POLL: if you were me in this situation would you breast feed or formula feed?

[electra]

I am on quetiapine (an atypical AP) but a relatively low dose - 50mg a day. Baby is due in 3 weeks...

My psychiatrist thinks it's ok for me to BF but my consultant told me that there is simply very little evidence to go on as to whether this drug is safe for a baby to ingest or not. All she can tell me, she said is that it will go into my milk if I take it and that only I can make the decision what to do.

I don't want to FF My older children were breast fed and it's what I'm used to aside from anything else.

But OTOH if I BF I will be taking an unquantified risk on my baby's behalf.

What would you do? TIA

It's difficult to balance the risks imo as formula has them too.

electra - have you read this?

toxnet.nlm.nih.gov/cgi-bin/sis/search/f?./temp/~JiOU29:1

My personal opinion is that none of this justifies not breastfeeding.

There are known risks with formula feeding - quantifed, and measurable, and unavoidable.

The risks with this med seem (on this evidence) very small, if they exist at all, and you will feel unhappy if you do not breastfeed.

It is your choice, but if you want my answer to your poll, I would deffo breastfeed.

I would also find out the half-life of the drug, which might help me time my dose.

I can totally understand what you are going through. I had to take medication after the birth of DD2 and the first consultant I spoke to said there was "a theoretical risk of hemmorage " associated with breastfeeding.

This frightened the life out of me, but I really wanted to breastfeed. After speaking to lots of different people with the help of my MW, I was finally offered a safer and much more expensive alternative drug which was considered safe.

Make sure you get to speak to the right people and then make your decision based on the best information. It may be that there is an alternative drug that is safe.

There is also a database - it's American "Lact" -something. This tells you about all the current research concerning the safety of drugs and BFing. Someone else will hopefully know what it is, but I'll see if I can find it.

I don't want to be in the position of making that decision for you, IYSWIM.
What I suggest you do is call one of the bfing helplines and get some advice from them - they will have a better idea of how to find the info you are looking for.
I found this number for you to ring:
Breastfeeding Network Drugline: 0844 412 4665

They'll be able to help!

Thank you so much for your replies That is all very useful and at a time when tiktok was online!

i would bf, no doubt

I would bf too.

Good luck, hope it goes well whatever you decide.

I would bf too.
I was on AD's almost the whole of Ds's pg and afterwards for a long time and bf the whole time(18 months). It was not that drug though, but an 'old fashioned' AD.
Good luck with what you decide to do.

www.breastfeedingnetwork.org.uk/drugline.html
That should be a link to the breastfeeding network Drugs in Breastmilk page. There is a drugline number there which you can ring for info. It is run by a pharmacist and a peer supporter with some additional training re meds. Hope that helps

I would breastfeed.

I took ADs during most of my pg with DD and then afterwards. I breastfed her for 10 months and was on ADs all that time.

Thanks so much for your replies. It has made me feel a bit better about breast feeding the baby.

Thomas Hale seems to feel it is OK.
There are several references on his site:
neonatal.ttuhsc.edu/lact/
If you enter as a guest and peform a search (click on the magnifying glass) you can read through all the refs. He was unsure around 2004 but now seems much happier based on new evidence. One link has a pdf on quetiapine which I couldn't download but you may have more luck.
He doesn't seem to have an issue with someone on 400mg a day.

Says on one thread:
"There's a ton of stuff on Seroquel (Quetiapine) in my 2008 book. Please check it."
The Bfn pharmacist will have this book at hand and will read it to you.

On another thread he says
"Quetiapine has a really low relative infant dose, about 0.09% of mom's dose"

After a 10 minute look at his forum I would have no hesitation in breastfeeding. If you aren't familiar with his work Dr Thomas Hale is pretty much the leading world authority on medication and breastmilk.

Hi there,
I understand that this is an extremely difficult decision for you. I am concerned that people with limited knowledge of quetiapine are giving their opinion regarding this decision. If i were you i would speak to your consultant, health visitor, pharmacist and psychiatrist again. Gain a full knowledge of the risks and make your decision from there. With the support of health professionals you can then make an informed choice.

Yep, another vote FOR BFing .

Am no specialist, but surely the unborn babe is exposed to Quetiapine during pregnancy as well? And the concentration in breast milk will be less than in your blood stream.

Agree with tiktok (how could I not ) re known and quantifiable risk of FF and known and quantifiable benefits of BFing.

I would ask your psychiatrist to discuss the matter (or arrange for you to discuss the matter) with a perinatal psychiatrist. these psychiatrists should have the most up to date and accurate information on quetiapine and breastfeeding. research in this area is very limited therefore it would be worth speaking to a specialist. there are other atypicals you can swap to if need be (even if you are using it more as a mood stabiliser).

Of course electra will discuss it with her HCPs....she was asking people what they would do with her choices and info and people were answering in that spirit.

The question of meds and bf is one that is too often answered by the words 'no you can't', even by people who are supposed to know about these things.

One problem is that it's a question that does not fit into psychiatry (because the baby is not the 'patient') or paediatrics (because the mother is not the 'patient' either). It's a very specialist niche.

Thanks again for your replies. This has been very helpful indeed. I will discuss it further with those who look after my case but am feeling much more positive that I should be able to feed my baby the way I want. The baby doctor at the hospital has written in my notes that there would be no great concern but that I need to keep an eye on the baby and perhaps time when I take it so that the baby doesn't get the highest concentration.

i'm not sure because i took anti biotics after birth and these upset my babies stomach and i think this is why he has become dairy intolerant and eeg allergic and a nightmare to wean.
But what i do suggest is that you take Bifidabacterium infantis powder (from a good health food shop) this will help balance the gut flora for you and pass through your bm if you decide. otherwise you can mix with formula or water for baby.

also at six months i started giving my baby flax seed oil. it helps repair the gut lining. incidently you could take this yourself aswell as it balances essential fats which in turn balance hormones and seratonin levels in the brain thus helping with depression

Flax seed oil tastes foul though kalo.

my baby loves it, and he refuses most food

I would bf. From what I understand, the amount of toxins that can get through are minimal and the benefits of bf in this situation would probably outweigh the risks. Human milk has the capacity to 'adapt' to poisins. Apparently it's still healthier to drink and smoke and bf than not bf at all.