Breastfeeding on Pysch Meds

My first goal in writing this blog was to make sure that something encouraging and human showed up in the search results for phrases like “klonopin and pregnancy.” Since I began writing here, my life has blossomed in ways that I once thought impossible. The biggest change is that I had a baby and took on a career as a stay-at-home mom.

The biggest lesson I have learned is this: when it comes to learning about pregnancy, motherhood and mental health, who you ask is as important as asking the questions.

I made this life happen by asking important questions and by asking different people until I found an answer that rang true in my heart. Luck has played its part. I got lucky a few times–living near New York City allowed me to see a psychiatrist who specializes in “perinatal” mental health (during and directly following pregnancy). Living near Stratford, Connecticut allowed me to see Dr. Christina Smillie, pediatrician and celebrated expert in breastfeeding medicine and in pediatrics. Her practice is called Breastfeeding Resources.

Breastfeeding has been an unexpected gift. I planned on breastfeeding and then mourned after being told that I couldn’t safely breastfeed on my meds. Then, I learned that that was not true! The doctor who told me not to breastfeed did so because she was concerned for my health and my baby’s health; the doctor who told me to go ahead and breastfeed on meds is simply better informed. It seems so obvious now–if you have a question about an infant’s health, ask a pediatrician! I talked to a mommy psychiatrist about meds and pregnancy; I can’t believe it never occurred to me to look for a breastfeeding expert to ask about meds and breastfeeding. Such experts are rare. We feel so blessed to have Dr. Smillie and her practice only forty-five minutes away. With her help, we made a plan. Real life happened, and we didn’t follow every detail of that plan. So I’ll tell you the story with the plan, then the real life. The science is going to have to wait. For now, I give you our breastfeeding journey.

In the hospital:

The plan was to feed Walter my colostrum while we were in the hospital. Dr. Smillie assured us that babies eat so little in the first forty-eight hours that we had no reason to worry for even a minute about the meds that might make it into the colostrum.

What actually happened? Well, he did eat only my colostrum. But he slept. He had a hard time latching, so he would exhaust himself trying and fall asleep again. This would not have worried me one bit, because in my reading on breastfeeding, I had read that some babies do not eat much in the beginning. The nurses, however, worried over my baby until I got scared, myself. Was he sleepy because he was withdrawing from my meds, or was he sleepy from dangerously low blood sugar?

They checked his blood sugar. It was not ideal but not dropping at an alarming rate. And yet. Nurses told me again and again that we “might have to supplement.” I had worked too hard to give my baby colostrum (mine and our milk donor’s) to start formula on day one.

I won’t even tell you the whole story of how the nurses managed to scare me to death about my child’s health by not giving me enough information, because it has nothing to do with my meds. I talked to a supervisor later about how the staff can improve communication. It was all much ado about nothing, as Shakespeare might say. And that right there is the big deal about our hospital adventure–the fact that nothing was wrong.

I had spent my entire pregnancy and a good deal of time before my pregnancy worrying over what my baby would go through after birth because I took medication while carrying him. I am happy to report that my baby was and is 100% healthy in every way. He did not lose an abnormal amount of weight after birth. He had some sleepiness and some rigid muscle tone that may or may not have been caused by withdrawal but, again, nothing outside the normal range. Not. A. Thing.

Again, I took (and still take) 4 mg of Klonopin and 225 mg of Effexor every day throughout my pregnancy. I had a perfectly healthy child.

After the hospital:

The plan was to feed Walter about 50% my milk and 50% donor milk to make doubly sure that he would not get enough of my medication to sedate him. We were going to continue this for about three months. As Dr. Smillie warmly explained, this plan was for my peace of mind (and Nathan’s). She did not think that there would be enough medicine in my milk to cause any problems for Walter. Again, story now, science later.

If you know much about breastfeeding, you may be wondering about my supply right about now. We had a plan for that, too! Because we planned to switch to just my milk eventually, I was pumping and freezing the same amount he was getting from my friend. In other words, I was producing the same amount of milk my child was consuming, give or take a few ounces, so that I would have enough for him when we switched to just me.

In reality, this plan worked very well for the first month. I was particularly grateful for the donor milk when we had trouble breastfeeding; he just wouldn’t latch for more than a few seconds. As it turned out, he had a tongue-tie. That means that the very thin skin that connects his tongue to the bottom of his mouth came forward, and this limited his tongue’s movement. It wasn’t a “first degree tie” that completely stopped him from lifting his tongue, but since we were having trouble with his latch, it seemed like it might be an issue. By the time we discussed that and had it fixed with a simple, in-office procedure, I was just so grateful that we had planned on pumping and bottle-feeding breastmilk. If I had planned on exclusively breastfeeding without using bottles or a pump, I would have been really stressed.

Reality stressed me out again about six weeks in to the 50/50 plan. My kid ended up eating about a hundred times a day and went through all available donor milk before his two-month check-up. It didn’t help that my friend’s baby was colicky and refusing to sleep and wanted to nurse 24/7, giving her less time to pump for us. (Send up a prayer for this fairy godmother friend of mine that her child grows out of this no-sleeping phase! It’s bad for everyone!)

I worried a lot the first weekend we had no donor milk to supplement. He was cluster feeding, which means that he would eat for hours at a time. I remember one stretch that began at about 11pm and went on until about 3am. He would stop to burp/spit up (I have a champion spitter!) or poop and then cry until I started feeding him again. I almost lost my mind. I watched entire days of television, nursing and nursing. He doesn’t do that all the time, but it happened to coincide with us running out of all our frozen milk.

Then, I did something I thought that I would never, ever, do; I used formula. My therapist and I discussed my state of mind when Nathan, his mom or other relatives had fed the baby bottles of donor milk and compared it to the state of mind I was in now that it was all up to me and my breasts. It was immediately apparent that something had to give. I was approaching a nervous breakdown, and we had been out of frozen milk for under a week. I sent Nathan out to get the formula I felt the least guilty about–Earth’s Best Organic. The company is one I know because I once knew one of its employees, and I had talked to a rep about their formula at last summer’s BlogHer conference expo.

Walter has never had more than six ounces of formula in any given day, but the naps I fit in, the time I spend all to myself… It’s glorious. Truly. He never had a tummy ache. I could have peace during migraines and a bad cold. Everyone is thriving.

Where we are now:

I breastfeed Walter, and he also gets either formula or my pumped milk about once a day. I try to pump a bottle if we’re going on a long car ride. I was comfortable and happy letting his relatives feed him formula while I got some quality time with my sister-in-law and fellow musical theater geek at the movie theater (Les Mis!). My supply is great. I love bonding with my baby in this special way. The point is that we are happy and comfortable with Walter having my milk, mostly because he is thriving.

What we’re doing is the exact right thing for our family. I can’t and shouldn’t give medical advice to anyone, so please don’t interpret this as me telling everyone to breastfeed, no matter what. This is just my account of how we found our comfort zone.

Of course, I worried about Walter getting too much of my medication. I watched him like a hawk for any signs of extra sleepiness. But even I could see what everyone who met my baby noticed: he is so alert! He loves to open those big blue eyes and look all around. He sleeps no more or less than any other baby. His pediatrician is completely happy with his physical health and cognitive development.

Our entire family is happy and healthy. And I cannot tell you how happy I am to be posting these photos:

The one and only time he successfully ate in the hospital.
The one and only time he successfully ate in the hospital.
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Yes, he does have an excellent latch, thank you!

 

3 Comments

  1. chelsea said:

    congratulations :) as a mother who breastfed, though i was not on medication, i appreciate your honest and thoughtful words, and i can feel your pride spilling through the words on the screen. you have worked hard. you are a total rock star, and your babe is adorable.

    on an unrelated note: your necklace in the hospital picture is great! what kind of stone/bead is that?

    January 11, 2013
    Reply
    • Anne-Marie said:

      Thank you, Chelsea! The necklace is Baltic amber. I almost never take it off, because it is supposed to have all kinds of healing properties, particularly when it comes to swelling (a common problem during pregnancy, in case you did not experience sausage feet). The most common crunchy use of them is actually to put one on your teething kid and let them chew on the amber. For more info, see: http://www.granolababies.com/collections/teething/products/baltic-amber-teething-necklaces

      January 11, 2013
      Reply
  2. Jennifer said:

    Was your med spread out throughout the day or all at one time? Was it the full 4mg every day? I am trying to figure out how to space my klonopin. .25mg 2x/day, or .5 once a day? I know you can’t advise, but just wondering what you did. Thanks! :-)

    December 14, 2016
    Reply

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