyd in reply to swylie]

What medication did you take last time you were unwell? Is it perhaps breastfeeding friendly. It is definitely worth looking into now so you are aware.

Sleep is often another factor in becoming unwell so it is often suggested to not do night feeds to enable you to sleep especially in the first few 'high risk ' weeks.

It is possible to mix feed with formula and breastfeeding. It can be harder but is definitely possible.

Saying all this breastfeeding can be a bit of a trigger so don't put too much pressure on yourself.

Good Luck in the next few weeks. I hope all goes well for you.

[swylie in reply to BronSyd]

Thank you for your reply I've bought everything I need to formula feed, as I'd rather be well than to breastfeed and be poorly.

That being said I had a good supply of milk last time and would be a shame to waste it so if I can I might do formula and a bit of breastfeeding until my milk supply runs out.

I've checked on the online resource and the previous med I was on if taken in low doses isn't meant to cause any problems for baby so that might be an option.

Either way what's most important is that I am well.

X

[BronSyd]

Just a few of my thoughts. Sorry it got to be quite a long response.

Is the current advice that these medications are not ok to breastfeed with? Can you contact someone with up-to-date advice? In Australia we have a helpline to call specifically about medications. Would your national breastfeeding association be able to provide a resource?Cause really psychiatrists don't have the need to find out about how it affects breastfeeding they just want to treat you. It's just usually written in their 'book' as to whether or not it is 'safe'

Is there an option for you to try different more breastfeeding friendly medication now to see if it works for you? Considering you are still taking medication and you are a couple of years from your last episode. I know it's a bit of a risk to try new medications but surely now is better than after you're pregnant or after the birth. You always have the option to go back to what works.

After my second was born my psychiatrist tried to switch my meds as I was finding them too sedating it took me a few days of crossover to know that I needed to go back.

I know different medications work for different people but I took quetiapine (anti-psychotic) and Sodium Valproate (mood stabiliser) starting at fairly high levels after my PP with my first and was able to breastfeed (I did mix feed but more due to low milk supply after my episode). I was required to have my son's liver function tested to ensure that he wasn't being adversely affected (from the sodium valproate specifically). Although it didn't seem to work as effectively for me I took Risperidone (anti-psychotic) after my second was born and was able to breastfeed.

As we become more aware of the benefits of breastfeeding and thus push the professionals for us to be able to breastfeed more medications seem to 'becoming' more breastfeeding friendly.

In terms of your current medication and breastfeeding sometimes it would depend on whether you have a slow release medication or not. So even if you took your meds at night they may be releasing throughout the day. I have found that often they (the medical professionals) really don't know if some medications are safe or not. I think there's simply not enough research done. From my understanding it's mostly decided based on the amount that can be traced in the breast milk. However I would think that could vary on different factors. You'll find that some say that one medication is ok while another says it's not. Advice is different across countries (I'm in Australia). It is often a possible risk but not definite and changes with how cautious you want to be.

Some medications definitely aren't ok but definitely talk to your Dr. Plus see if you can find a pediatrician or breastfeeding expert that can give more accurate advice on breastfeeding on medications.

Good Luck. I'm all about research and finding out rather than just going with what I'm told.

But also be conscious of your mental health. Breastfeeding is great but you being healthy really is more of a priority especially with your higher than normal risk factors.

[suzannah0]

My drs said it was absolutely fine on risperidone. My family thought otherwise and I didn't get the family support and I really regret it. I found breast feeding much easier as we coslept at night and didn't have to stuff round making bottles etc (my hubby didn't do the bottles at night, I did). I had difficulties breast feeding due to baby's lip tie, but it was managebla. after six to eight weeks it's supposed to get better. My baby was an excellent sleeper, so I never had to worry about this after 7 weeks. I would get a lactation consultant to help with understanding how to make more milk again after hospitalization. either way, as long as baby and you are healthy, that's the main thing.