important question about Wellbutrin and breastfeeding-xpost - Mothering Forums

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#1 of 15 Old 06-20-2006, 08:26 PM - Thread Starter
 
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I have been researching high and low, both Dr. Hale's website and his book, and have found not much information. It seems that it is probably okay to take this, but sort of unknown what the risk level is, as true for most antidepressants it seems. So at this point I'm looking for personal stories. has anyone taking this medication noticed any symptoms of poor weight gain or decreased appetite in their breastfed child or infant? My daughter is not gaining well, and I don't know if this medication is responsible, but it is helping me a lot, so I'm in a tough spot right now. Any advice at all would be hugely appreciated.
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#2 of 15 Old 06-21-2006, 02:52 AM
 
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I took Wellbutrin during the third trimester and during the first few months of breastfeeding. I can't remember the specifics of the medical research (it was 2 years ago), but it really seemed to be the best option for me and my baby compared to other treatments. I consulted with a psycho-pharm research specialist during my pregnancy, so I was somewhat comfortable being on it.

My daughter had no weight issues while I was on Wellbutrin. She weighed 9 lb 5 oz at birth, and stayed in the upper end of the growth charts until she started walking (at 9 months). A year later, she is at the bottom end of the growth charts though, with a FTT diagnosis from her pediatrician (for no reason other than her failure to gain much weight in her second year). I would be very surprised if the Wellbutrin was related to her current weight issues. I stopped taking it about 3-4 months after she was born. I wasn't having problems with the Wellbutrin, I just prefered not to be on it long-term.

I guess I don't have specific advice for you, but I wanted to share our experience.
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#3 of 15 Old 06-21-2006, 11:46 AM - Thread Starter
 
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Thank you! What happened with the FTT thing? That is my fear about our next visit to the pediatrician. I think they are going to tell me to stop nursing or change meds or order a bunch of awful tests for her
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#4 of 15 Old 06-21-2006, 06:16 PM
 
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Here's from Dr. Hale's website:

http://66.230.33.248/discus/messages/43/615.html

Quote:
I have a mother, EDC 9/7/03, who is taking 200 mg Wellbutrin SR in the AM and 100 mg Wellbutrin SR in the evening. She really wants to breastfeed and this is the only medication that has been effective.
What is your opinion re nursing with a sustained release drug?
Thank you.



Tom Hale Ph.D.

Posted on Thursday, August 21, 2003 - 08:53 am: Edit Post Delete Post View Post/Check IP Print Post
Christine:

While we have some data on bupropion that suggests the clinical dose via milk is not too high (about 0.189 mg/liter of milk), I have had several case reports of reduced milk supply in breastfeeding mothers.

Thus, I would not be overly concerned about the prolonged release formulations, nor the drug in general, but I would caution the mom to be observant for reduced milk supply. Also, never use bupropion in patients (mothers or infants) subject to seizures.

Tom Hale, Ph.D.

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#5 of 15 Old 06-21-2006, 06:31 PM - Thread Starter
 
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I'm not concerned so much about decreased milk supply as I am about decreased appetite in general. I think at this point her primary source of calories is table food, and nursing is only secondary. I'm just wondering if any other moms out there felt that Wellbutrin decreased their dc's appetite.
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#6 of 15 Old 06-21-2006, 10:32 PM
 
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I have been taking 100mg of Wellbutrin SR since my last trimester of my second pregnancy, and I was also nursing my daughter at this time. She would have been 13-15 months then. My daughter DID have weight gain problems and WAS diagnosed with FTT (and we were accused of neglect and forced into a whole series of major blood tests that left her in shock, but thats a different topic)---HOWEVER, my daughter's weight gain issues began before I started taking the Wellbutrin. The doctor first became unhappy with her weight gain at 9 months, and she continued to gain slowly, I began the Wellbutrin (at 150mg, later dropped to 100 just before the birth of #2) at 13 months, and around the same time was when we were forced to have the blood tests (which all came out negative for any problems, of course, my DD is just plain small). I do not think that the Wellbutrin has had anything to do with it. I continue to take it, and my son (#2) is small as well, and his gain slowed around the same time as my daughter's but fortunately picked back up again quickly. Thankfully we had switched to a ped who just said "feed him lots of fatty stuff".

At the time I began taking the Wellbutrin I called a LC I'm familiar with, and she said that her sources said that the medication in bupropion does come through in the milk, but that no babies in the test group experienced any adverse affects, so that would answer your question. Sorry I couldn't tell you the actual test or anything, I didn't ask for specifics.
My other thought is that having untreated depression could actually cause more problems for you anyway. I think I read somewhere that women with depression experience lower levels of prolactin, which may affect your let-down, and would definately affect your general mothering experience, making things a lot more difficult (I'm saying that from experience- I wish I could have those wonderful loving nursing moments I hear so much about). I'm not saying that Wellbutrin would raise your prolactin or have any affect on that, but at least it would take the edge off the emotional problems and make that end of things easier.
Also, get counseling too if you aren't! I hear so much about people who get prescribed anti-depressents from their regular doctor and then never get counseling. Counseling makes an indescribable difference, and it is possible to find counselors who agree with your parenting views, or even ones who may not, but will respect them and not ask you to change them. I go every two weeks to see a male counselor who talks to me for an hour while my 1 and 2 year olds nurse and wreck his office.
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#7 of 15 Old 06-21-2006, 11:54 PM - Thread Starter
 
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Thank you so much for telling me about your experience! I do go to a therapist as well, and she is awesome! I'm currently taking 300mg of Wellbutrin, which seems kind of like a lot, but at 150 I was still having anxiety and depression. It seems that my daughter's poor weight gain also started before starting the med, but I'm worried that it might be contributing, ykwim?
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#8 of 15 Old 06-22-2006, 01:09 AM
 
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I am interested to hear more about wellbutrin. I have taken it while not preggo or bfing and did well on it. Right now I am on 20mgs of paxil and still having a lot of anxiety problems. I am not sure I have thought about trying xanax just as needed- have done in the past. I didn't know wellbutrin was considered safe. Does anyone have a good site for anxiety meds and breastfeeding?? All I can say is anxiety sucks!!
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#9 of 15 Old 06-22-2006, 12:44 PM - Thread Starter
 
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Dr. Thomas Hale's site:
http://neonatal.ttuhsc.edu/lact/

Or you can go to Amazon.com and do a search inside his book, "Medications and Mother's Milk" if you use the "search inside this book" function, you can type in the name of any med you want and read about it online.
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#10 of 15 Old 06-23-2006, 03:30 AM
 
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I'm currently taking Welbutrin. My son is not having weight gain problems. He *is* smaller than his older brother and sister were at his age, but he was also a month preterm, and while he is on the smaller side, he isn't in danger of being dx'd FTT. I took Paxil while nursing the other two, FTR.
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#11 of 15 Old 06-23-2006, 01:53 PM
 
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Quote:
Originally Posted by Lousli
Thank you! What happened with the FTT thing?
We still have the diagnosis, but I think it's absurd. DD is so energetic, super active, and truly "thriving" EXCEPT that she isn't gaining weight. The ped gave us a referral to a nutritionist, but I never went, partly because I broke my ankle, and partly because I thought it would be a waste of time, given how much I already know about nutrition and early child development.


Quote:
Originally Posted by Lousli
I think they are going to tell me to stop nursing or change meds or order a bunch of awful tests for her
I think you can count on it.

The pediatrician thinks that the extended nursing is part of the problem. I told her I wasn't concerned with keeping up with the standard growth charts, since they are based almost entirely on formula-fed babies, and that breastfed babies follow a different pattern, with more weight gain in the beginning, and less weight gain later on, compared with formula-fed babies, and the pediatrician said that this is because older breastfed babies aren't getting enough nutrition for optimal growth.

We had to have extensive bloodwork done, drawing 5 vials at Childrens Hospital "to rule anything out." Everything is in the normal range.

I think I need to switch pediatricians at this point. I am a little worried about how it might look, since I would be doing it mainly because I don't want to follow the doctor's advice (such as weaning now and feeding DD lots of chicken mcnuggets and fries). I feel I can't be open and honest with her on many topics, and with my "mental health issues" (a long history of depression) I get concerned that medical professionals won't trust my judgment or instincts or my ability to comprehend complex issues.
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#12 of 15 Old 06-23-2006, 02:02 PM - Thread Starter
 
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OMG, that sounds horrible. I would describe my daughter as thriving in exactly the same way, just not gaining weight very rapidly. However I didweigh her a few days ago and found that she had gained 6.5 ounces . But of course if I take her to the pedi in July, they will think that isn't enough. The doc i saw said the same bs about breastfeeding, and essentially implied that I don't feed my daughter, just nurse her : (which is not at all true). She also told me she shouldn't be nursing at night and that I should let her CIO. Needless to say I made her 18 month appt with someone else, but I still have no idea if they'll be reasonable. If not, I'm looking into switching too.
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#13 of 15 Old 06-23-2006, 04:21 PM
 
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Quote:
Originally Posted by slacker_mom
the pediatrician said that this is because older breastfed babies aren't getting enough nutrition for optimal growth.

Quote:


I think I need to switch pediatricians at this point.
Sounds like a good idea.

Twin boys 04/2005 : Support breastfeeding rights at FirstRight.Org : warrior
Face the rear for MORE than a year! Toddlers' necks are safest in a rear facing carseat
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#14 of 15 Old 06-23-2006, 04:33 PM
 
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Yeah, it's so discouraging to have done so much research, and to made decisions and commitments for the benefit of my child, and then be treated by medical professionals like I'm hurting my child, and causing problems.
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#15 of 15 Old 06-25-2006, 11:46 PM
 
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I have been taking 150 mg of wellbutrin through out my pregnancy and now for 12 weeks after now. The only issue I had with BFing was my milk was a day late coming in and sore nips. Pretty normal.
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