Meds and breastfeeding?

[deliakate]

I'm 39 weeks +3 and went to see a mother and infant psychiatrist last week, who's said she would recommend I start anti-depressants as soon as my baby is born.
I have taken them on and off for a number of years, but came off altogether last July to try and get pregnant.
I just don't feel comfortable bfeeding whilst taking any psychoactive meds however. I remember getting all kinds of paradoxical symptoms when I started them before - like paranoia, and horrible withdrawal if I miss a dose for a few hours even. I can't imagine the baby going through those feelings of fuzzy heat, electric shock feelings etc, even though I know there are some that are considered 'safe', as a personal choice, I wouldn't feel good about passing any dosage on in my milk.
So I really have a choice of whether to start the meds right off the bat, like she suggests, in which case, I'd have to get to grips with the idea of formula feeding. Or whether to just breastfeed straight and hope I don't get any pnd. And if I did, to just stop breastfeeding and go on meds then. The only problem the psych saw with that approach is that pnd can come on very quickly, and can be very hard to get rid of once its there.....
What are anyone else's experiences/ thoughts?
Do you think bfeeding in itself can help ward off pnd (because of the oxytocin/ other hormones you get whilst doing it??)?
Or should I just give my baby the benefit of having a happy healthy mummy, instead of the benefit of breast milk?

Which one was working well for you?

I think antidepressants sound like a good idea - but my readings imply that they don't go through into the breastmilk very much, if at all. this page has a fair bit to say about various anti-depressants.

A combination of cipramil and the contraceptive pill dianette were working ok for me before pregnancy (although cipramil gave me the horrible dreams, paranoia etc).

Psych has queried whether I have a hormone imbalance, and said that a good treatment would be the oestrogen patches that are being developed - but currently, this hormone therapy for pnd is not available on the nhs.

Thanks for the link

Cipramil sounds like it's ok for BF. Is the psych supportive of you breastfeeding while on ADs?

I personally believe that breastmilk even with a bit of meds in it is better for the baby than formula. (And it's soooo much less work! [lazy])

She is supportive, but she recommended only to do it with sertraline or seroxat....

I guess its a personal thing, but the horrible symptoms I get when first starting them, or when I miss a dose.... well I can't imagine a baby having to go through that. I know the child would probably always be fine, but the guilt would be too much worrying about what the future could hold for them.

So difficult, because the benefits of bf are so emphasised by other bodies, eg. the nct, and other parts of the nhs too.

Your baby would be getting a much lower dose (even in relation to body weight) than you, so may not experience the same side effects as you.
Will you see the psychiatrist again after the baby is born, or have any other support?

There are studies showing how much of a dose comes through in the breastmilk - for Cipramil, which isn't one of the best ones for bf, it was something like 5% of the dose (per kg of body weight) that you get. So if you were getting 1g/10kg mass of dose, the baby would be getting .05g/10kg mass of dose. Iyswim.

Is therapy or counselling an option?