BF and anxiety/insomnia

[weeklyplanner]

Has anyone here successfully BF through severe anxiety? I managed to do it with DS1 until my medication kicked in and I started to feel better. I then went on to nurse him for 15 mo, only stopping to begin fertility treatments for number 2. I absolutely loved months 2-15 of nursing. I still miss it. However, it was hell and I was just barely surviving the first 2-3 months. Mainly, it was the panic attacks (that I had never had before in my life--thank you pregnancy and BF hormones) that were absolutely horrific. And, of course, I was told I couldn't take any fast acting pills like Xanax.

I'm trying to make a "plan" for DD arrival on the 20th (c section). I'm praying my recent increase in Zoloft avoids any disasters like last time, but I'm current in a bad place with anxiety and insomnia, so I realized I need to have a plan in case this doesn't get better or gets worse.

I was thinking a few things:
FF and take meds to help me sleep
Pump and dump whenever I take a med like Xanax for the appropriate amount of time. Although this sounds like it could cause nipple confusion, etc.

Tl;dr What was your experience?

[emmyg65]

It looks like benzodiazepines are relatively safe to use during BFing (link).

Are you working with a therapist? You can develop some coping strategies to fall back on if necessary.

Make a plan with your partner now to maximize your sleep. I have a disorder that flares up when I don't get enough sleep, so my husband committed to handling all nighttime issues except the actual nursing. Our son slept in a PNP next to my side of the bed for the first 4 months, and I would nurse him at night, but my husband would handle burping, changing, soothing, etc. Once we moved the baby to his own room, my husband would go get him at night, bring him to me for nursing, and then put him back to bed, so as to cause the minimal amount of disruption to my sleep.

While bottle preference may be a thing, nipple confusion generally isn't. When/if you give baby a bottle, make sure to use the slowest flow nipple and paced feeding techniques. We had to use a bottle in the first few days (and I gave a pacifier from Day 1) and we never had an issue. I'd much rather see you treat your anxiety than try to tough it out. Good luck!!

[vvvvvfee]

+1 it looks like xanax is okay so long as you are only using it intermittently:

Alprazolam (xanax) is rated L3-limited data-probably compatible. The amount transferred to milk is 8.5% of your dose. The half-life is 12-15 hours. Alprazolam is probably safe to use during breastfeeding when used short-term, intermittently, and low dose after the first week of life. Monitor the infant for sedation, slowed breathing rate, not waking to feed/poor feeding and weight gain.

(source is infantrisk, the premier BFing/drug researchers, from this thread. you can always call them to ask about your specific meds and dosages: 806-352-2519)

+1 to therapy if you're not seeing someone already. even if you are only able to go for a few sessions, you could at least get some help with coping strategies. look for someone that specializes in cognitive behavioral therapy.

if you can get through the first 6 weeks or so nursing exclusively before you get into pumping/bottles, that would be ideal. then your supply will be well-established and there is not as much of a chance of nipple confusion. then perhaps you could try pumping right before bed and your partner can give LO a bottle when they wake in the MOTN, enabling you to at least get a good block of sleep in. also +1 to having the baby in your room with you. you might want to consider a co-sleeper. then, as emmyg65 suggested, you can nurse LO with minimal sleep interruptions and have your partner take care of diaper changes/burping, etc.

best of luck!

[vvvvvfee]

p.s. RE insomnia- nursing LO in the MOTN always helps me go back to sleep because of the oxytocin. i'd also look into guided relaxation scripts or guided meditations if that is something you haven't tried. tara brach is great: www.tarabrach.com/meditation-collecting-quieting-mind/

p.p.s. breastfeeding is associated with lower rates of PPD, so i think i'd at least start out trying to BF, rather than formula-feeding from the get-go.

[weeklyplanner]

Thanks everyone...lots to think about.

I am working with a therapist and I have a psychiatrist that focuses solely on women's issues. I will be talking to her about the safety of Xanax while nursing. I've only ever taken xanax one time in my life, but I think a very low dose would be good to have on hand so I can sleep and heal from a c section. I only get panic attacks while pregnant or breastfeeding because the dr thinks it's the surge of hormones that does it to me. Of course, it's horrible timing because it's right at a time when I have to put the baby first.

Good points about pumping before bed, etc. I also get so antsy with excessive energy with the panic that it's hard to sit and nurse. A few bottles would at least give me a reprieve of that duty if I'm having a panic attack kind of day. With DS I never used bottles early on, so this is all new to me.

Last time I was actually the opposite of a co sleeper. At two weeks old, I put him in his crib. I just felt like I needed space, which sounds awful. I guess as I get more anxious, I become the opposite of "let's cuddle these adorable babies." I just want some personal space. I'm really hoping to keep DD in her bassinet in our room much longer this time. DH and I discussed and if I need space, he will keep her by his side of the bed. Also, he's great about MOTN diaper changes because he knows I go a little crazy with no sleep and hormones.

[seamonster]

I found a mindfulness CBT program incredibly helpful for dealing with my PPA. It was an 8 week program at home, but it helped with intrusive thoughts and general anxiousness.

[emmyg65]

Girl, you do what you need to do. If that means putting your baby in their own room, that's fine. You. Come. First. Think of it like the oxygen mask: you can only take care of your children if you take care of yourself first.

[weeklyplanner]

Jan 5, 2017 20:42:49 GMT -5 emmyg65 said:

Girl, you do what you need to do. If that means putting your baby in their own room, that's fine. You. Come. First. Think of it like the oxygen mask: you can only take care of your children if you take care of yourself first.

Thank you for this. It means A LOT.

[bocaburger]

First of all, congratulations! And I'm sorry you're dealing with so much anxiety.

I have an anxiety/panic disorder and have been BF for almost 5 months. I started Zoloft right away after delivery and it has been very helpful. I have never taken benzos so I can't speak to that.

My first 2 weeks PP were incredibly difficult, but once my hormones leveled out and the meds kicked in it got much better. I also have twins so I think that added to it.

At 8 days PP I had a major panic attack at the circumcision/naming ceremony. I realized that the sleep deprivation was making my anxiety worse and I was not functioning in a way that allowed me to safely care for my babies. I made the necessary decision to supplement for a night so H could do all the MOTN feedings. I pumped once before bed and once MOTN and otherwise I slept. After that first night we were able to give pumped milk instead of formula.

At the time I felt guilty about my decision to supplement and introduce bottles so early - it went against all the LC's advice. But in retrospect it was absolutely the right choice. Fortunately neither baby showed bottle preference, and I honestly think if I hadn't started sharing the night duty I would have had to stop BF entirely from sheer exhaustion.

All that to say: you can absolutely BF with anxiety, but you need to take care of yourself. In the end, a FF baby with a happy healthy mom will do better than a BF baby whose mom is falling apart. Take it day by day, be proud of every ounce of BM you can give, and don't feel guilty if ultimately you need to supplement or just stop BF altogether.

[emmyg65]

Jan 6, 2017 14:55:00 GMT -5 bocaburger said:

...

All that to say: you can absolutely BF with anxiety, but you need to take care of yourself. In the end, a FF baby with a happy healthy mom will do better than a BF baby whose mom is falling apart. Take it day by day, be proud of every ounce of BM you can give, and don't feel guilty if ultimately you need to supplement or just stop BF altogether.

I need to embroider this on a pillow for every new mom in my life.