Breastfeeding once baby is born

[mtala]

I am currently 32 weeks pregnant with my second child. It was not an expected pregnancy. I was taking Klonopin for anxiety before I became pregnant. My psychiatrist weaned me off the Klonopin over a weeks time. The Perinatologist then stated I could get back on Klonopin when I was 12 weeks pregnant because there was no longer any danger to the fetus. I am now trying to plan for future breast-feeding. I take several medications to control anxiety, depression and migrain headaches. My psychiatrist has said that I should NOT breast fed, while the perinatologist has said that it is fine. I am so confused and want to do what is right for my unborn child. I am currently taking, Klonopin 1 mg, Topamax 200 mg, Effexor 150 mg in the a.m. and 75 in the p.m. and Trileptal 900 mg in the p.m. I wish someone could give me a more clear answer. I was taking a much higher does of Klonopin with my first pregnancy and was given the go ahead to breastfeed, but I was taking Zoloft. Any advice or research would be helpful.

[copeace]

Good Morning,

The amount of the medications you are taking are all within the normal adult dose. The infant is getting more of the medication in utero than it will be getting through breastmilk. In your situation, these medications are probably compatible with breastfeeding.

The main thing you will need to monitor the infant for is sedation. Also, be sure the infant?s pediatrician is aware of the medications you are taking, so he or she will be able to monitor the infant?s growth and development appropriately.

When the time comes to wean the baby, be sure to wean slowly over a period of two to three weeks. This will help to lessen any problems the infant may experience such as irritability, nervousness, or crying.

If you have any further questions, please call us at the InfantRisk Center at 806-352-2519. Our hours are Mon-Fri from 8am-5pm, CDT.

Colleen Peace, BSN,RN
TTUHSC InfantRisk Center

[hassan123]

Hi, I am wondering about the risk of taking a low dose valium or another anti-anxiety drug for a flight when 16 weeks pregnant? I have a fear of flying and the only thing that helps is taking a xanax but Im not sure I can do that so any advice on what could be taken would be a great help...I cant avoid this upcoming flight.
Thank you for your time in advance.

[admin-james]

Hi, thanks for your post.

Valium (diazepam) and Xanax (alprazolam) both belong to the benzodiazepine drug class. Benzodiazepines as a group are associated with neonatal withdrawal when taken chronically in the 3rd trimester and loosely associated with birth defects if taken in the first trimester. Studies that specifically examine the effects in the second trimester are not available. Valium seems to be one of the more benign choices in pregnancy and some authors recommend it as first-line over Xanax. Both drugs are FDA pregnancy category D (positive evidence of risk). In my opinion, a single dose of Valium in the second trimester is unlikely to cause problems and is likely to be better for the baby than a panic attack.

Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

-James Abbey, MD

[RobertMoore]

Thanks for sharing informative piece.

[Roguerrilla]

Hi! There are some medications that sometimes, GP will tell you it is okay to take. But still, it has chemicals that shouldn't be taken by your child. Remember, everything you ingest will go to your breast milk. So for your child's sake, if you cannot avoid taking medicines, I suggest not to breastfeed but if you can pause your medications for 6 months. You can breastfeed your baby for six months then continue your medication after that.