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Safety of progesterone & anxiety med/supplement combo for breastfeeding 2yr old
Hello,
I had some questions regarding the safety of 2 medications that have recently been prescribed to me. The provider, a women's health NP, thinks they will be safe in breastfeeding but I feel that most providers lack experience and education in using medications and supplements in lactation.
For brief background, I am having major anxiety, depression, and high sympathetic tone/adrenals firing constantly due to a number of life circumstances that are not immediately changeable for me. I'm trying to overcome them, but the anxiety is so bad that I'm having trouble even working on the basics of improving my life. I had wanted to avoid drugs, but am so desperate for improvement that I am now considering it and my provider is understanding of this. I know from reading other forums that you tend not to comment much on supplements and tend to recommend drugs such as SSRIs etc, but I wish to defer on stronger anti depressants such as SSRIs at this time for multiple reasons, including past experience and the fact that I do not think an anti depressant drug will solve the reason for my anxiety (eg isolation) but rather I would prefer to try a more nuanced approach to "take the edge off" my flight or fight system so I can address my anxiety production situations more adequately. Anxiety producing situations include but not limited to: marital problems, stress of mothering in isolation, traumatic birth, breastfeeding difficulties, isolation before and since childbirth two years ago, lack of support, grief and loss, health problems, exhaustion, infidelity, history of trauma, and more. I go to weekly psychotherapy, try constantly to build community and support for myself, and dearly love my child and being her mother- and especially breastfeeding- but it has been a difficult time.
I am breastfeeding my 25 month old multiple times per day and freely overnight. I am concerned not only for her safety with anything I ingest, but also for maintenance of the milk I am producing. This is so that she can continue to nurse, of course, as we both desire this, but also because she has been having trouble getting back to sleep after middle of the night wakings, looking for milk, tugging my breast and I think not finding as much milk as she expects. This results in hours of us being awake in the night until I get her soothed, fed sometimes with solid food, and back to sleep. That being said, I dearly want to keep my milk flowing at the same rate so as not to worsen this sleepless nights problem.
1) Progesterone - my provider recommends this to help balance my hormones as she has identified a lower than ideal level of progesterone in my luteal phase of my cycle. I use the Creighton fertility awareness method to track my cycle. I would take it for 10 days in a row in my luteal phase. It is a compounded, bioidentical progesterone, one 200 mg capsule taken by mouth at bedtime once daily for 10 days in my luteal phase. Would this be expected to cause any adverse effects on my daughter OR drastically lower my milk production? I know progestins can lower milk production, but I feel this is usually referred to in the aspect of hormonal contraceptives, which is not what I'm taking. The idea being to restore my body to what it should naturally be producing, but is not, due to imbalances that I have tried to resolve but have apparently not resolved. Another idea here is that this would help greatly with mood, anxiety, etc as my mood instability and despair are especially severe pre-menstrually.
2) Compounded anxiety treatment - Lithium/Propanolol/Taurine/Theanine/Magnesium Glycinate 6/2/75/200mg capsules. Take 1-2 capsules at bedtime, take 1 capsule every 6 hours as needed during the day for anxiety, sleep, calming sympathetic dominant. Would this be expected to cause any adverse effects on my daughter OR drastically lower my milk production? Would it be considered safe to try 2 capsules at bedtime and 1 capsule q6 hours during the day? I take another distinct supplement that contains Taurine and Theanine, what are the maximum recommended daily doses of these?
Thank you so much for your help. I own the book Medications and Mother's Milk, and have read the corresponding sections for these drugs as well as the pages in the LactMed database, and still appreciate contacting an actual human being. I am a medical professional (veterinarian) and I know that professionals often hedge away from giving advice regarding supplements for many good reasons, yet I still greatly appreciate your opinion. What I have found suggests that there is no evidence of great harm to be done by these substances and doses, but I appreciate that there are unknowns here as well. My child and I have no desire to wean. I am also considering that if a small drug and supplement intervention helps my mental status enough, that too helps avoid damage and harm to my child if her mother's mental health can improve and I can be more present as a mother.
Thank you again!
Gina
I had some questions regarding the safety of 2 medications that have recently been prescribed to me. The provider, a women's health NP, thinks they will be safe in breastfeeding but I feel that most providers lack experience and education in using medications and supplements in lactation.
For brief background, I am having major anxiety, depression, and high sympathetic tone/adrenals firing constantly due to a number of life circumstances that are not immediately changeable for me. I'm trying to overcome them, but the anxiety is so bad that I'm having trouble even working on the basics of improving my life. I had wanted to avoid drugs, but am so desperate for improvement that I am now considering it and my provider is understanding of this. I know from reading other forums that you tend not to comment much on supplements and tend to recommend drugs such as SSRIs etc, but I wish to defer on stronger anti depressants such as SSRIs at this time for multiple reasons, including past experience and the fact that I do not think an anti depressant drug will solve the reason for my anxiety (eg isolation) but rather I would prefer to try a more nuanced approach to "take the edge off" my flight or fight system so I can address my anxiety production situations more adequately. Anxiety producing situations include but not limited to: marital problems, stress of mothering in isolation, traumatic birth, breastfeeding difficulties, isolation before and since childbirth two years ago, lack of support, grief and loss, health problems, exhaustion, infidelity, history of trauma, and more. I go to weekly psychotherapy, try constantly to build community and support for myself, and dearly love my child and being her mother- and especially breastfeeding- but it has been a difficult time.
I am breastfeeding my 25 month old multiple times per day and freely overnight. I am concerned not only for her safety with anything I ingest, but also for maintenance of the milk I am producing. This is so that she can continue to nurse, of course, as we both desire this, but also because she has been having trouble getting back to sleep after middle of the night wakings, looking for milk, tugging my breast and I think not finding as much milk as she expects. This results in hours of us being awake in the night until I get her soothed, fed sometimes with solid food, and back to sleep. That being said, I dearly want to keep my milk flowing at the same rate so as not to worsen this sleepless nights problem.
1) Progesterone - my provider recommends this to help balance my hormones as she has identified a lower than ideal level of progesterone in my luteal phase of my cycle. I use the Creighton fertility awareness method to track my cycle. I would take it for 10 days in a row in my luteal phase. It is a compounded, bioidentical progesterone, one 200 mg capsule taken by mouth at bedtime once daily for 10 days in my luteal phase. Would this be expected to cause any adverse effects on my daughter OR drastically lower my milk production? I know progestins can lower milk production, but I feel this is usually referred to in the aspect of hormonal contraceptives, which is not what I'm taking. The idea being to restore my body to what it should naturally be producing, but is not, due to imbalances that I have tried to resolve but have apparently not resolved. Another idea here is that this would help greatly with mood, anxiety, etc as my mood instability and despair are especially severe pre-menstrually.
2) Compounded anxiety treatment - Lithium/Propanolol/Taurine/Theanine/Magnesium Glycinate 6/2/75/200mg capsules. Take 1-2 capsules at bedtime, take 1 capsule every 6 hours as needed during the day for anxiety, sleep, calming sympathetic dominant. Would this be expected to cause any adverse effects on my daughter OR drastically lower my milk production? Would it be considered safe to try 2 capsules at bedtime and 1 capsule q6 hours during the day? I take another distinct supplement that contains Taurine and Theanine, what are the maximum recommended daily doses of these?
Thank you so much for your help. I own the book Medications and Mother's Milk, and have read the corresponding sections for these drugs as well as the pages in the LactMed database, and still appreciate contacting an actual human being. I am a medical professional (veterinarian) and I know that professionals often hedge away from giving advice regarding supplements for many good reasons, yet I still greatly appreciate your opinion. What I have found suggests that there is no evidence of great harm to be done by these substances and doses, but I appreciate that there are unknowns here as well. My child and I have no desire to wean. I am also considering that if a small drug and supplement intervention helps my mental status enough, that too helps avoid damage and harm to my child if her mother's mental health can improve and I can be more present as a mother.
Thank you again!
Gina
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