crisis: should I stop bfing? - Mothering Forums

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#1 of 18 Old 05-22-2009, 02:44 AM - Thread Starter
 
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I love nursing. This is my second child and so far the bfing was going well, unlike the first time round when I struggled to maintain a supply for 18mnths. Anyhow I'm now in a crisis. I've been suffering from post-partum depression and anxiety. It stops me functioning at times, which is scary, but I've always felt the bfing helped me bond with baby. I'm on zoloft and gabapentin right now, and I've just seen my psychiatrist who wants me to go on a low dose of risperidone too. All these drugs seem to be ok for baby, according to my LC.

But my other problem is my weight. I'm 5'9"and 225 lbs. I've actually gained weight since my son was born 9mnth ago, despite exercising regularly (if modestly). I'm hungry all the time, and I try to be careful. Apparently all the drugs I'm on can cause weight gain.

So today I saw an endochrinologist who wants me to stop bfing right away so she can put me on metformin and the induction part of the atkins diet. I had gestational diabetes and don't want to get the real thing. Plus the weight is really bothering me and making it hard to overcome some mobility problems I'm had with my pelvic problems since the last birth. But I really don't want to stop nursing if I can help it.

Am I mad to want to keep nursing regardless? Does anyone know if metformin is safe with bfing? And what about the atkins diet (I'm convinced that one's a nonstarter, but perhaps someone else knows better). The doctor didn't seem very bfing friendly. Any advice/help/sympathy greatly appreciated. I'm really upset by all this, and feeling really at a loss.

Sorry this is so long, but thanks for reading!
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#2 of 18 Old 05-22-2009, 02:59 AM
 
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Hi,

I'm so sorry to hear you are having a hard time. To answer your questions, it is usually fine for a breastfeeding woman to take metformin. Let me know if you need a reference for this to take to your endocrinlogist.

In terms of the Atkin's diet it is probably ok to continue breastfeeding while following it but, from what I've read it can cause a drop in milk supply due to the decrease in caloric intake and possible dehydration (although this should be easier to overcome by making sure you drink enough water). Most things I've read also suggest skipping the induction phase so maybe you could ask your endocrinologist of this is an option.

Would it be an option to find a more helpful endocrinologist?

I hope you can get things sorted out and start to feel better soon.

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#3 of 18 Old 05-22-2009, 06:53 AM
 
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Great advice from Kate - Dr Hale classifies metformin as L1, meaning it is in the safest category of drugs to take while breastfeeding. Hopefully you will be able to look at the evidence with your doctor and work something out which will preserve your breastfeeding relationship and safeguard your health.
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#4 of 18 Old 05-22-2009, 07:37 AM
 
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Here's another reference for the safety of metformin: http://toxnet.nlm.nih.gov/cgi-bin/si...temp/~y3ZGUY:1
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#5 of 18 Old 05-22-2009, 08:53 AM
 
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I'm going to stick my neck out and say that the induction part of the Atkins diet might be compatible with BFing - with a few Buts...

Induction on Atkins basically means avoiding many carbs and eating protein and fats
So you can't eat:
bread, pasta, rice, couscous etc, any baked goods, anything containing flour or sugar, fruits, milk and a few other things. Caffeine to be avoided.
You can eat:
meat, fish, chicken and other animal protein, eggs, small amounts of veggies and salad, fats (butter, oils) and some cheese and nuts.

You would be encouraged to drink a lot of water to 'flush' your system and stay hydrated.

So it's not completely carb free, there are carbs in the veggies and salad. But no carbs of the processed, flour, sugar variety.

BUT doing induction is 'meant' to kinda kick start your body into losing weight and adapting to the low carb life, so there can be a period when you feel really really tired and sick at the start. It lasts for 4 to 5 days. Also it is expensive (all that meat and butter!) and means you have to prepare all your food from scratch as most processed foods have added carbs of some form.n So it can be time consuming as well.

For me the difficulties with Atkins tend to relate to the cost and time consumption of food preparation. Otherwise it's a pretty enjoyable way to eat and a great way to remove processed, junky carbs from your diet.

Maybe someone else can say whether this would work with BFing?
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#6 of 18 Old 05-22-2009, 12:11 PM
 
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I would not do Atkins and BF. Personally, I think eliminating any food group is unhealthy, regardless of BF status. It is also not do-able in the long-term. I did Atkins many years ago and was able to lose 40# in about 5 mo. But I was not able to maintain it. I'm doing weight watchers now, which is compatible with BF. You even get extra calories to help maintain your milk supply. The weight loss has been slower, but I feel that the program is something I can stick with for the rest of my life. I've lost 18# in 11 weeks. There is wonderful weight watchers support group here on MDC, which has really helped me stay on-track with the program.

I really hope you'll look into WW and try to find a new endocrinologist. It sounds like your current endo just wants you to stop BF because she doesn't approve of it. I think BF has helped me keep my moods even because of the hormonal rush I get from it.

Oh, here's the link to our MDC WW group, if you're interested:

http://www.mothering.com/discussions....php?t=1078737

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#7 of 18 Old 05-22-2009, 12:29 PM
 
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Sweetie!! Keep on Breastfeeding!!! Firt of all it really helps with Depression/anxety. It really does, if you were to stop BF you would get a new *rush* of hormones do to the abruption of BF that can cause major major moodswings and irritability +if you haven't already had your ppaf, you will if stop bf which i lovely in itself think PMS! i WOULD KEEP AT IT.

+ Atkins, um, I'd find a bettter way to loose wieght it just doesn't seem healthy.

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#8 of 18 Old 05-22-2009, 12:58 PM
 
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i am in your boat!! I would not stop nursing. I am a calorie counter. Adkins is... odd. WW is excellent for bfing mamas! Just dedicate yourself and get support!

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#9 of 18 Old 05-22-2009, 01:32 PM
 
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Another vote for WW here. I started off at stats similar to yours (I'm about an inch shorter) and started WW when DD2 was 2 months old, I've lost almost 60 lbs so far. I'm also on gabapentin. The WW has been great for me because it taught me portion control, which has been even more important since I started the gabapentin.

I never tried Atkins, but I did try South Beach several times (after my other kids were born) without any success.

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#10 of 18 Old 05-22-2009, 01:46 PM
 
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Atkins is a perfectly healthy and very maintainable way to lose weight. There is no harm at all in getting rid of all the bad carbs in your diet, while maintaining good carbs in the form of vegetables.

The thing about breastfeeding and weight loss is that as you lose fat, you release toxins into your bloodstream that can be hard on the baby. Plus the danger of dehydration and milk supply problems.

I would definitely not stop breastfeeding! Just talk to your doctor about skipping the intro part of Atkins for now. It will be really good for you to just start eating the maintainance diet for now. You will lose weight more slowly but still steadily, and there will be fewer toxins for your nursling.

Here's a NYTimes article explaining why Atkins is a healthy way to lose weight, much healthier than low-fat diets which in the end are impossible to maintain: What if it's all been a big fat lie?

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#11 of 18 Old 05-22-2009, 03:41 PM
 
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Ohh - I agree about the WW thing... I have heard really great things and supply shuldn't be a problem if you are eating all your points for BFing moms.

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#12 of 18 Old 05-22-2009, 10:05 PM
 
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FWIW, my LO is sensitive to dairy, soy and I'm also thinking gluten. So I'm now basically on the Paleo diet which is similsr to Atkins: no carbs from grain, plenty of protein and fat, nuts, fruits and vegetables. I'm losing weight easily, have more energy...and my milk supply actually increased :

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#13 of 18 Old 05-22-2009, 11:21 PM
 
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Many Moms take Metformin while bf to help with PCOS and supply issues. WW gets another vote here though Atkins may be easier with diabetes. I would say a diabetic diet would help just as much. Especially if you are following it correctly. I would get Hales nfo into your endocrinologists hands and get yourself a good dietician(which your endo should help with as well.)
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#14 of 18 Old 05-23-2009, 12:26 AM
 
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Carbs are not the enemy!!!!! Processed junk food is!!!!!! We have done so much to change our food supply in the last 100 years. GMing, breeding for higher yield and gluten content, etc.

There are good sources of carbs- ancient grains- emmer (farro), amaranth, millet, heirloom unrefined rice, etc. These are unrefined and packed full of fiber, B vitamins, etc.

The primary and preferred source of fuel for the brain is glucose. A low carb diet puts your body into a state of ketosis You get fatigued and irritable. I wish you luck, but I don't think Atkins is a good long-term diet solution.

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#15 of 18 Old 05-23-2009, 02:22 AM
 
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Thanks, unconventional, I was trying to remember that word, ketosis. But I don't think you really need to hear my opinion about Atkins, you need a professional who knows the details and most current research on a variety of dietary approaches as well as the chemistry. I'm wondering, like some previous posters, if a different MD is what you need. I'd be skeptical of any MD who recommended weaning for a med that isn't really considered to be dangerous, esp when you love bfeeding. Why take away something you enjoy, you're already depressed!

Hope things turn around for you soon!
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#16 of 18 Old 05-24-2009, 01:54 AM - Thread Starter
 
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Thank you so much for this encouragement. I'd greatly appreciate a reference for the endochrinologist -- thank you. As an aside I also got a reply from Jack Newman (a hero of mine) who said that both metformin and atkins are safe for baby while bfing.
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#17 of 18 Old 05-24-2009, 05:41 AM
 
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Westcoastmummy, I'd really suggest you talk to someone (semi-)professional (LLL, IBCLC). I know from questions I once had on fasting and bf that LLL has good resources on bf and nutrition (and medication).
If you already got information on your medication and Atkins (Dr. Newman) it is probably a good idea to print it out, show it to your doc and work from there. In case he is still adamant about weaning you could still get a second opinion.

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#18 of 18 Old 05-24-2009, 08:55 AM
 
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I also invite you to visit the Nutrition and Good Eating forum, where you can get more ideas on diets and how to lose weight, while keeping healthy fats in your diet.

Equuskia in with Nodtveidt DD1 : DD2 :
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