A Baby Timeline! But, Wait… No Breast Feeding?!

I read the research. Very carefully. And it just didn’t say much about breastfeeding on Klonopin. So I thought that meant “go ahead” and “maybe some risk.” Apparently, all it means is that not much of the medication goes into the breast milk, and that the amount varies quite a bit (milk is mostly fat cells, this medication is designed to travel through the blood, milk is not an efficient delivery system). What I learned today is that that little bit that makes it into the milk has a sedative effect on the baby. This is dangerous for many reasons, including the possibility that it will interfere with the little one’s ability to breath. Not good.

I cried in Dr. P’s office. I felt like I had already failed at some part of motherhood. She assured me that the ability to breast feed has absolutely no correlation to the ability to mother. I will be a good mother. She said it. Nathan says it. I say it. But I so want to breast feed my babies. I feel grief. I keep picturing the sweet moments I won’t have with my baby. And I have to fight like hell against the tiny voice in my head that says, “If you just tried harder…” It’s not all medication, every medication. Just the Effexor would be ok. But if trying could make it happen, I would have been off meds a long time ago. And the one that says “You won’t be special anymore; anyone can give a baby a bottle.”

I’m a babysitter. I know that this is untrue. I have given bottles to babies. They still love their moms!

Yes, if I could go off the Klonopin, I could breast feed. Yes, we’re going to try the one alternative that might work. But we’re going to try it (Ativan, aka Lorazepam, also a benzodiazepine) because if it works for me, I might be able to take less of it during the first trimester, when the risk is greater for cleft lip and palate, and during the final weeks of pregnancy, so that the baby will not have to go through withdrawal. If I can’t switch, or if I can’t “taper” to a low or as needed dose, it’ll probably be just fine. But this is the best we can do. And we have November, December, January and February to try getting me off Klonopin and on to Ativan without causing a nervous breakdown.

So, things to do in the first month of my timeline:

Find a psychiatrist in New Haven who knows about perinatal mental health. Anyone know of one? They are not easy to find. The one Dr. P suggested only does research and this Yale researcher gave me a list of referrals, but none of them list perinatal psychiatry as something they do. My therapist might know. We’ll keep trying. But tapering my Klonopin dose is dangerous, and I can’t do it without closer supervision. Going back to New York once a month is just not feasible. Why do I need to be “closely monitored?” Because the only time I have been off of Klonopin entirely was also the only time I have ever actually hurt myself. In fall 2007, I stopped leaving my house and twice tried to use a razor to release some of the pain by making tiny cuts in my upper arm.

I’m scared and want to clutch the medicine like some sort of physical life raft. I’m scared that I won’t bond with my baby. I’m scared.

It’s still possible to give my baby breast milk, even if it’s not mine.

With a prescription, I can get it from a breast milk bank like the Mother’s Milk Bank of New England.

Here’s some more information on breast milk banks in general.

If I find someone who is willing, I could do Milk Sharing.

But for now, I’m exhausted, not pregnant and going to cuddle with my supportive, wonderful husband, who is going to make a fantastic dad.

11 Comments

  1. Caitlin said:

    Hey Annemarie, I totally get you — except one of my best friends (who did EVERYTHING right in her pregnancy, stayed away from EVERY potentially dangerous food and substance) wasn’t able to breastfeed because her daughter had jaundice at birth. I’m sure she was just as crushed, but my goodness she is THE best mother (I’m probably partially biased, but everyone who meets her agrees) to the most wonderful, healthy, happy, smart, adorable children you could imagine. I really cannot comprehend her having a stronger bond, or miraculously brighter children, than she has now. You being happy will make so much more difference, but I’m sure you know that. You will be great!

    November 5, 2011
    Reply
    • Anne-Marie said:

      When it comes to everyone else I ardently believe that happy mom = happy child. But knowing that, and feeling ok about it are different. So thanks for your support, Caitlin. It helps to hear it from a friend!

      November 5, 2011
      Reply
  2. Megan said:

    AnneMarie,
    I want to preface this by saying that LOTS of FANTASTIC mothers don’t breastfeed. It is not a requirement. However, it sounds like you want to for many reasons. So I recommend you do some of your own research. I first recommend picking up a copy of Medications and Mother’s Milk by Dr. Tom Hale or going to his website http://www.infantrisk.com. He is considered to be the expert on drugs while nursing. According to his info Klonopin and Ativan are both L3 drugs. Meaning that these drugs are moderately safe but there are no controlled studies. You refer to Dr. P as a perinatal specialist, this does not mean that she knows about lactation, I wish it did. The fact is that doctors are taught very little about lactation.
    Second look up your local La Leche League. They are a great resource on all things nursing.
    Again I am passing on this info because you seem to really want to nurse and I want you to have ALL the info you can before deciding not to. If you decide that the risk is to great then that is the right decision for you and your baby. No one can make it for you and not breastfeeding does not dictate how good a mother you are. Also if you decide to bottlefeed you may want to look into donor milk. It can be expensive or hard to find but you should know that it exists.
    So that you know who you are talking to I am currently pregnant with my first and am Bipolar II and on Lamictal. It is L3 as well and does transfer. I have a few big decisions to make.

    Good Luck!

    November 5, 2011
    Reply
    • Megan said:

      Ooop sorry, you do already know about donor milk. Most excellent.

      November 5, 2011
      Reply
      • Anne-Marie said:

        Yes! Donor milk! All about the donor milk. I don’t know how our insurance company feels about it or how much of it we’ll be able to afford, but definitely looking into this.

        November 5, 2011
        Reply
    • Anne-Marie said:

      You’re right, her title does not mean that she is an expert on lactation. I’m not supposed to write about her credentials or real name, but I can assure you that if there was any way to safely breastfeed on MY DOSE, she would help me do it. She does say that she is “a little conservative about meds.” But I begged. I cried. I asked if there was any way. She explained all the science. But her “I’m sorry, but no” answer is NOT based solely on my medication; it’s based on my combination of meds and my dose. She was kind, warm and sympathetic. She knows me and my other (non-perinatal) psychiatrist very well. I say all of this because this decision is SO INDIVIDUAL. And I really don’t want anyone to think that this applies to her! Always consult your own trusted medical people!

      November 5, 2011
      Reply
  3. […] I explained (apparently it was too much to ask that she read the blog post I wrote about my heartbreak over not breastfeeding) why the medications I take, in combination and at my dosage, might make my milk supply dangerous. […]

    March 16, 2012
    Reply
  4. Ren Waters said:

    Hi.. I am 5 months PP and having bad anxiety and trying to find something I can take.. The dr wants me on Zoloft but I don’t want to take meds -every- day but just something whenever the anxiety is unbearable. I know this is possible with ativan or klonopin. I looked on infantrisk.com but couldn’t seem to find anything.. I want some good information to show my dr. Could you possibly be any help?

    March 26, 2012
    Reply
    • Anne-Marie said:

      I wish I could help, but I’m really not comfortable giving advice about meds. You could ask your doctor to look at a database called ReproTox. That’s where my doctor got the info she gave me, but it’s more about pregnancy than lactation. In fact, there is just plain not much research about lactation. That said, you can go to OTISpregnancy.org and MotherRisk.com (although I’m not clear on the difference between MotherRisk and InfantRisk). You can even call OTIS for free counseling about possible teratogenic medicines. They won’t give you advice about which medicine to take, but they will try to answer your questions about the research on the risks involved with any drug you ask about.

      March 26, 2012
      Reply
  5. Adrianne said:

    “I keep picturing the sweet moments I won’t have with my baby.”
    I breastfed for two years, but the main reason I feel bottle feeding parents miss those moments is because (in my experience) they give in to the temptation to prop the bottle or let baby hold the bottle and feed while they do other things.  Don’t give in to the temptation.  Hold your sweet baby.  Just sit and hold and rock and cuddle your baby while he/she feeds.  Your child is only this young once, and the chores will wait.  You’ll have those sweet moments.  I wish you the best!

    March 26, 2012
    Reply

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.