Risk/rewards

[packmomma]

So I may need to go back on mood stabilizers and I was wondering what the reward vs risk is for a 17 month old to continue bf with a mom on meds. I know the reward is high when they're under a year but didn't know if it continues to be as they get older. Should I wean before starting meds or continue breastfeeding?
All meds would be classified as "safe while breastfeeding" but it's still in his system.
He nurses about 4-6 times a day and almost exclusively when he gets sick so either way we may wait until after cold/flu season.
I'll obviously be talking this over with my psychiatrist but I just wanted to know how other breastfeeding mom's felt on this issue.
@amyg vvvvvfee

[Deleted]

I take psych meds. For me it's worth it and will be until I want to wean. I know it transmits small amounts into breastmilk, which I'm not a fan of, but ultimately it's worth it for me.

[Deleted]

Call infant risk.
tell them which drugs and ask how much actually transfers and what risks may be of any drugs to baby

Also ask if there are certain times of day that you could take them and reduce the amt that is in milk (depends on half life of drug etc)

[Deleted]

And as long as baby nurses, they continue to get human growth hormone, antibodies, nutrients in better bioavailable form etc. The benefits don't go away just cause they are older.

[packmomma]

Jan 23, 2017 23:06:39 GMT -5 @amyg said:

And as long as baby nurses, they continue to get human growth hormone, antibodies, nutrients in better bioavailable form etc. The benefits don't go away just cause they are older.

Ok this is what I was thinking but I've been able to be off meds for most of his life so I didn't know if exposing him to medications was worth it. I called infant risk and the meds aren't a huge risk but I'll call back and ask about times that would be best. Thank you.

[packmomma]

Jan 23, 2017 22:12:07 GMT -5 @led said:

I take psych meds. For me it's worth it and will be until I want to wean. I know it transmits small amounts into breastmilk, which I'm not a fan of, but ultimately it's worth it for me.

Thank you. I was looking for other moms experiences who are dealing with the same thing. I don't have a lot of irl support for extended bf so I didn't know if it was worth it to continue even though we both want to.

[vvvvvfee]

+1 i would continue to nurse. i think the reward outweighs the very small risk. it's also less of an issue when your LO is older because they are physically bigger/less vulnerable, and they are nursing fewer times per day. and yes, ask infantrisk about the half-life of the drug you will be taking- you can probably time it so that most of the drug is out of your bloodstream by the time LO nurses. but again, we're talking about minuscule quantities of the drug.

also, some info from dr. jack newman (BFing expert)-- see the last paragraph especially!:

More on drugs and breastfeeding. Why are the vast majority of drugs taken by the mother compatible with continued breastfeeding. The reason is that the amounts of drug that get into the milk are very small, only rarely enough to be of concern.

Any drug a person takes is diluted throughout the whole body but not uniformly. Some drugs do not get into the brain easily. Some drugs are stored in the fat. However, the only way drugs can get into the breastmilk is for them to be in the blood stream, and the concentration of the drug in the blood stream is usually extremely low. As an example, paroxetine (Paxil), used to treat depression, is found mostly in the brain so that only about 1% of all the drug taken is actually in the blood stream. Amounts of most drugs are usually measured in micrograms (millionths of a gram)/ml of blood or even nanograms (billionths of a gram)/ml of blood. These are very small amounts and that means that only very tiny amounts can get into the milk.

Very important also is the proportion of drug that is bound to proteins in the blood, since only the drug unattached to protein is available to enter into the milk. Some drugs are almost completely attached to protein. Ibuprofen (a non-steroidal anti-inflammatory drug) is over 99% bound to protein. Thus, less than 1% of the tiny amount that is found in the mother’s blood is available to be excreted into the mother’s milk. The result is that though mothers may take close to 400 mg every six hours, the milk will contain less than one (1) mg in a litre of milk. If we treated a baby with ibuprofen (for pain, for example), we would generally give 10 mg per kg of his weight so that a five kg (11 pounds) baby would get 50 mg as a single dose. The baby taking a litre of breastmilk would get only a mg or two all day.

Again, paroxetine (Paxil), the antidepressant, is 95% protein bound so that of the already small amount in the blood (most paroxetine is in the brain and other parts of the body), 95% will not be available for transfer into the milk.

In other words, the majority of drugs do not get into the milk in quantities that should make us worry about negative effects on the baby’s system. The real question is: which is safer for the baby, breastfeeding with tiny amounts (often vanishingly small amounts) of drug in the milk or artificial feeding? Or in the case of an older baby/toddler, forced weaning from the breast of a baby for whom, besides breastmilk, breastfeeding is stability, warmth, comfort and love?

ETA: Info on benefits of BFing past 1 year: kellymom.com/ages/older-infant/ebf-benefits/

[packmomma]

Thank you so much vvvvvfee I've been feeling so conflicted about this and have actively postponed meds to just keep trying to "tough it out/get through it" for awhile longer. I'm thinking though that I could be a much more present mom if I went back on meds and was really worried if the anxiety of ds being exposed would override the help of meds. I'm rambling. But thank you so much for your replies. I feel much better about this desicion and will be seeing my psychiatrist this week to discuss.