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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To think GP’s should encourage breastfeeding?

95 replies

Sofedup2022 · 05/03/2022 22:28

I’m so fed up and furious this evening! I’ve been struggling with anxiety and depression for a few months now and have an 11 month old baby.

I finally worked up the courage to book a doctors appointment - which was a nightmare in itself as it’s impossible to book into our local surgery. I finally got a telephone appointment with a nurse this morning.

I explained how I was feeling and she asked if I was breastfeeding. Once I said yes she said that meant I couldn’t take any drugs and the only option was to refer me to counselling. I politely said I’d been told by the breastfeeding network that there were antidepressants that were safe while breastfeeding, at which point she said she’d speak to the junior doctor and call me back.

She rang me back to tell me that almost all antidepressants aren’t safe while breastfeeding as it passes to the baby so I had two options

  1. Take Amitriptyline which may make the baby sleepy
  2. Stop breastfeeding and take another antidepressant!
I was pretty irritated but decided I would try the Amitriptyline. I have gone to take my first dose this evening and realised I have been prescribed 10mg. I have checked the NICE guidelines and that is the dosage they prescribe for back pain, while they advise at least 50mg for treating depression.

I am so furious. It took a lot for me to make the appointment and they made me feel like a selfish mother for wanting drugs and have essentially made it clear that if I want anything that will actually help me they expect me to stop breastfeeding.

Breastfeeding has been hugely protective for my mental health and has been one area of motherhood that I feel really good about. I have no intention of stopping and luckily know enough to query what she said initially or I’d have ended up stuck on an 18 month long waiting list for counselling! I do have counselling privately which I did explain to her, it’s not that I’m looking for a magic pill to fix everything, but I have taken antidepressants in the past and they were the only thing that was truly effective.

WIBU to complain? Should I book another appointment? Who would I even complain to?!

OP posts:
ParalysisByAnalysis · 05/03/2022 22:32

Why are you believing the “breastfeeding network” (whatever that is) over the opinion of two doctors?!

Also, with the best will in the world, your almost-1 year old will benefit much more from you being in good mental health, than your breast milk.

ParalysisByAnalysis · 05/03/2022 22:33

One doctor. Apologies I misread.

dizzydizzydizzy · 05/03/2022 22:36

@ParalysisByAnalysis doctors and midwives have very little training in breastfeeding whereas the breastfeeding network do nothing else.

OP - you could also try phoning a breastfeeding counsellor at the NCT. They know about this stuff too,

DontLookBackInAnger1 · 05/03/2022 22:36

@ParalysisByAnalysis

Why are you believing the “breastfeeding network” (whatever that is) over the opinion of two doctors?!

Also, with the best will in the world, your almost-1 year old will benefit much more from you being in good mental health, than your breast milk.

Because it's written by qualified people.

OP - good on you. There are Plenty of antipressants you can take while breastfeeding. I know many mothers who take them.

I would ask to speak to a doctor directly.

AwkwardPaws27 · 05/03/2022 22:37

Is there a perinatal mental health team you can ask to be referred to? My GP is pretty shit with MH & badgered me to come off antidepressants (on them partly due to recurrent miscarriage) before TTC again.
The perinatal team, including the specialist pharmacist, are happy for me to have sertraline or citalopram (27 weeks, considering restarting medication) & are aware I'd like to breastfeed. I have an appointment next week to discuss and decide.

Original poster
Sofedup2022 · 05/03/2022 22:38

Because there are plenty of antidepressants which are safe to take while breastfeeding - as stated on the NHS website. They also emphasise “ It is important to continue taking sertraline to keep you well. Breastfeeding will also benefit both you and your baby.”
I do believe doctors! But I appreciate that drugs and breast milk is a pretty niche area and I’m frustrated that the advise they are giving goes against the NHS website and could be very damaging for mothers.
I appreciate that babies don’t need breastmilk and I could give formula etc. but I want to continue breastfeeding and there’s no reason the two can’t go hand in hand!

OP posts:
Motherchicken · 05/03/2022 22:38

Could you try researching the tablets you want to try and take this information to the doctors and ask for it specifically?

Original poster
Sofedup2022 · 05/03/2022 22:39

Sorry that should have been @ParalysisByAnalysis

OP posts:
Samanabanana · 05/03/2022 22:40

@ParalysisByAnalysis HCPs, including doctors, refer to the breastfeeding network for advice when prescribing medicines, etc

OP, hope you get sorted Flowers it is really infuriating when you can access proper treatment when breastfeeding

FlibbertyGiblets · 05/03/2022 22:40

Okay the staff at the BFN are highly trained and give advice that is gold standard. GPs otoh really are generalist practitioners by their very name and won't have specialist knowledge.
www.breastfeedingnetwork.org.uk/about-us/

OP I am so sorry. Can you grit your teeth and get in touch with your HV who might be able to advocate for you?

Cowardlytiger · 05/03/2022 22:41

GP here. Can’t comment on what’s appropriate for you obviously as haven’t seen you, but there are definitely antidepressants you can take while breastfeeding. Amitryptiline wouldn’t be my first choice either. I’d ask for an appointment with a different GP for starters and and discuss there.

If you want to complain, ask anyone in the practice for complaints process or just send it in to the practice manager. But the most important thing is going to be addressing your own needs - good luck and I hope you feel better soon, I’m sorry you had such a negative experience

@ParalysisByAnalysis breastfeeding network is actually a pretty good source of info used by lots of doctors as a resource

ParalysisByAnalysis · 05/03/2022 22:42

Fair enough. I stand corrected. Good luck to you then, OP. Hope you get it resolved.

Cowardlytiger · 05/03/2022 22:43

My only other piece of advice would be to consider talking therapy alongside antidepressant treatment - really good evidence for it. But hopefully you’ll get an appointment with another GP and you can talk it all through properly.

lochmaree · 05/03/2022 22:43

I started taking a really low dose of sertraline while bf my 18m old. I think its the preferred SSRI for bf mums but citalopram could also be used. I'm also pregnant and there's been no issue with me continuing the sertraline.

@ParalysisByAnalysis OP clearly said that bf helps her mental health, why should she have to stop simply because her HCPs have given incorrect advice? bf past 1 year has benefits for mum and baby, no reason why she can't continue. also worth noting that some mums experience a temporary decline in mental health after weaning from bf due to the hormonal changes, so stopping may make her mental health worse.

Sundance5 · 05/03/2022 22:44

You are amazing for breast feeding whilst struggling with your mental health. You really are incredible. Of course there are plenty of anti d's you can take, ask for a second opinion, you saw someone who doesn't know what they are doing. But please don't forget.... you are smashing it!

Glitterheart · 05/03/2022 22:44

Don’t give up OP, ask to see a different doctor/second opinion. I went on sertraline while breastfeeding - it changed my life for the better and my baby certainly benefitted from
A much calmer mummy (while still bf!) x

KindlyKanga · 05/03/2022 22:45

To think GP’s should encourage breastfeeding?

The answer to this question is YABU. It should be based on the patient's needs. Best thing the GP did was tell me it was ok to stop trying.

Thefrenchconnection1 · 05/03/2022 22:51

I'd just lie and say I'm not breastfeeding if I had reliable advice elsewhere. Go back and ask for one you know is safe.

lochmaree · 05/03/2022 22:53

@KindlyKanga but the OP clearly wants to keep bf, so her doctor should support and encourage it. of course if a mum doesn't want to bf then they should be supported to stop.

Jellyfishjean · 05/03/2022 22:56

They're just telling you the scientific facts.They can't change them just because you don't like them.

Futurequ · 05/03/2022 22:56

GPs are encouraged to promote breastfeeding but unfortunately there isn’t much teaching around it in the training programme (there is a lot to fit in in 3 years). I have also seen it the other way where mothers who are in need of support feel pressurised to continue breast feeding, again because it isn’t really taught well. I don’t have an answer as how to fix it but it is sad that so many are misinformed with regards to breast feeding and medication.
The information you were given by the nurse and doctor is wrong. You mentioned junior doctor in your post- that would suggest that it was either a GP in training or even a foundation doctor rather than a qualified GP. The junior doctor is a doctor but may have had even less experience with breast feeding and prescribing. I would request another appointment with another GP to discuss your options- if they are more amenable to prescribing something like sertraline I would then raise the previous consultation and the wrong information given. This will allow them to raise it with the nurse and other doctor. If that doesn’t work then I would write to the practice manager with links to the breast feeding network and the nhs guidance. Lots of GPs do use the breast feeding network guidance when prescribing but unfortunately not all know about it.
Sorry you are having a tough time and hope you get the help you want soon.

Bizawit · 05/03/2022 23:00

Your GP is an idiot. I’m breastfeeding and on antidepressants. I was advised to start them when I was pregnant but opted not to and wait until after I had given birth. Make a complaint and ask to speak to another GP xx

Cowardlytiger · 05/03/2022 23:01

@Jellyfishjean they’re wrong though and not giving accurate advice (or appropriate treatment). That’s the problem here.

BurnDownTheDiscoHangTheDJ · 05/03/2022 23:01

I breastfed both of mine until they were at least 2.5yrs (the eldest was keener to continue than her sister- she would probably still be going now if i hadn’t gotten pregnant again and the milk dried up) and medical professionals treated me like I had two heads. I’ve got lupus and some other medical issues and kept being told by various GPs that it was dangerous to continue bfing (it wasn’t, I had talked with my consultant before I even gave birth) and once each of my daughters turned one GPs that I was seeing for very much non-bf reasons would actively encourage me to stop. One said “you’re making your life and your lupus harder” which I really wasn’t.

My experience was that from day one with my eldest (when a health care assistant tries to force a bottle of formula on my 12hr old baby who wouldn’t stop crying on the postnatal ward) right through NHS professionals were very unsupportive of breast feeding. I only received one encouraging comment once, when I had totally given up feeding and had to attend the breast clinic because of a (thankfully benign) lump. The consultant asked me if I had ever breastfed and I said yes, for around 5yrs total. She was surprised and said “very well done, your daughters will feel the benefit!” Only positive comment I ever got.

The NHS talks the talk about breastfeeding but it’s very different in practice.

Chloemol · 05/03/2022 23:01

I always understood that you start of on a low dose and work up to the required dose

I think you will find taking 10mg will start to help and that it’s better to listen to a doctor than a breastfeeding site

Drs will always do what’s best for the baby with regards to feeding

Try the tablets at the low dosage, then go back if it’s still not right