Medication v Breastfeeding, advice anyone?

[MissHerde]

Hi all,

I'd like some advice or thoughts on what I should do next please.

I have been diagnosed with depression, I am waiting to hear back from the GP regarding talking therapies and who knows how long the waiting list is.

My son will be 2 in May and I am still breastfeeding. I feel like absolute sh*t everyday I feel like I am drowning in treacle. I'm very very angry, aggressive, shouty and exhausted no matter if I get sleep or not. I'm a total mess so the GP offered medication. So far I declined as I am still breastfeeding, the only people I have told about this just state that I should stop feeding him and take the damn tablets but if I am honest, I feel like feeding my son is the literal only thing I have succeeded at as being a mother so far. I worry that if I stop I really am going to go over the edge. I am on the very tip of that right now and those calm moments when he feeds in the morning is the only stillness I get. I am trying to read up on mindfulness but even that is exhausting.

I have minimal support really so cannot go over the edge, I feel I have to be very careful in my next move, can anyone see a solution here?

thank you in adance x

Hi Herde I'm much more of a lurker than a poster but didn't want you to go unanswered.

Did your GP discuss the actual risks of taking the medication offered and does he/she know you're breastfeeding? I'm feeding a just-turned two year old and have been taking Sertraline for about a year - my GP felt that the benefits would far outweigh any risk (which was very low anyway)

Obviously medication might not be your first choice anyway, but don't think that it has to be a choice between that and carrying on feeding

Hello. If in doubt look up the breastfeeding network. this links to the anxiety and bf factsheet.
You don't need to stop bf to take antidepressants - just need some better advice. Then you can make an informed choice.
I take citalopram and have done all through the 2.7 yrs I've been bfing my ds.

Thank you both for replying, my GP just said that the medication would come through in the milk so we left it at that. I wonder if she was trying to put me off? Though she appeared to be very understanding. I think I will make another appointment to discuss it further, I'm just so bad at advocating for myself when I feel this low :(

The charity Breastfeeding Network (BfN) have fantastic helpline specifically for medication queries. I can't do a link but please Google it and get in touch with them. They are volunteers but have had good training. There is also a good leaflet accessible as a download from the website. Hope that helps

Sorry, cross post with sunflower

I am sure that breastfeeding your son is absolutely no way the only thing you've succeded at so far, the very fact you're worried about whether to stop shows that. As pp says though, have a look at the research on this and see how you feel about it.

Equally, you need and deserve to feel happier / calmer / more yourself, so if you choose to stop BF in order to start anti-DS, or choose to start them but continue to BF, then you're doing it having made a conscious decision to help yourself feel better, and either option is OK, as you've made the decision yourself to take control and help yourself and ultimately your child, by having a happier mother.

I wish you well and hope you feel better soon. And total absolute sympathy for how you're feeling. Am still bf-ing 16mo dc3, mainly as he's dairy intolerant so it's more reassurance / back up. Hand in hand for me goes the co sleeping and disturbed sleep. I'm borderline myself now, and have had depression and PND previously, and felt so much better after starting medication.

Check out kellymom (can't link as on phone) and poss la leche league too. Yes some meds get through in the BM, but one of the meds has a lower half life which means it stays a shorter amount of time in your blood/ milk. This means that if you work out the half life of your meds, you can time taking them so that its most reduced by the time of the feed (am guessing yours down to bedtime / nighttime now?)

A GP should be more helpful and would quickly be able to work this out, if they had the information in front of them.

Hi there,

I took fluoxetine whilst pregnant and breastfeeding.

A few things to bear in mind:

Antidepressants can make you feel worse before you feel better so aren't always a quick fix. It can take some time to get the dosage correct as well.

Although it's considered safe to take them whilst breastfeeding, no longitudinal studies have been undertaken so we can't know for sure that antidepressants (even in the low doses ingested via breast milk) have no adverse effects on the child.

BUT

The waiting lists for talk therapies can be long; I had to wait 3 months for my first CBT appointment (and as luck would have it I went into labour so had to cancel it anyway).

If they work for you, antidepressants can be a godsend. If you're struggling to function normally, it may be worth starting the antidepressants now, even if just as a interim measure whilst you wait for the talk therapy.

If you feel better on the antidepressants, you can then make a decision about the breastfeeding from a more 'rational' perspective (not that you're being irrational at the moment, just that you might feel more clear in your thinking when feeling better).

Hope this helps.

Please remember - the way you're feeling is down to a chemical imbalance in your brain, and many of the thoughts you're having are a direct result of this imbalance. Please do go back to your GP; that feeling of drowning in treacle is incredibly painful - I really sympathise.

I went on sertraline for severe anxiety while bf my 5 month old and continued both until he weaned at 18 months. I found bf my baby the most calming thing and agree i felt stopping that would make things worse. My gp was adament i should stop but i researched and got advice from LLL and a very supportive HV. I was adviced that the amount of the meds passing to the baby are very small and become much less of an issue as the baby gets older, particularly once they are on to solids and bm becomes a much smaller part of their overall food intake.

I've breastfed 2 of my kids from 6 months/birth on anti-d's. I was worried but consultant and GP stressed that there are only tiny amounts that are passed through breast milk and there are no known bad effects (although lack of longitudinal blah blah blah). They said that it is likely that having a depressed mother will cause more damage than the tiny amounts of anti-d through breastmilk. Having done a masters in psychology I have to agree. My kids are now 8 and 5 and are happy, sociable intelligent kids- I don't think they've suffered any ill effects at all.

I too have taken antidepressants whist pregnant and breastfeeding. I hope you have enough information to make the right decision for you. Best wishes for a speedy recovery.

I was/am under the care of a perinatal mental health team and was prescribed sertraline which wasn't right for me so I am now on peroxatine, both prescribed by the perinatal specialist. I also had my reservations but did a lot of research and decided the benefits far outweigh the cons. I believe my children are much better off have a mum who can just about function and have the benefits of breastfeeding rather than the mess I was before. Hope you get the support you need

Hi all, thank you for all your replies and sorry I have not messaged sooner. I've been getting worse and worse by the day really so I will go back to my GP this week as I'm not really able to function well now. I'm getting to the point where I think I might start self harming again as a way to not hurt other people, totally not cool that my brain is going down that route again so I think medication is the only way forward now, I can't fight it off on my own.

Thank you for all your messages, just knowing at least there are some people out there that get it makes me feel less alone xx

Make sure you get the help you need and are honest with the Drs about how you're feeling and your thoughts.
I was too scared to tell anyone what I was going through with my first son because I thought they would take my baby away, when I finally admitted how I felt I got real help really quickly, as a mother to a young child I was made a priority.

You're getting help and that's the best thing you can do for yourself and your child, you're a good mum so don't beat yourself up about having a mental illness, it doesn't define who you are and you can overcome it with the right help. taking medication is not admitting defeat it's the start of your recovery and you will feel good again.

Please remember there are lots of helplines/services and charities you can call for support if you're struggling.

Stay strong for yourself and lo xx

Oh that sounds tough, please call the GP in the morning, I really hope you have some support in RL at the moment x

I'm sorry to hear you are feeling so bad

You've had excellent advice here. I can only add that I was told three times by GPs and even by a consultant that I woudld have to stop BF to take various medications . On each occasion, when I checked it out I discovered that they were wrong .

Either that med was in fact fine while BF or there was another similar drug I could take . Or I could just alter the time I took it so it wasn't near a feed. One time it was a drug with a low blood to plasma transmission rate and the drug was actually approved to be prescribed to a toddler ( which is what I was feeling at the time )

IME doctors are paranoid about the risks to your baby of you taking a drug, they do not even consider

The age of your baby - a newborn isn't the same size as a toddler

the risk to your baby of stopping Bf prematurely

the risk to your emotional health from the hormones swings that you can get when you stop

The risk to your mental health of coping with an upset baby / toddler when you can't comfort them as usual

the risk to you of NOT taking the drug you need because you are put off taking it / delay because of their bad advice