Help! Asthma meds decreasing supply

[lil_miss_understood]

Okay, so I have asthma and haven't been taking a preventor inhaler, until now. Problem is that the inhaler I've been put on has a steroid in it and is decreasing my supply (read: I have almost NO milk when I take it). DS is 6 mo and, obviously, this upsets him greatly. I don't want to wean him and would really prefer not to supplement... not sure he'd take a bottle even if I tried. what can I do? Fenugreek is out of the question because, as I said, I have asthma.

[Violet2]

Have you tried Fenugreek to at least see if you're sensitive? I have pretty severe asthma, I'm on preventatives including inhaled steroids ALL the time.

While it's true that with Fenugreek, I've had to add some extra inhaled steroids, I'm not having any symptoms now. So, any 'edge' it gives to my symptoms I can control.

Other than that, try Goat's Rue. The only thing is it takes a month to work (or so I've heard). I've been taking it for a while with the Fenugreek and I think it's helped. You can buy it at Motherlove. It's said to be one of the more potent herbs you can take.

Good luck.

V

[greeba]

Can you switch your medicine? I've been on Pulmicort and have had no supply problems.

Greta

[lil_miss_understood]

Unfortunately my doctor is not receptive to medication suggestions. It's one of my two big beefs with her (the other is her pushing formula from day 1).
There isn't really a choice in this town as to which doctor to use either.

[sappylady]

I have pretty severe asthma as well. I understand about the decrease in supply with the steroid. I assume you are taking it daily at least once per day. I've never not taken my preventative inhaler so my supply is always built while I'm on it.

I notice though when I need a prednisone burst that my supply dips. I just keep nursing through it and it eventually builds up around it. When I go off the pred I get ingorged again.

I would try some oatmeal right before bed and when you wake up in the morning. Have you tried fenugreek? I'm not sensitive to it so I can take it.

[CathMac]

Originally Posted by JacquelineR

Unfortunately my doctor is not receptive to medication suggestions. It's one of my two big beefs with her (the other is her pushing formula from day 1).
There isn't really a choice in this town as to which doctor to use either.

JacquelineR,
Historically I've had moderate to severe asthma / asthmatic bronchitis. Having said that, it has been very much under control since moving into a house with hardwood floors and no longer being around a cat.

I took fenugreek quite a bit with DD1 and never noticed it trigger my asthma.

Regarding your doctor, does he or she have an email address? I find that medical professionals are more responsive to what they may perceive as "oddball" requests or anything that requires them to put aside their "one size fits all solutions" when you put your concerns in writing. I am guessing that's largely a subconscious reaction to the fact that there is a paper trail and at some fundamental level they become more concerned about accountability for what they do. Or at least they become more sensitive to the fact that if something were to go wrong that they will be on the defensive when explaining why they took a particular position.

So I suggest a brief, gee whiz tone that might read something like this:

Dear Doctor "So and So",
I've been giving some more thought to the effect that my asthma medication is clearly having on my milk supply. The effect is obvious and dramatic since my supply seemed to drop immediately after I started taking it.

I still don't quite understand why you recommend (you could put the word "insist" if you don't think that comes across as too confrontational) that I stick with "fill in the blank". I believe that "fill in the blank" would have less of an impact on my supply. Although I am receptive to alternatives if you have the research to explain why you think they would be better than "fill in the blank" (the med you believe is better). (Note, this is a subtle way of suggesting that she hasn't really looked into your specific situation.)

I would really like to resolve this before DC's weight gain becomes an issue. I realize that you recommended formula at the outset, and would probably simply recommend formula if DC's weight gain should become an issue. However, I am striving to meet the AAP's guidelines for nursing for a year --or perhaps even beyond-- and would really appreciate your support on this.
Regards,
JacquelineR

If you are feeling nervy contact the front desk for the name of the Senior doctor managing the practice and carbon copy them. Or you could hold off on contacting them until you see how your doctor reacts.

If they don't have email, or if they don't give their addresses to their patients, I would recommend that you write it out on white lined paper (rather than type it) if possible. Make sure to date it. Keep a photocopy in case they can't or won't photocopy it for you. Drop it off in person rather than mail it, but by all means ask someone behind the desk to photocopy it. I think it's likely it will receive closer attention if you do this. Again, be polite and casual about it: "would you mind copying this for me".

I won't bore you with the details but I had trouble getting a breast care specialist to authorize diagnostic tests on a lump I detected on my left side. At the time he said it was because the breasts are very "changeable" when you are pregnant and nursing (I was both pregnant and nursing) and that since all indications were that the lump was benign there was only a 1% chance it was malignant. He recommended watchful waiting with a follow up physical exam 6 months later. I didn't feel like "playing the odds" since I would have had a 3 month old baby at the time of the follow up and I was more concerned about being able to nurse the newborn than possibly interrupting the BF'ing relationship with DD1.

Once I emailed him and explained that he ordered an ultrasound and ultimately he removed the lump (instead of doing a biopsy). Because it was so close to the surface the removal wasn't much more intrusive than an aspiration would have been. Interestingly, he eventually said that you should never leave a lump without a definitive diagnosis in a woman my age (I think I was 40 at the time).

He was a genuinely nice guy and I actually liked him overall. I just think that in any profession (doctors included) that they get into this groove or "one size fits all" mentality and they simply go with the flow or follow their standard operating procedure until they are forced to look at you as an individual. I don't know whether it's mere laziness or out of pressure to be as efficient as possible with the increasing demands being placed on their time.

The trick is to politely find a way to force them to look at your specific circumstances.

Good luck and please keep us posted.
~Cath

[CathMac]

In follow up to my post directly above.

Another way to get your doctor's attention might be to simply call and leave a message asking how they feel about "Primatene Mist" as an over the counter alternative.

I think any self-respecting doctor would be concerned about you taking that on a regular basis in general, let alone while you are nursing. My Dad used to take it and I would occasionally use it when I was first diagnosed. It will seriously get your heart racing.

Just to be clear, I'm not sure it's safe for occasional use, much less regular use. I am not recommending that you take it, but that you use it as a way of emphasizing to your doctor that you are serious about looking into alternatives and forcing him or her to start "thinking outside the box" and maybe getting off their duff and making some phone calls or doing some research.

If leaving a message along these lines doesn't prompt your doctor to give your concerns some more thoughtful attention you could follow up with the email suggested above, and throw in a mention to the Primatene Mist.

http://www.cvs.com/CVSApp/cvs/gatewa...h+results..y=7

Good luck,
~Cath

[lil_miss_understood]

Sorry it's taken me so long to respond to everyone's posts and thank you all for responding.
I was also recently (very recently- the day after the original post, to be precise) diagnosed with hypothyroidism. This could be a contributing factor to the low supply perhaps, although the supply problems occurred only on days where I was taking the med, so...

With that said, I've been reading your posts during the last week and this is what I have done: I stopped taking the med in the morning and am just taking it at night (temporarily) in order to increase my night time supply. I will be starting to take my morning dose in 2 days, after giving the night time supply a full week to readjust. I've found that this has had no effect on my daytime supply, so I'm still capable of functioning throughout the day like normal and, since DS co-sleeps, hasn't really disrupted our nights either.
I will keep the letter someone suggested for future reference and possible use. I greatly appreciate it. I think that the doctor is honestly just annoyed with me because I have a son with ADHD whom I refuse to drug ("It would be easier to just put him on Ritalin.") and because of my refusal to put ds2 on formula as soon as he started having weight problems, opting instead to see a paediatrician and LC. I'm not a patient that takes everything she says as the one and only way, so I'm challenging (I've actually seen her make a note to that effect, although I believe the word she used was "confrontational"- sorry lady, but I'm not poisoning my kid with Ritalin).
Excuse the off-topic tangent, please.
Again, thank you ladies. Your help and suggestions are appreciated.