will someone please just tell me what to do?

[entropygirl]

Is it time to give up BF?

DD is nearly 8 mo. She has been on a nursing strike for 5 days (probably due to a cold but maybe just due to her being an independently minded young madam).
I am suffering PND and would dearly love to go on anti-depressants and hopefully stop being terrified of my DD. The anti-depressants say they should only be given to BF mothers if the risk to the mother out weighs the (apparently unknown) risk to the baby o_0. I am not her primary carer, DH is. I have not previously stopped because BF is the only thing I have with DD that isnt a fight. Now I dont have even that and I dont know if it will come back or if thats it and I certainly cant face expressing 4 times a day....

Right I think thats it so PLEASE TELL ME WHAT TO DO.

right, hang on.

slow down a bit.

Do you like BFing?

Are you thinking that because she is refusing you can give up, like you want to give up?

Or is it that you feel like you need to give up because she is refusing?

The Anti-Ds are another thing, but not the whole.

So sorry you've been having a rough time. Have you been expressing while she's been on nursing strike? If not, I would guess your supply might be down a bit anyhow.

I am a breastfeeding peer supporter, and usually I would encourage mums to continue feeding through a nursing srtike, as ofen babies come out the other side still wanting the breast. But... your circumstances are really complex, and I guess you need to decide how unwell being off your ADs is making you. No one can give you permission to stop, it does have to be a decision you make for yourself.

It looks lke your choices are...

1. To carry on trying to feed (and there are techniques which can help with a strike) and not take your ADs. Baby gets the best milk, but you are unwell.
2. To carry on feeding and take your ADs, acceping there might be an effect on baby's milk (although this is balenced against the benefits of breastfeeding)
3. To stop feeding - you get better, baby gets artificial breastmilk (formula) which will not give her the same protection and benefits as your milk, but which is a perfectly adquate replacement.

Reading through those options, how do you feel about each of them?

Agree with Nagoo that really, the strike and the meds are two different issues. Which do you want help with right now?

Okay I see what you are saying regarding them being two issues....what makes it muddled is that I feel so utterly despairing when DD refuses the breast. Like she is trying to rule me out of her life.

Okay so nursing strike help please!

I have to express 2/5 feeds a day anyway due to work. So I have just been expressing all 5. But I dont think that is sustainable. No large effect on supply yet.

ADs are compatible with bf, and your doc should explain this and select a type known to have no issues.

Nursing strike - loads of possible strategies for this (call a helpline maybe?) but main thing is not to struggle, not to fight, not to be cross, not to show distress or upset...patience, skin to skin, bathing with the baby, letting her 'come back' on her own terms, and it will happen.

Hope today goes better.

tiktok thanks for the advice - I will try a helpline. My DD doesnt do hugs or being held much though so Im not sure that skin to skin wont be more of a fight than trying to BF. Once reason for wanting to carry on was that BF is the only time she will let me hold her.

Regarding ADs I have been given ADs that are the safest according to doctors and BFN but not actually what I would consider to be safe according to the research. Or perhaps a better way of putting it is that they are safe in the approximately the same way that formula is safe. It's unlikely to give your baby a serious reaction but increases the risk of all sorts of other things you would rather not think about.

It seems DD will nurse for the first feed of the day but not after that and not at night. confused.

Which ADs do this, though, entropy: "It's unlikely to give your baby a serious reaction but increases the risk of all sorts of other things you would rather not think about."

Many ADs have no adverse effects on infants at all - nothing about increased risk of anything :)

I can see that with a baby aged nearly 8 mths skin to skin is less easy - but try bathing with her and having fun with watery cuddles :)

Yes I would second a bath with her, warm and relaxed and fun, and your nipples there as a reminder to her!

Also, a lot of the studies are based on neonates being bf by mothers on XX drug, not bouncing great 8m olds! The amount of drug a neonate can tolerate is likely to be less due to the liver function being a little slower (also the proportion of BM to body size & the exclusivity of BM).

Which drug have you been prescribed? You can ask for another drug to be prescribed or ask for a very low dose to watch for side effects rather than jumping in at a full therapeutic dose.

I took ADs and BF at the same time when I was feeding DS1, there is no need for it to be an either or. It was hugely important to me to continue BFing, and it would have worsened my PND to give up I am fairly sure.

With the strike, I would also recommend getting in the bath with her. My 9mo DS2 loves feeding in the bath and it is lovely :)

I dont want to say what AD it is in case I give others the heeby jeebies, especially as they may already be taking it and BFing, but really I have looked up the research and it is less than conclusive and horrible reading. I take the point about bouncing 8 mo though. I will have another think.

So tonight we played romp around the bed half naked before bedtime (both me and DD - sorry I will pass the mind soap if you need it) and had a half arsed feed after but better than nothing. I didnt manage the bath as I was having a bit of a moment at the critical time, but I will try tomorrow.

lol at reminding her about nipples...she has just started to explore squirting milk out of her bottle teats using a very nice pincer grip, if I do say so myself, and after one look at my nipples she was at the same trick...so I think she at least remembers what they are for.

Oh I meant to say thank you everyone! Just having some people to talk to helps enormously!

entropygirl - the trouble is you can find studies that make horrific reading for most things. Thomas Hale/Wendy Jones/LactMed all do meta-analysis so that one or two studies may be washed out with numerous others that show minimal side effects....

Even if you don't want to divulge the drug name, I have a feeling I am on the drug you have been prescribed. I wouldn't say it's 'safe' (because what is!) but it is compatible with bfing, especially an older baby. I have been on that med for 5y (I need it for one of it's other uses). I am also on another med for epilepsy.

Have a look into Kathleen Kendall Tackett's work - she has done lots into bfing and depression and bfing's mitigating the PND's effects on baby. Some really fascinating stuff. Lots of stuff on inflammation and more 'natural' ways to deal with depression without eschewing modern medicine!

TS yes unfortunately it was the meta-analysis that concluded that we essentially have no idea if it is safe for children because it is too new, but that the initial findings are that there are no serious side effects but some evidence of central nervous system problems....

The thing is that it isnt a matter of comparing the risks of PND against anti depressants, it is about comparing the risk of formula against the risk of anti-depressants. And the risk of PND with BF and PND without BF. ITs just all too much to look into and I am far from being able to think about the issues dispassionately.

I got two feeds into DD yesterday though so things may be easing on the strike front. On the other hand I am back at work today so she will be back on the bottle....