Can someone help me work out a bf strategy to cope with my migraines?

[plasticspoon]

Baby is due in four weeks and I am determined to do my darndest to breastfeed. However I suffer from fairly regular and pretty severe migraines and would like to think ahead about how to deal with them. The two issues are:

1. I may well be so incapacitated that I am physically unable to feed

2. Pre-pregnancy I was using imigran, aspirin and co-codamol to help with attacks. I'm unsure if any of these are ok while bf and assume that that the imigran is definitely off and that I will have to wait for it to clear my system.

My migraines last about 6 hours so I might be unable to feed for that long plus however long it takes the medecine to clear my system (will check with GP). Now, my NCT group leader said to avoid expressing at first but my (fuzzy) plan is to express and freeze some milk asap. Does that sound sensible? How much should I put aside and how quickly might I be able to build up a store? Can I do anything to minimise the risk of nipple confusion?

Many thanks for all help and advice in advance :)

Hello there
Good plan to work out contingency now rather than waiting til it happens, excellent mummying already! :)

How often do they occur?

Lets say that with a newborn, for a 6hr migrane you might be missing 3 or 4 feeds. You might want to express a couple of oz per feed to start with perhaps? (I don't really know, someone like tiktok would be the person to answer that properly) So you'd want to 'bank' 8oz at any one time.

It used to take me 20 mins to express a couple of oz but I don't think i had the best pump out there. I can't see why you couldn't express enough in say a week without it becoming too onerous - so as long as you don't have more than one a week you should be able to do it quite easily? But as I say I am really guessing on amounts - there's no way of knowing how much a BF baby takes at each feed, obviously!

Bear in mind your baby's needs change as they grow so it's not necessarily wise to 'bank' huge quantities up front, better to do smaller batches as you use it up.

You could speak to the bfn who will be able to advise you about your medication.

see here for more info

I have had migraines on and off for years, but since feeding DD have only had one and that was triggered by extreme tiredness

She is now nearly a year and i haven't had a single attack

I was on amitryptaline and maxakt wafers

Just a thougt ... Don't know if there is anything scientific behind it but feeding seems to have suppressed my migraines

Agree with talking to the BFN

co codamol is fine while bf. I take it daily for other reasons and ds is nearly 5 months. Incidentally you may get headaches when starting to bf in the early days,its the body adjusting to the let down reflex which is controlled in your brain hence the headache-not everyone gets this but some do.

I heard re not expressing in early days but tbh i think there is so much advice out there and then you just have to do what you have to do. My mw diacussed expressing with me in first week post birth bc i had a tough time so we thought it might help me rest with dh doing night feeds. We didnt in the end but anyway the point is when some of the 'perfect' advice out there doesnt fit in with real lives,and then when you go against that advice you realise the consequences arent always as horrific! Obviously im not saying dont listen to the experts, im just saying it sounds like you have little choice and that maybe expressing so early may not be as bad as the advice suggests.

Hi,

Agree with talking to the bfn. kellymom has some useful information about migraine medications and breastfeeding, and it would probably be worth talking to your doctor regarding safe medications to take while breastfeeding, although be aware that some doctors are fairly clueless about bf and pretty much think all drugs are bad, so go prepared.

There is another article here which talks about the effects of sumitriptan (active ingredient of imigran) on breastmilk. Cut&Paste:

"5. What is the latest about taking Zomig, Sumatriptan, Maxalt:

Sumatriptan, trade name for Imitrex, is a newer anti-migraine medication that is closer to the serotonin reuptake agonists. It has been studied during breastfeeding and a small amount does get into the milk. The total amount of drug found in the milk after a single dose was very small. This concentration in milk corresponded to an infant exposure of only 3.5% of mother's dose. The oral bioavailability is only 14%; thus, the infant would only absorb 0.5% of the mother's dose. Thus, it is not thought to be a risk to the suckling infant. The milk half-life is 2.2 hours. The concentrations in milk are very low."

Sumitriptan has also been approved by the AAP (American Academy of Pediatrics) for use in breastfeeding mothers, see list here

I would also add that I used to suffer from regular migraines (aura, nausea, only thing that I could do was lie down in a dark room), and I've only suffered from 2 since starting bf (DS has just had his 2nd birthday). When I did get one, I followed my usual lie down in a dark quiet room thing and fed him lying down in the dark (he was still fairly young and happy to cuddle up to me, not sure that would work now...), and handed him over to DP when the feed was over.

Hope that helps.

Thank you all for your replies and sorry it's taken me a while to reply.

gingerkirsty, thanks - I have a hand pump at the moment but will have dh primed to nip out and get an electric one if it's not working well and try to have a small store. I hadn't really thought about the fact that milk changes over time and so not worth building up a large stockpile. I had visions of being permanently hooked up to the pump!

crikeybadger, thank you for that link - I hadn't heard of the breast-feeding network so that's very useful.

muslimah, that's useful advice about co-codamol, thank you.

Rubyslippers and Alieight - very excited to hear that you have both seen a reduction in the number of migraines you suffer! I have noticed that pregnancy has had a very positive effect on my migraines...long may it continue!

I'm also relieved to hear that sumatriptan has a relatively short milk half-life.

Thank you everyone!

Hi, I suffer from hemiplegic migraines - was taking amytiptalline pre-pregnancy, stopped whilst pregnant and luckily didn't have any.
I had one when DS was 3 months and was hospitalised. DS was still feeding every 3 hours so my DH just brought him in, I fed him lying down with my DH making sure DS didn't roll off the bed as I was totally out of it!
When DS was 6 months I went back on amitriptalline, as DS was only feeding 4 times a day, and I'd take it after his last feed at 7pm, and hope that most of it'd be out of my system by the time I fed him next.
Amytriptalline is such an old drug that whilst they can't sday its "safe" it's considered pretty safe by GPs.
Good luck with bf-ing - there are workarounds with migraines, don't let it stop you.

my migraine were always hormonal, and have only had one since I have had DS (and none in pregnancy).

When I had the migraine I fed DS lying down. It was ok, no more problematic than anything else with a migraine. I just lay there and DS latched on in the dark.

I could however have given him expressed milk, and see no problem with doing this from the beginning. It is however important that even if you don't get a migraine at the beginning once BF is established you try and introduce your baby to a bottle so he'll take one when you do get a migraine if that's what you are planning to do.

At the beginning I worked on the hospitals guidelines for how much milk to give my DS which was somewhere between 150 - 185 ml per kilo per 24 hours, and assumed that DS would feed fairly evenly (just to make the calculations easier). Ds does however take more milk when its in a bottle and may take more than he needs then.

Kellymom has some advice on how much expressed milk you might be likely to need: here.

I've rarely had migraines but I used to get very frequent headaches, but have had hardly any while I was pg and DS was born (he's 9 months now) despite being sleep deprived.

My migraines also almost disappeared when I was BF. Amazing when you consider how tired you are with a baby. Only had one severe attack and a couple of medium ones. I expressed and froze as soon as I was able to, also made sure DD could take a bottle.