So conflicted about my meds

[angela1435]

I am taking Trileptal right now at 29 weeks pregnant. I have seen specialists and a psychiatrist that approve me taking it. But they aren't so sure it is ok for breastfeeding. I looked it up in Hales and he gives it an L3. Which is moderately safe I think? I am so nervous about breastfeeding while taking this med! Part of me wants to stop taking it and part of me just wants to not breastfeed. I am so confused! Anyone dealt with something like this?

[annekh23]

I looked the drug up in Hale's like you said it's L3, I noticed it was an anticonvulsant, but you mentioned a psychiatrist, so I'm answering on the assumption that it's a psychiatric problem, not epilepsy.

When there is any psychiatric problem, it's definitely worth having the discussion about what is going to be the best thing to keep you well and what is the back up plan if you don't stay well. For some people that means not breastfeeding is the best decision for them.

However, statistically breastfeeding does reduce the incidence of postpartum depression, so it's worth considering that too.

I have had severe PPD with two of my babies, meaning severe as in being hospitalised, but I've breastfed through it, with one of them that did mean mixed feeding between 4 and 6 mths, it may not have done if he'd have had a stronger suck and had been thriving on breastmilk before the worst spots, but it was important to me to get back to full breastfeeding and we did. This time around it turned out that baby had a hard time learning to feed and I almost ended up as an exclusive pumper, but that also meant we had milk frozen that got used in a crisis. Because I've been blessed with oversupply, we could implement my psychiatrists idea of me sleeping through the night, though that's gone right out the window now!

My baby is 10 months and I'm doing pretty well, but if I'm tired or feeling a bit low, it's nice to be able to snuggle in bed and breastfeed and have her be safe and happy with me also getting a bit of rest, rather than not having that option, so for me breastfeeding does seem to have been a good choice.

Even if you decide not to do it long term, you could still offer at the beginning, some babies take to it no problem and you can take it from there, sometimes it's not so easy and you can move on, only you and your team can figure it out, there are many many benefits to breastfeeding and I've found that as baby grows they become tangible day by day benefits.

[mommylovesra]

IMO the risk of not breastfeeding for mom and baby outweigh the risk of an L3 drug. If the drug where really noncompatible with nursing then it would not have an L3 rating. Also in general the baby is getting much more of an effect through the placenta then the very, very small amount that gets in breastmilk so if it was safe while pregnant then it should be safe for nursing.

I have had to take several different L3's over my nursing years for medical problems from back surgery to currently high blood pressure. I believe after my first they even had me on phenabarbitol(sp?) nursing because of severe pre-e and seizure risk and my babies have never had any side effects. I would just go ahead and nurse and not let the meds worry me . I am sure from my experience with nursing and meds that it will be fine. Good luck and try not to worry.

[angela1435]

Thanks so much! I am going to talk to my psych about it. I don't want to give up breastfeeding. I think that will push me into a depression by itself.

[SallyN]

I think it's GREAT that you're talking about this with your HCPs now.
In addition to Hale's book, he also has online forums that have more current and detailed information. Only HCPs can post on the forums, but anyone can read. Perhaps one of your HCPs could sign on? Dr. Hale seems pretty proactive and responsive.

http://neonatal.ttuhsc.edu/lact/medi...orumspage.html