I have to give up b/f and I need help please.

[MarkStretch]

Bit of a long story but basically I have been diagnosed with eptopic heartbeats, not really much in themselves but I am having them very frequently and landed me in A&E on Sunday.

Been to the Dr's today and they have spoken to the cardiology department at the hospital who have advised that I start on a course of beta blockers whilst I wait for my Cardio appointment.

(Please don't think I have taken this decision lightly, I have been avoiding taking any meds for months)

Anyway, Dr has advised that I stop b/f my 7.5months baby as the beta blockers will pass through to him in my milk.

I fed my dd for 14 months, stopped when she self weaned so I have NO idea how to do this. I am also completely clueless about bottles/formula/amounts etc.

I have sobbed my heart out this morning and the thought of stopping is so painful but it has to be done.

I would love some practical advice on how to do this please...

[MrsBadger]

some (not all) beta-blokcers are safe when bfing
has he looked for alternatives to the first-suggested drug?

this page has useful info and suggests that doctors avoid water soluble agents e.g. atenolol,nadolol,celiprolol and go for propranolol,metoprolol or labetalol instead.

Ring them up.

[twirlymum]

Sorry to hear about your problem, I hope it all gets sorted out for you.
It's actually quite easy preparing formula (I bf for a while, then expressed, then moved on to formula).
All the tins will have clear instructions on them, but always use their scoop, provided in the tin. This will make sure the concentration is right.
A microwave steriliser is your best bet. Mine only cost £10, and has been brilliant.
Try to rinse bottles as soon as they have been used, then wash them up in washing up liquid along with your dishes, and rinse well.
The microwave steriliser only takes about 7-8 minutes.
I then filled mine with cooled boiled water, (you will have to do a bit of trial and error as to how much your baby will take each time).
I used to make up a couple of bottles at a time, so I didn't have to wait for the kettle to cool down when ds was hungry! The formula can then be added when needed, and you can warm the bottle up in a jug of hot water.

[MrsBadger]

um and if you do need formula, storing cooled boiled water isn;t recommended - the powder needs to be mixed with hot water to kill any bacteria in it.
Proper guidelines here

[tiktok]

Oh my goodness....it's so good you have come here to get more info before taking the almost certainly unnecessary decision to stop.

toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT is another good site - put the word beta blockers into the search box.

The link in MrsB's post is good, too.

The cardio doc is unlikely to be an expert on paediatrics, or the pharmacological effect of drugs in breastmilk, or indeed on breastfeeding. The fact you have just been told to stop, with no advice on what to do, what alternatives there might be, is a spur for you to find out more for yourself, and then discuss with the doc again.

Hope this all helps.

[MarkStretch]

Thanks Twirlymum, it's so much to think about! How many bottles will I need?

DS is a brilliant eater and was only really having a main feed morning and night, with maybe the odd couple during the day.

Mrs Badger- I've looked it up and it says the risks are 'unknown'.

[thehouseofmirth]

MS definitely get advice re drugs. My friend's GP told her to wean because of thyroid meds she needed to take. Because of her training she had access to correct info and GP was totally wrong....

What's the name of the drug? I can get her to look it up in her reference book & let you know.

[twirlymum]

I would check what the options are re the drugs, but if you do need to ff, then I would say you would probably need three or four?

[tiktok]

MarkStretch - twirlymum's advice on prep of bottles is incorrect...check the up to date stuff in the link from MrsB's post.

The fact your baby is only having two feeds makes it even less obvious you need to stop bf.

By finding out the half life of the drug you could time the dose, and you could also find out how much of the drug enters the breastmilk. It might be too little to worry about.

What does the LactMed link I posted say about the drugs? You can always ask the doc to consider prescribing a diff. drug, too.

[twirlymum]

Sorry - wasn't aware of that (I stopped ff a couple of years ago)

[MarkStretch]

It's this one

[tiktok]

Link doesn't work, MarkStretch. What's the name of the meds?

[MarkStretch]

Oh sorry - Bisoprolol.

[MarkStretch]

Just popping out now, will check back later.

Thanks everyone.

[tiktok]

LactMed gives 3 preferred alternatives, MarkStretch. Would you feel able to speak to doc and ask for a discussion on changing to one of them?

[PacificDogwood]

Drug safetety of Bisoprolol in pregancy and BFing

[twirlymum]

Just checked the link. I did put cooled boiled water in the fridge.

[MrsBadger]

doesn;t help, twirlymum
the water neds to be hot when it meets the powder

if you have no option but to make ahead of time then make up the powder with hot water, cool the made-up milk and store that in the fridge

[CMOTdibbler]

this links to the toxnet search for Bisoprolol. They recommend Propranolol, Labetalol, or Metoprolol - you might want to ask your doctor whether these might be suitable for you

[tiktok]

twirly - putting the cooled boiled water in the fridge is not per guidelines.

The water has to be no cooler than 70 deg C at the point at which the powder is mixed.

This is because the concern is about the powder, which is not sterile; it is not about the water.

[twirlymum]

Oh, I see now. Thanks.

[tiktok]

I think the newer guidelines are taking forever to become understood and accepted, because until recently everyone has boiled the water because the water is what people worry about....you're not the only one to post on mumsnet and be unaware, twirly.

[twirlymum]

Thanks, that makes me feel slightly better.

[duedec2]

MarkStretch, if you DO have to stop breastfeeding I don't think you should beat yrself up about it. Seven and a half months of breastmilk for yr baby is brilliant; lots of (health-minded, intelligent, well-informed) women stop a lot earlier. Anyway, you now know how to mix formula!

[PinkTulips]

{{{{hugs}}}} (who cares what the MN police say )

MS... i can't imagine how tough this decision is for you, i hum and haa about taking painkillers for a headache fgs so it must be awful to have to make this choice but my gut instinct tells me that for me personally i think i'd prefer to bf and take the alternative drugs if possible rather than give up.... but who knows how i'd feel in your shoes.

Either way you've done a fantastic thing feeding F for this long and he's already a healthier happier child for it, don't beat yourself up if you decide to stop. If you wouldn't feel completely comfortable feeding while on the meds then don't feel guilted into doing so, on the flip side of that if stopping would break your heart and your confidant about the safety of the alternative drugs then don't let the docs bully you into stopping.... fgs my dentist told me to put a stop to feeding A to protect my teeth

Hope you're feeling ok, sounds like a horrendous weekend

[ramblingmum]

Hi if you need more information about the choice of medication and its safety in breastfeeding then I would ring the hospital and ask for the Medicine Information department. This will run by pharmacist who will have access to all the relevant information and can help to interpreter if necessary