Being a Good Mom (while having bipolar disorder)

Lately, I've been struggling with the concept of being a good mother. In the past few weeks, I have been rapid cycling between depression and hypomania. I feel like I can manage taking care of my daughter in the morning for a couple hours generally 7-10 a.m., but then I need someone else to take over or I start feeling overwhelmed and frustrated. By the evening my energy level has gone down a little and I can focus on her again.

I work from home so I do have a part-time nanny (15 hours a week). I also have a father-in-law who is retired and loves watching my daughter one to two days a week for three hours (in fact if we don't have him over he says he misses his granddaughter and wonders when he can see her.) My husband is self-employed so he watches or baby a couple hours a day while I work as well or run errands or do household chores. I am very fortunate to have so much help - especially in times like these.

But I keep feeling guilty and I don't know how to get rid of it.

This Thanksgiving, I'm Grateful For ...

I'm grateful for ... the fact that I was finally blessed with motherhood. The journey hasn't necessarily been easy, but it has 100% been worth it. I can't describe the amount of joy that I get from raising my daughter.

I'm grateful for my supportive husband. If it wasn't for my husband I would not be alive. And I mean that in the sense that he actually has saved my life at least twice. I sometimes worry that living with me must sometimes feel like a huge burden, but he always assures me that I'm worth it. And that every marriage comes with struggles. Our struggles always seem to stem around my bipolar disorder.

I'm grateful for modern medicine and science. If I was alive in a different century ago, I probably would have been locked up in a mental institution. Not so today. I live a productive, successful life and medication helps me live that life.

I'm grateful for having a good doctor who I trust. Having a psychiatrist who trully looks out for your best interest isn't always easy to find. My doctor went above and beyond when I told him I wanted to start a family. He even consulted with a few experts at managing medications during pregnancy ... he doesn't just look things up in one book ... he goes the extra mile. If anyone reading this lives in South Florida - I have a great doctor to recommend in Boca Raton. I like him so much that I drive from Naples for my appointments (it's about a two hour drive).

I'm grateful for my physical health. I am strong like bull and healthy as a horse.

I hope that next year I can say that I am grateful for mood stability. I know I will get back on track where I'm not switching between depression and hypomania - I just don't know how long it will take.

Just when you think you are getting better ...

So I thought I was really handling things well and working really hard to stay on track. Then went to see my shrink and I guess was put in my place.

I was told that as someone who has been diagnosed as bipolar 1 with psychosis my little hypomania can become full blown mania is just one day. I begged my doctor to just give me a few days to get my sleep under control. I know if I can get my sleep regulated my energy level will go down.

He said OK, increased my Ativan. And made me agree that if I don't see improvement I will go on Zyprexa. He is going to check to see if it is compatible with breastfeeding. I hated Zyprexa it made me gain a lot of water weight and made me so hungry that I ate all the time and gained a lot of weight. It took me years to lose the weight I gained on Zyprexa and Depakote.

I am so disappointed in myself. I tried so hard to stay well. And now this. I mean I know that I cannot 100% control my illness. But I did well for so long. Then I got postpartum depression and now may be hypomanic. And I know that this wouldn't be happening if I hadn't messed with my medicine and had the hormonal swings. Although my baby is 100% worth it.

I just hope that I can get better soon.

Sleep walking Vs. Blacking Out on Ambien

I spoke with my doctor yesterday about my Ambien incident. And he said I wasn't really asleep at all. It is more like I was "drunk" on Ambien. So I basically blacked out and do not recall anything. He said it would be similar to if I had gotten drunk enough on alcohol to blackout.

So now I am taking Ativan for a few days. My doctor felt it would be better than Ambien anyway because Ativan has some anti-manic properties so it will help me sleep and help me ensure I do not escalate. I took it last night and felt great in the morning. I felt rested and calmer.

Very Real Dangers of Taking Ambien

I wanted to let you know the very real dangers of taking Ambien. I recently have been having a hard time sleeping .. my sleep has been disturbed because of my daughter teething and I couldn't get back on track. And I started to become hypomanic.

So I found out that Ambien is compatible with breastfeeding according to the American Academy of Pediatrics. So I took a pill the other night.

I apparently proceeded to Sleep walk, sleep eat, sleep fall (my knee still hurts) and sleep email. Yes, sleep email. (which may seem very funny) All of which I have no recollection of. I only discovered this happened when I was complaining to my husband that my knee hurt and he said ... must be because of when you fell last night. And I said what are you talking about? And he said I woke him up telling him that our baby needed a blanket and then proceeded to go to the kitchen and eat something. I was very wobbly due to the ambien and apparently fell.

I discovered the sleep emailing because I went to email my doctor in the morning about a flu shot and discovered that I had logged onto the secure messaging site and sleep emailed the night before.

I remember years ago hearing about sleep driving on ambien and thought it was an excuse for getting out of a ticket. Apparently it is very real.

Read about it here or here

Ambien Safe During Breastfeeding!

Sleep and me need each other. Badly. Lack of sleep throws me into hypomania. Hence the feelings I have now.

Last night while not sleeping I discovered that the American Academy of Pediatrics considers Ambien compatible with breastfeeding! I was so happy to hear that.

You know I have been so afraid to take ANYTHING while breastfeeding except for my Lamictal which I take religiously.

So last night I took 1 Ambien. And I slept for 4 hours straight. Yippee! Tonight I will take another Ambien and hope to sleep for 6 hours or so.

I discovered this about Ambien on my favorite breastfeeding site: KellyMom

Mood Swings Post-Partum

I was so happy when the depression lifted and things could get back to normal. And I was fortunate to have several good weeks ... and now things are on the upswing.

As usual the problem started with sleep. On Wednesday I got a stomach bug or food poisoning of some sort. And I didn't sleep all night ... because I was glued to the toilet. Yes, I know too much information.

I am not a good daytime napper. So I was basically up for 36 hours. Not good for me at all. Then on Thursday my baby was restless all night because of a new tooth coming in. So there are two really bad days of sleep.

And now I feel hypomanic. I only slept for 3.5 hours last night. Why? Because I couldn't turn my mind off. I was worrying about the financial crisis (I am one of those people with two houses because one has not sold), the upcoming election (I am very worried about who will be elected), the future of my consulting business (due to the economic climate I have lost two big clients in the last two months) and the state of my marriage (which is mostly strong however I am extremely irritable due to lack of sleep and the hypomania and I've begun resenting that my husband gets to sleep in and do this and that).

And now once again I feel like a failure. I promised myself that I would stay mentally stable for my daughter. I don't want her to have memories of a "crazy" mother. And now after having a few nights of bad sleep I'm getting sick. And the sad part is some of me is happy because at least I have energy to get things done -- which I have lacked the last few months because of the depression.

Medication During Pregnancy & Breastfeeding

The most frequent emails that I get from readers are about being on bipolar medication during pregnancy and if they can breastfeed. I have to say that it really is shocking that more information isn't available on the topic.

A few women I've been emailing have been really afraid to take ANYTHING during their pregnancy. I know that I myself wished I could have a drug free pregnancy. However, I know that realistically that would be dangerous for myself and would have been for my baby.

I personally was off my bipolar meds during the first trimester. Prior to getting pregnant I tapered off my all drugs except Lamictal. And I lowered my dose from 400mg of Lamictal to 150mg. Once I had a positive pregnancy test I went from 150 to 0 in 5 days. And remained off of the medication until week 14. When I went back on I did the starter pack all over again starting at 25mg and going to 150mg over several weeks.

An interesting thing happened during week 7 of my pregnancy. I got VERY sick. It was not normal morning sickness. I was throwing up more than 10 times a day. The day before I saw my OB/GYN at the beginning of week 8 I threw up 12 times in one day. Needless to say I was dehydrated and very weak. I lost 5 pounds in one week and had ketones in my urine (which is not good during pregnancy since it means you are burning stored fat). My doctor diagnosed Hyperemesis. And put me on zofran - a strong nausea medicine originally developed for patients undergoing chemotherapy. I would not have been able to continue my pregnancy had I not been on zofran. I would have certainly lost the baby and put myself in dire straights since I was not able to keep even water down.

There is one positive thing about having to go on zofran -- it made it easier to accept that I was going to go back on Lamictal. It helped me to realize that sometimes medication is REALLY a good thing. And that the benefits of many meds outweighs the potential risks.

Some moms have questioned the fact that I am on Lamictal while breastfeeding since it does pass into breastmilk. However, both my psychiatrist and my baby's pediatrician felt the benefits of breastfeeding outweigh the risks associated. I've talked about this is past posts -- but I wanted to mention it again. Pretty much ALL medications pass into breastmilk -- as does environmental toxins like dioxin. The question is really how does a baby respond. If you are considering taking medication while breastfeeding I highly recommend the book Medications and Mother's Milk by Thomas Hale. I also recommend reading KellyMom's article about breastfeeding and medications.

Feel free to email me.

Finally, Postpartum Depressions Has Lifted

Today, I realized that the postpartum depression seems to be completely gone! And I'm happy to say that I got through it without increasing my medication. I decided that since I was starting to feel better when I talked to my doctor that we would try to get through this without increasing my Lamictal.

So, I did the following things which I think helped:
1. Increased the amount of Omega-3. While pregnant I was taking 8 500mg capsules of OmegaBrite. At some point after the pregnancy I went down to 4 pills. So I went back up. I take it two times a day.

2. Increased the amount of exercise. Whenever I start feeling bad, stressed, busy I cut back on exercise, which only makes me feel worse. So I am now recomitted to weight training a minimum of twice a week and cardio 4-5 days a week.

3. Better food choices. When I'm not feeling well I start not eating as well. I start skipping meals and start eating more prepared foods. I'm not sure why this happens since I strongly believe you put junk in your mouth you begin to feel like junk. I think it is becuase when I'm depressed I'm tired and the last thing I am looking forward to is spending time in the kitchen at the end of the day. So I'm now back to cooking every meal at home pretty much from scratch.

4. I reached out and started talking about it. I have been amazed at how many women I know have been through postpartum depression and many have no history of prior depressions. Talking about it has helped me feel less alone and less like a failure as a mother (which I was feeling like since to me motherhood is supposed to be joyful so the unhappy feelings I had made me feel very guilty).

5. I accepted that this is what it is. And that it's okay to be depressed - it is something that I cannot control. I can certainly try to change the duration and depth -- however having bipolar disorder means I am not ever going to be 100% in control. Oddly enough there was a huge feeling of release from the acceptance.

6. I got out of the house. Sometimes I don't leave the house for days. Not because I'm depressed just becuase I don't need to. I work from home as an IT consultant so the majority of my contact with clients is by phone and email. I visit clients in person maybe once a month. So some days the only people I saw all day were my baby and husband and my babysitter. I have decided this is not healthy. I need more interaction. So now I have to get out of the house at least 6 days a week - even if it is just going to the park with my daughter or going to the store.

I joined a local moms group and am now taking Leila to one to two playdates a week - some are at the park, some are at other mom's houses. I am finally getting to know other moms who live near by which is wonderful. Almost all of my friends currently live on the east coast of florida where I used to live. So they are two hours away - which isn't so convenient for a visit especially now that I have a baby.

Looking back now that I realize I had started to underestimate just how bad I was feeling. There were times when I didn't want to be around my baby in the evening - mainly because I didn't want to have her see me upset or cry. Luckily she is only 9 months old so she probably wouldn't know what was wrong - but babies do know when mommy or daddy doesn't feel well.

Thank You for All the Emails

I wanted to thank my readers for reaching out. It is really good to know that people are reading this blog and that it is helping you.

As I mentioned last month I was going through some postpartum depression which I think I am now really coming out of. And although I may not have been good at answering every email promptly ... I have been reading them and appreciate the support.

I've told my husband about how I get such nice emails from people I've never met and he said he gets why I started this blog -- it is kind of like a support group -- althogh support groups are a little more of a two way conversation.

Years ago before I moved to Naples I used to facilitate 3 DBSA groups a week. It was one of the best things I've ever done. It felt good to help people and also to be understood. But after two years of running 3 groups a week I was glad to get a break when we moved. It was a great experience but also very draining since I got lots and lots of phone calls from group members who needed to reach out -- sometimes at odd hours of the night.

If you haven't ever been to a DBSA support group -- please look for one in your area. Go here

If you need someone to talk to ... please feel free to email me at bipolarpregnancy @ gmail.com (remove the spaces).

Mom’s Mood, Baby’s Sleep: What’s the Connection?

Just came across this interesting article about how the mother's mood affects the amount that an infant sleeps!

Mom’s Mood, Baby’s Sleep: What’s the Connection?


University of Michigan, Sept. 2, 2008 — If there’s one thing that everyone knows about newborn babies, it’s that they don’t sleep through the night, and neither do their parents. But in fact, those first six months of life are crucial to developing the regular sleeping and waking patterns, known as circadian rhythms, that a child will need for a healthy future.

Some children may start life with the sleep odds stacked against them, though, say University of Michigan sleep experts who study the issue. They will present data from their study next week at the European Sleep Research Society meeting in Glasgow, Scotland.

Babies whose mothers experienced depression any time before they became pregnant, or developed mood problems while they were pregnant, are much more prone to having chaotic sleep patterns in the first half-year of life than babies born to non-depressed moms, the team has found.

For instance, infants born to depressed moms nap more during the day, take much longer to settle down to sleep at night, and wake up more often during the night. It’s a baby form of the insomnia that millions of adults know all too well.

Not only does this add to parents’ sleepless nights, but it may help set these children up for their own depression later in life.


Read full article

Bringing Baby Home: Your Postpartum Plan

I received this article from the author of "Understanding Your Moods When You're Expecting" she felt it would be helpful to readers of this blog. I've got the book on my recommend reading list and I highly recommend it.

Bringing Baby Home: Your Postpartum Plan
By Lucy J. Puryear, M.D.,
Author of Understanding Your Moods When You're Expecting


You went in to this pregnancy with one goal in mind; bringing a new baby into your home. One of the most important ways you can prepare for this enormous event is to make plans for those first six weeks after delivery. Bringing a baby home is not about what color is right for the nursery or do the socks I bought match the outfit Aunt Doris sent? There are more important issues to consider before you carry that cuddly sweet bundle across the threshold.

The most important plans include: What kind of help will I need when I get home? Who will come to visit and when? Will your husband take off work during the first week, or will he wait until later when the company is gone. How will you make sure you get enough sleep? Having a well-thought-out plan will help decrease the sense of being overwhelmed when the nurse puts the baby in your arms and you realize this new little person is going home with you. It also will minimize your risk of developing anxiety and depression.

For some women, the answer to these questions is easy: Mom of course. Some new grandmothers go into superwoman mode when there is a new baby in the house. They cook, clean, do laundry, and get up with the baby in the middle of the night. But not every woman is so lucky, or this plan may not work for you. If, for example, you don’t have a good relationship with your mother or mother-in-law immediately after the birth might not be the best time for her to visit. A newborn will stress even the healthiest relationship, let alone one where there is already resentment or hurt feelings. In these cases, ask your mother or mother-in-law to come when the baby is four to six weeks old. You will fell physically better and have a better handle on how to care for your baby. Tell her you want her to come when you’ll be more settled and have more time to enjoy her visit. If she insists on coming immediately after the baby is born, explain that you have a plan for who will be helping when and ask her to honor that. She’s welcome to come, but when you and your baby come home from the hospital, your needs must take priority.

Do not schedule all of your help to come for the first two weeks. Many new mothers have described to me the total terror they felt when all of the relatives went home and they were alone. You go from having too many hands to having none. Ask you mother to come the first week, your mother-in-law the second, your sister the third, and your best friend from Albuquerque the fourth. They will enjoy not having to compete with one another to hold the baby and will have more of your attention. You will enjoy not being overwhelmed with company and will be glad to have the help spread out over a longer period of time. By the end of the fourth week, you should be feeling much more confident in your role as a new mother.

Some new families decide that they want to get used to the new baby without outside interference during the first week. This can work well as long as your partner understands that you will need a lot of help. Other families decide to wait until all the relatives have gone home for the father to take time off from work. That way, he can be with his new family after things have calmed down. It might not make sense for Dad to take time off when there is other help available and he will be competing with being part of the team.

Remember this is your baby and your new family. Make sure that you feel like you’re in charge and can ask for the help you need, when you need it.

©2008 Lucy J. Puryear, M.D.
Adapted from Understanding Your Moods When You're Expecting by Lucy Puryear, copyright (c) Lucy Puryear. Reprinted by permission of Houghton Mifflin Harcourt Publishing Company. All rights reserved.

Author Bio

Lucy Puryear is a practicing psychiatrist specializing in women's reproductive mental health. She has been director of the Baylor Psychiatry Clinic, Baylor College of Medicine, and was an expert witness for the defense in the trial of Andrea Yates. She is the mother of four and lives in Houston, Texas.

How Did it Sneak Up on Me?

The last day or so I've really been pondering how did this depression sneak up on me? I try to remain in touch with my emotional and mental state. I would say that many times I am hyperaware of how I am doing. So how did I miss it?

But then again almost all the women I've known who have gotten post-partum depression say the same thing. It took them a while to realize it ... it starts slowly and just builds a little. I also have found out that getting PPD is common to happen between 6-8 months.

Looking back over the last month I now know the triggers that probably set this off ... my sleep has been interrupted while Leila was teething. She started waking up several times a night ... meaning I was waking up several times a night. And my biggest sleep issues is I have a hard time falling asleep. So for every time I wake up a night it is between half an hour to an hour before I can fall back to sleep.

Trigger #2 was that my mom and I got in an argument. And the stress from that wasn't healthy for me.

Trigger #3 - Work. I work for myself which can sometimes be very stressful. I was successful at cutting down my workload during my pregnancy and taking on less projects - but I started taking on more than I should have after I hired a part-time nanny last month.

Trigger #4 - Money. Finances have a tendency to stress me out. I currently am one of those lucky people who own two houses. Not because I want to own two houses but because the market in Florida has tanked and I haven't been able to sell one of them. Well, this is only partially true -- until having my daughter I didn't want to sell our other house. I had fantasies about moving back to the east coast of Florida. And because at the time both my husband and my business were doing well there was no urgency to sell. Fast forward a year and my husband's business is slow (he's in construction) and I'm working less because of the baby and now the second house is a huge drain on our finances. I know hindsight is 20/20 - but I should have sold the house 3 years ago when we first moved to the west coast of Florida and the market was still great.

Is it Postpartum Depression?

I have debated if I would post this on my blog because I have really wanted to maintain a positive feel here so that other bipolar women thinking about having a baby or currently pregnant would be encouraged and know that its possible. In the end I've decided that really this blog is also partially about my real life.

So, here it goes. I am starting to think that I may be starting to suffer from a mild postpartum depression. I know that traditionally it starts within weeks of birth - but they say it can be anywhere in the first year. Currently my daughter is 8 months old. I just got my weekly email from babycenter and saw this:
Which new moms are at greatest risk of suicide? (here's the link). I have some history with that subject so I checked it out. And as suspected the article says women who have previously suffered from depression (checkmark needed) or other psychiatric conditions (checkmark needed) or who have attempted suicide previously (checkmark needed), have been hospitalized in the last five years (checkmark almost - It has been 5 years and 2 months since I was hospitalized) are at a 27 TIMES higher risk than the general population. (Please note I previously wrote 27% and that was not accurate)

At the bottom of the article there was the link to the postpartum depression article. So I checked that out and was surprised to see how much it sounded like me from the past few weeks.

I've known that I've started to feel a little down ... and have been somewhat irritable and am not sleeping as well as I would like, but I hadn't started the crying until the last week and then yesterday I had a brief thought of "why am I here" - which just happened to be my 30th birthday. Do not get me wrong I am not suicidal -- it was a brief moment where I questioned my existence. Witin minutes I realized I am here to raise an amazing little girl - who I know will do great things in her life.

And now my dilemma is do I wait this out for another few weeks, be more diligent about exercise (which I have slacked off on the last two weeks because I've been busy with the baby and work), focus on healthier eating, increase my omegas and maybe go to a support group -- or do I call my psychiatrist and either increase my Lamictal or start an antidepressant.

Ordinarily I would do both. However, I am worried that by getting on something else I will need to stop breastfeeding. And that makes me feel horrible. I really, really wanted to breastfeed for at least a full year since I know that is what is best for my baby. But then again, mommy crying clearly isn't best for baby either.

So I guess I know what I really need to do ... pick up the phone and call the doctor and maybe we will find something that still feels safe for me to continue breastfeeding. I am already having guilty feelings that I'm going to be a bad mom if I have to prematurely wean my daughter ...

The funny thing is until I read the babycenter email I just thought I was a little down due to some stress in my life.

I was so proud of myself for maintaining everything so well ... I have been on a low dose of medicine for so long (I was without all medicine for 3 months and for the last 14 months have been on less than half of my former dose of Lamictal) and only on one medication (no klonpin, ambien, sonata, antidepressants -- nothing) and it felt great to know that I was just healthy. Almost feels like a letdown that I now am feeling like this.

I also wonder if turning 30 has contributed to this ...

How Motherhood Has Changed My Outlook

One of the unexpected things of my pregnancy and now motherhood is how it changed my outlook on life and having bipolar disorder. For years (many, many years), I didn't really have acceptance that I was really bipolar. You would think having a mania induced psychosis that landed me involuntarily in a psych ward with hallucinations would have cemented in my mind that I was bipolar. But still somewhere way down deep I wished or hoped that maybe my diagnosis was wrong. And that one day they'd say that really I had something that is "curable."

Deep down I have struggled for the last 15 years with taking antidepressants, tranquilizers, mood stabilizers and anti-psychotics. I secretly worried that by taking the medicines I was changing who I am. I always wondered "where does the line between personality and illness begin or end?" Sometimes when I was depressed I would think that maybe the person that I am is a negative person who was just meant to be suicidal. When I was up ... I thought hey maybe my personality is just meant to be energetic and happy. That's who Rachael is.

Over the last few years I stopped obsessing over whether I was meant to take medicine or not. And started to realize that I may have to take them for the rest of my life. But still I had the lingering thoughts -- what if ... what if it was because of the antidepressants that I became so severely manic in the first place. Maybe the course of my illness isn't really Bipolar 1 -- maybe it is something less. Somewhere in the last year I realized it doesn't matter anymore.

My therapist used to tell me that true acceptance would mean that I wouldn't feel any internal struggle about taking medicine and that I would stop "wishing" for things to be different. That I would accept that this is what is ... I am bipolar and I have to take medication to keep my illness in check. And suddenly now that's OK.

Somewhere during my pregnancy I realized that things could be a lot worse. I'm fortunate that if I eat well, exercise, maintain positive sleep habits and take my medicine I'm fine - I have no symptoms, no bad effects of my illness if I maintain myself. And honestly I could have a lot of diseases that are far worse ...

I also now realize even more how important it is for me to maintain my health because now someone else depends on me being well. As much as possible I don't want my daughter to ever think that she's been given the short stick with a "crazy" mother. I sure when she is a teenager she will think her mother is crazy - but hopefully it won't actually be because of my illness - just one of those things that happens between mothers and daughters during adolescence.

How Food Impacts Mental Health

Are you really what you eat?

I've come to realize that what I put into my body has a huge impact on how I feel both mentally and physically. If you've read past posts on my blog, you probably realize I think that Omega 3 fatty acids are wonderful. I honestly believe it is like a wonder drug -- although all natural since basically you can get your omega 3s from fish, flax seed or walnuts.

Science Daily had a great article about how food affects the brain. The opening paragraph sums up a lot of what I try to focus on in my life.

In addition to helping protect us from heart disease and cancer, a balanced diet and regular exercise can also protect the brain and ward off mental disorders.

"Food is like a pharmaceutical compound that affects the brain," said Fernando Gómez-Pinilla, a UCLA professor of neurosurgery and physiological science who has spent years studying the effects of food, exercise and sleep on the brain. "Diet, exercise and sleep have the potential to alter our brain health and mental function. This raises the exciting possibility that changes in diet are a viable strategy for enhancing cognitive abilities, protecting the brain from damage and counteracting the effects of aging."

The article talks about the importance of vitamins, nutrients and minerals to your mental health ...

Here's the full article:
Scientists Learn How Food Affects The Brain: Omega 3 Especially Important

Black Box Suicide Warning for Epilepsy Medications

I just came across an article about how research has shown that epilepsy medications can cause increased suicidial tendencies in patients. The FDA was considering making drug companies include a black box warning on the following medicines: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR), Felbamate (marketed as Felbatol), Gabapentin (marketed as Neurontin), Lamotrigine (marketed as Lamictal), Levetiracetam (marketed as Keppra), Oxcarbazepine (marketed as Trileptal), Pregabalin (marketed as Lyrica), Tiagabine (marketed as Gabitril), Topiramate (marketed as Topamax), Valproate (marketed as Depakote, Depakote ER, Depakene, Depacon) and Zonisamide (marketed as Zonegran).

I thought is was interesting since so many of the epilepsy drugs are used to treat bipolar. In the end the advisory panel is advising that they do not this the statistics are enough to warrant putting the strong label on them.

Read the full article here:
FDA Advisers Don't Back 'Black Box' Warning for Epilepsy Drugs

Missing Mania?

There is a really interesting article at BP Hope Magazine called "Missing My Mania." Read it here

I was really stricken by these two paragrapghs:

I feel unpopular...
Mania makes you feel like the “it” girl or boy. But in remission, you’re just another pudgy neighbor on a quiet cul-de-sac.

AND

I can no longer crank out three magazine articles a day.
Mania brings energy! I can’t stay up all night. I’m so sluggish when I’m in remission. It’s the sluggishness of the average man and/or woman. I’m Average.

They are really such true statements. I felt like I was so much of a more interesting person when I was hypomanic. Not so much when I was manic. The last time I was manic I was completely delusional with lovely hallucinations. Apparently I used to think I was speaking to "Indians on the Plains" clearly I didn't realize what decade we were in. I also was paranoid that people were out to get me ... so clearly not feeling very popular then.

One particulary interesting thing was during my last bad mania five years ago I had these ideas that I would publish a magazine for bipolar people. I even met with some magazine publishers that I know. No one I talked to thought it was a viable business. So it is really funny that a couple years later BP Hope came out -- a magazine for bipolar people!

I do sometimes wish that I could have a "little" hypomania so that I could get more done during the day - so that I could feel more confident about myself.

And then I remember that hypomania can escalate to psychosis. And I don't ever want to find myself crawling on the floor of the psych ward because I am too doped up to walk. I'm grateful that I don't remember much of being in that state. The brief flashbacks I get are enough. How much do I really want to remember about being treated like a non-person in a hospital, being so overmedicated that I could barely walk out without my husband physically supporting me.

Now that I am responsible for a precious little baby I know I will always take my illness more seriously. I can't let myself get seduced into the upside of hypomania. I can't image having a childhood memory of my daughter's be visiting mommy in the hospital. I know the reality is that I will most likely at some point in the next few years have an episode ... I just hope that I'm able to catch it before it gets too bad.

Do any of you ever long for a little mania? Feel free to email me at bipolarpregnancy @ gmail . com

Staying Healthy & Sane with Minimal Meds

I've gotten several emails recently where people asked how easy or hard it's been to reduce my bipolar meds. So I wanted to share what I think has made the difference for me.

There was a period after my last manic/psychotic episode that I was on a whole slew of drugs: zyprexa, depakote, paxil, ambien, klonopin and lamictal. And honestly with all the meds I felt like a zombie. For a while that was OK because at least I was sane and stable. But the mental stability for me came at a price. When I went on Depakote & Zyprexa I gained 55 pounds in 3 months going from a size 4 to a 14. I had no energy and would actually sleep 12 hours a day. I would have to take 2 naps a day just to function. The final straw for me was when my hair started falling out (every morning I'd find clumps of hair on my pillow and in the shower). So I may have been stable but I was overweight, tired and felt like I'd be bald soon. (The hair loss was a side effect of Depakote - but it didn't get bad until I was on it for about a year but I was at a high dose - 3500mg a day (I was on Lamictal so the dosage for depakote has to increase because of the interaction between the two).

Because I didn't want to remain on so much medication I talked with my doctor about slowly reducing. First to go was the zyprexa then the paxil (which I had severe with drawl from and it took me 6 months to get down from 80mg to nothing) next the depakote. And then the ambien was switched to Sonata as needed and the klonopin was changed to as needed. And my Lamictal was increased to 400 a day.

In the meantime I focused on the other things I could do to help maintain stability.

1. Omega3 - I religiously take these at the suggestion of my psychiatrist. Studies have shown that Omega3 are beneficial for treatment of bipolar. Not to mention that there are also studies that show it is beneficial when pregnant!

2. Exercise - Exercise is key for me. Whenever I stop my regular exercise routine my mood shifts and I start to feel like I could slide into depression. I've had a lot of stressful things happen in the last two weeks and I haven't been to the gym. Today my husband said he's drag me there if I didn't get back because he could already tell a difference in me -- I'm getting irritable and more moody.

3. Healthy Eating. I really believe that what you put into your body affects you. The documentary Supersize Me showed that eating junk can make you depressed, fat and hurt your liver. So I avoid fast food - I maybe eat it twice a month. I'm a vegetarian so I really focus on getting the right mix of nutrients and being a vegetarian means I don't typically like to eat out because of limited food choices.

4. Supplements - In addition to the Omega3's I religiously take a multi-vitamin (prenatal a few months before getting pregnant) prior to that Centrum. I also take extra Vitamin D (a deficiency has been shown to contribute to depression), extra Calcium, B-Complex (labeled for stress) and additional folic acid. When I was pregnant I was taking about 2-3 mg (they recommend u to 5 mg for women taking AED during pregnancy. Regular pregnant women take less than 1mg typical prenatals have around 800mcg.) Since I'm breastfeeding now I also take extra Iron, grapefruit seed extract and caprylic acid (good if you'd had issues with thrush). Altogether it is a big handful of pills. But I think that the supplements really help especially the Omega.

5. Sunshine - I try to get at least 15 minutes outdoors a day. Sunlight helps your Vitamin D levels which helps you feel well more Sunny. :-) That's why light is recommended for people suffering from Seasonal affective disorder (SAD).

Does anyone else have non-medicine strategies for staying healthy? If you don't want to post a comment - email me at bipolarpregnancy @ gmail.com

Breastfeeding Resources

I've been getting a number of emails from pregnant women with bipolar who are contemplating breastfeeding. I wanted to mention that breastfeeding can be difficult -- it takes patience. I told myself that I would stick with it for 6 weeks and then if it still hurt to much I'd reconsider. Then I said 3 months, now I say 6 months. Each time I hit the goal I challenge myself to stick with it a little longer.

So I wanted to share some of my favorite breastfeeding resources.

Websites:
Kelly Mom - Site features lots of articles on breastfeeding and good advice on what to do if you have problems - i.e. treating sore, cracked nipples, thrush, etc.

Dr. Jack Newman Articles on Breastfeeding Online - Helpful articles and videos from Jack Newman who is a doctor who specializes in lactation.

Breastfeeding & Peppermint Water Article - This is a scientific study about using peppermint water to reduce nipple soreness and cracking. Peppermint water is traditionally used in Iran.

Books:
If you aren't sure that you are going to breastfed beware that these books are a little dogmatic about the benefits of breastfeeding. So if you might be considering formula beware that they could induce guilt ...


The Womanly Art of Breastfeeding - This book by the La Leche League is very infomative.





The Ultimate Breastfeeding Book of Answers : The Most Comprehensive Problem-Solution Guide to Breastfeeding from the Foremost Expert in North America -- This book is by Dr. Jack Newman. I haven't read this book yet - I just ordered it. But I really like his articles and advice that I've found online.

Pros & Cons of Breastfeeding for a Bipolar Mom

I never realized how much breastfeeding is a hot topic among bipolar moms -- particularly when taking mood stabilizers. Lately the biggest percentage of readers to my blog are finding me through a search on the topic of Lamictal and breastfeeding and I've gotten numerous emails from pregnant moms who are contemplating breastfeeding while on their mood stablizer.

So, I have to report that so far the experience of breastfeeding has gone well - I beleive that it has helped me recover physically and emotionally better than I would have had I not choosen to breastfed.

After 4 1/2 months of breastfeeding I've come up with a list of Pros and Cons. I'll start with the Cons so that I can end on a positive note.

Cons:
- Lack of Sleep -- If you are breastfeeding, in the beginning you have to feed the baby every 2-3 hours around the clock. You can't delegate this one to your hubby, mom or other helper. They calculate the time between feedings from the beginning of one feeding to the beginning of the next. So if your baby eats every 2 hours and takes half an hour to nurse that means you get a maximum of 1 1/2 hours of sleep at a time. In the first three or four weeks my daughter ate every 2 1/2 hours, then she moved to having two four hour stretches at night by 6 weeks. By 9 weeks she was sleeping for 7 hours between feedings at night. By 11 weeks she was sleeping for 9-10 hours at night. I realize that I was blessed with a baby who likes to sleep at night. I have friends with 7 month olds who don't go that long at night. So the lack of sleep could potentially last a long time. You could of course mitigate this lack of sleep by pumping or using formula at night and having someone else take "night duty." But by using the bottle early on you risk negatively affecting your breastfeeding by having a baby who prefers the bottle, has a poor latch durig feeding and a potential reduction in your milk supply.

- Unknown Effects of Medicine - Although all the literature I've found suggests that there are no known harmful effects of breastfeeding while on Lamictal or other mood stabilizers there are also no long term studies or studies on more than a hundred women.

- Not Being able to Take some Medications - Before getting pregnant I used to take sleeping pills for my insomnia. When I get several days of poor sleep I start to "ramp" up so it is important to control my sleep patterns to control my bipolar disorder. This has been a lot harder since I don't want to take medicines while nursing (except for my low dose of Lamictal). Also, I sometimes worry that I am taking too little Lamictal before getting pregnant I was taking 400mg Lamictal now I only take 150mg. I want to stay on a low dose to limit my daughter's exposure to Lamictal - but I sometimes wonder if I am putting myself at a greater risk for relapse - although so far so good.


- Trapped! And Never Having Break - Sometimes breastfeeding can feel somewhat confining. I've told my husband before it is like I'm tethered to the baby. Especially in the beginning I really couldn't leave our daughter for more than an hour and a half. So I really couldn't go anywhere without her and sometimes that can be hard. No going out with the girls for a couple drinks, or going to a movie. I think everyone - especially new moms - needs some mental health time - a break from responsibility. At 6 weeks I started pumping and now my daughter gets a bottle once or twice a week - so I can now get away at least once a week for 4-5 hours. Oh the freedom! After breastfeeding is established (generally between 4-6 weeks), you could of course have someone bottle feed more often and get some extra time. Which of course if you are going back to work outside the home you'd have to do this. (I work from home so I don't really do any regular pumping.)

- Breastfeeding Isn't Easy - You'd think that because it is natural and the way natue intended you to feed your baby that that breastfeeding would be easy. Think again. Getting the hang of nursing can be difficult, frustrating and really sometimes make you feel like a failure and loser. Which can be especially hard if you are feeling the baby blues. And nursing can be painful in the beginning. Your nipples are sore, they can get cracked, your boobs sometimes feel like they will pop, luckily this gets better (as long as you don't get thrush and the baby has a good latch)

- Leaky Breasts - OK, this is just my own annoying thing and in no way related to being bipolar or mental health at all, but I never realized how much leaking there can be. Granted this is different for every woman - but I have to wear nursing pads 24 hours a day. Which means I have to have a sleep bra to hold the pad in place. If I don't I will wake up wet and sticky. Yuck. And you have to make sure you wear the right bra otherwise you might be able to see an outline of the nursing pad.

Pros
I strongly beleive that the benefits of nursing far outweigh the cons. There are so many benefits that I don't even think I could describe them - so I'll list my top Reasons Breastfeeding Rocks.

- Best Nutrition for Baby - Breast milk has over 100 components in it that formula hasn't been able to replicate. Breast milk changes to adapt to your babies needs so as your baby gets older the ratio of protein and fat changes. Breast milk is the perfect food. You don't have to worry about finding a brand that agrees with the baby like you do with formula because generally babies are happy with your breast milk as nature intended it.

- Breastfed Babies are Healthier - Numerous studies have found that breastfed babies are healthier than formula fed babies. They have lower incidences of ear infections, colds and allergies. And breastfed babis are less likely to be overweight later in life -- which considering that two-thirds of Americans are overweight is a huge advantage. Breast milk passes antibodies to the baby and so strengthens their immune system.

- Breast milk contains Stem Cells - A few months ago scientists discovered that breast milk contains stem cells. They don't know what the purpose of them is or how the baby utilizes them - but they are there. The scientist who discovered them believes that they help guide a babies development later in life. Click here to read the full story about stem cells in breast milk.

- Higher IQ - Studies have shown that breastfed infants end up having higher IQs. Being smarter makes life easier so being able to help increase your babies IQ has life-long benefits.

Of course there are a ton of other benefits to the baby -- but what about to the mother -particualrly a bipolar mom?

- Bonding with Baby Helps Baby Blues & Depression - There is a special bond that occurs between a breastfed infant and her mother. (Not to say there isn't a bond between bottle fed infants and moms but it is different.) I've mentioned before that immediately after having the baby I really kind of felt empty and looking back I can now admit that there were a few days where I really didn't want to have anything to do with the baby. Breastfeeding ensured that I held her and looked into her eyes and that helped the nurturing process. They say that during breastfeeding the hormone oxytocin is release and it makes you feel good - it's the bonding hormone the same one that your body releases when you are falling in love. Having the close physical contact with the baby did I think make a difference and helped me get through my emotions. A couple studies have shown that breastfeeding moms experience less postpartum depression - which is a huge advantage when having bipolar disorder puts you at an increased risk for postpartum depression and psychosis. So any amount of decrease in the risk is a HUGE bonus.

- Breastfeeding Helps the Body Recover - The hormones released during breastfeeding help the uterus contract back to the prepregnancy size.

- Breastfeeding Helps you Lose Weight - When the body makes milk it burns a lot of calories - and uses up the fat stores that your body creates during pregnancy. So breastfed mothers typically get back to their pre-pregnancy weight quicker. Becuase you are burning more calories you get to eat more and still lose weight! It's been 4 1/2 months since I had my baby and I'm only 4 pounds away from my pre-pregnancy weight. I know it may sounds vain - but for me being overweight does affect my mental state. When I was on Depakote & Zyprexa I gained 55 pounds so I went from a size 4 to a size 14 in about 3 months. It made me feel bad about myself and that leads to depression. And it took me two years after getting off those to get my weight back down. So losing my baby weight quickly has made me feel better.

- Breastfeeding Requires no Preparation - You don't have to sterlize bottles, measure or mix formula or wait for the forumula to warm up. When the baby is hungry all you've got to do is unbutton the shirt and bra. So it is less time-consuming to get started which is important when you are tired and it is 3 am.

There are really too many benefits to list. I'm glad that I decided to breastfeed. I do think that the benefits for both the baby and me outweigh the risks associated with being on Lamictal while breastfeeding.

Study: Breastfeeding while on Antiepileptic Drugs (like Lamictal) OK.

I was happy to read this morning on WebMD that a study released a few weeks ago says that the use of epilepsy medications does not appear to affect cognitive abilities in babies. In fact the breastfed infants whose mothers were on anticonvulsants (like Lamictal which I'm on to treat my bipolar disorder) scored higher on the scored Mental Development Index.

I've now been breastfeeding for 4 1/2 months and I continually wonder if being exposed to lamictal affects my daughter. As I posted previously the studies on the subject are very limited however none showed negative results they just showed that the drug is passed through breastmilk to the baby.

Here's the article

Having a Bipolar Child

I was recently reading an article from BP Hope magazine about Bipolar Parents concerned that they could have bipolar children. The article was titled "Parents and the Waiting Game"

It really kind of disturbed me to think that a mom would be
"angst-ridden that her child ... will inherit her illness." I just wonder how that would affect a child if you were always watching for the signs of bipolar. A mom in the story said "Because I was looking for something, I thought there was something." She went on to say that she took her child to a psychiatrist at 7 and now that he's 16 there is still no sign of a mood disorder.

At what point would a mom's watchful eye turn into something that would cause anxiety in the child?

Years ago I used to facilitate several DBSA support groups. It was amazing the number of women who said they would never have children because they wouldn't want to pass along the disease. I even had a woman tell me that I was selfish for ever considering having children. It always made me wonder if they really felt that the world or their parents would have been better off not having them. I found it sad to think that these woman truly must feel that you can't have a good life because you are bipolar.

For years I discussed with my therapist coming to "acceptance" with having bipolar disorder. I finally came to understand that true acceptance is when you can get to the point where you no longer wish it was different. I now realize that the sum of who you are is molded by your experiences. If I wasn't bipolar I don't think I'd be as emotionally as strong a person. I don't think I'd strive as hard to succeed at everything I do. Finding out how far your mind can go into insanity changes your outlook on life. And I don't think I would have as much compassion for other people.

I also used to struggle with having to take medicine for the rest of my life. I just wanted a cure - I finally came to realize that I just need to be thankful that modern medicine has come up with a solution that works for me. If I pop my little pills I will be healthy and happy. And what more could you ask for than that?

As my baby gets older I really hope that I don't become one of those parents who are always "waiting" for a sign that my child has a mood disorder. I take comfort in knowing that the statistical chances of my daughter becoming bipolar are actually quite small.

Exercise during Pregnancy to Stabilize Moods

During my pregnancy I maintained an active exercise regimen - I did weights 3 times a week and did cardio at least 3 times a week - in fact I was at the gym doing weights 12 hours before I went into labor - I think the squats made my baby want to come out. I am a big beleiver that exercise helps maintain mood stability. For me exercise helps keep depression at bay.

And research suggests that exercise can be more effective than medicine.

A 1999 Duke University study headed up by James Blumenthal PhD divided 150 participants with depression age 50 or more into three groups. One was put on an exercise regimen, another administered Zoloft, and a third given a combination of the two. Those in the exercise group worked out on a treadmill or stationary bicycle at 70 to 85 percent of their maximum heart rate for 30 minutes, three times a week.

At the end of four months, all three groups showed significantly lower rates of depression.

The big surprise came from a follow-up conducted six months later when it was discovered that those in the exercise group experienced significantly less relapse than those in the Zoloft or combination groups. Only eight percent of the exercise group had their depression return compared to 38 percent of the Zoloft group and 31 percent of the combination group.

I think that speaks volumes ... only 8 percent had a relapse compared to 38 percent who were on Zoloft!



During my first trimester there was a couple weeks where I was too sick to exercise because of both the hyperemesis (extreme nausea and vommitting) and beause I had gotten a very bad cold.

Those few weeks were really the only times during my pregnancy that I felt unstable -- I was both a little hypomanic and slightly depressed during those weeks. And I strongly suspect that not being able to exercise contributed. Of course being off of all psych meds probably also contributed as did not being able to sleep because I would wake up coughing and/or needing to throw up.

My psychiatrist once told me that he felt that my committment to exercise and healthy eating was one of the key factors that had kept me without relapse. When I first started seeing my current psychiatrist I had just gotten out of the psychiatriac hospital after a severe manic episode that lead me into psychosis (I expericed hallucinations, was paranoid and had lots of gradiose ideas). It was when I was finally diagnosed as bipolar. At that time I asked him what the prognosis was - would I have a manic episode like that again and how long would it be. And he said it wasn't "if" it was when. And most likely becuase I was bipolar 1 with psychoic features I would relapse within two years and should stay on an antipsychotic like Zyprexa long term. A few appointments later I mentioned that at some point I wanted to have children - and he suggested that it would be wise for me to reconsider.

I say this to show that things change and I beleive that we do have the power to successfully manage bipolar disorder. My pschiatrist always told me that in order to stay well -- I needed to make a lifestyle change. At that point I had been seeing psychiatrists for 10 years (since I was 14) and none of them ever suggested that diet and exercise was just as important as taking my medicine.

So back to the exercise - whenever I stop my exercise routine I start to feel bad. After I had my daughter my OB/GYN told me I shouldn't do any exercise for 6 weeks - I injured my knee during deliver (don't ask how) and I couldn't exercise for a few weeks longer. I wonder if that contributed to the mild depression post baby.

One website I really liked to visit while pregnant was Babyfit.com and Fitpregnancy.com

Here are a couple sites/articles about exercising for mood stability:

Exercise and Bipolar Disorder at McMan Web

ABC News Video: How Can Exercise Or Lifestyle Help Bipolar Disorder?

Exercise to help mania

Latest News: Blood Test May Determine Bipolar Disorder!

This is great news in the mental health field -- a physical test to determine bipolar disorder! I imagine this could help misdiagnosis and could help get people treatment much sooner. I've read in numerous places that the average bipolar patient took 8-10 years before they were properly diagnosed. Which is tragic -- how many lives were ruined because they weren't getting proper treatment?

I personally was misdiagnosed as having depression and an anxiety disorder for 10 years. I started seeing a psychiatrist when I was 14 -- I was even hospitalized and saw at least 3 different psychiatrists and 3 therapists - and yet no one picked up on the fact that I was bipolar - despite the fact that I was clearly going through periods of hypomania and even full-blown mania. And yet they couldn't figure out why antidepressants didn't work when I was in a low period. So they just kept raising the dosage.

In fact it was antidepressants that threw me into the worst manic episode I ever had -- where I went into a full-blown psychosis. Going into psychosis and being hospitalized had a tremendous affect on my life. I don't think I returned to a more "normal" state for 3-4 months -- and I didn't feel like myself for at least a year - because I was doped up on antipsychotic medications that made me constantly tired and dampened my personality (it kept me from being manic and it also kept me from feeling normal happiness) - not to mention that the combination of Depakote and Zyprexa made me gain 55 pounds in 3 months.

And now back to the news on the blood test ...


Here's the story from FoxNews.com:
Study: Blood Test May Determine Bipolar Disorder
A simple blood test could now diagnose and help treat patients suffering from bipolar disorder, according to new research from Indiana University’s School of Medicine.

The study is published in the Feb. 26 online edition of the Molecular Psychiatry journal.

Research has shown that certain biomarkers are found in differing amounts in the blood of individuals who suffer from varying degrees of mood disorders, according to a news release. Doctors could use these biomarkers to determine treatment for those suffering with bipoloar disorder, the study found.

"This discovery is a major step towards bringing psychiatry on par with other medical specialties that have diagnostic tools to measure disease states and the effectiveness of treatments," said Dr. Alexander B. Niculescu III, lead author and assistant professor of psychiatry, medical neurobiology and neuroscience at the IU School of Medicine Institute of Psychiatric Research, in a news release.

"Although psychiatrists have been aware that bipolar illness and other psychiatric conditions produced molecular changes in the brain, there was no way to measure those changes while the patient was living," Niculescu said. "Blood now can be used as a surrogate tissue to diagnose and assess the severity of the illness."


Here's a longer more indepth article from MSNBC on the blood test and what it means to the mental health field

Check out the full study on Nature.com

Omega 3 During Pregnancy for Mental Health

Research shows that consuming Omega 3 Fatty Acids has both a mood elevating and mood stabilizing quality. There have been 21 human studies that have looked at Omega-3 for mood in adults. Some of them have been in bipolar disorder, some in depression.
There is also one study found that Omega 3s can be a treatment for pediatric bipolar patients. Here is an excellent article about the benefits of Omega 3 for people with bipolar disorder.

A mention this on this blog because Omega 3 are also great for pregnant women. Studies have shown that women who consume (either through diet i.e. fish or supplements) higher amounts of omega 3 are more alert and more advanced than babies whose mothers did not consume Omega 3s. Read the article here

I first started taking Omega supplements because my psychiatrist recommended it years ago as something to use in addition to traditional psych meds. During my pregnancy I upped the amount I was taking to 4 grams a day of a highly concentrated supplement - I like OmegaBrite it is a lot more expensive than most brands but highly distilled.

I've always believed that taking the Omega has helped my moods ... so if you are pregnant I highly recommend adding this to your prenatal vitamin regimine especially if you are not on meds.

Sleep Deprivation in the Early Weeks

By far the biggest challenge of being a bipolar mom is the lack of sleep in the first few weeks. (I believe it is probably the biggest challenge for ALL moms) I've gotten a bunch of emails asking me if that has affected my bipolar disorder. Unfortunately I have to answer that yes it has been difficult -- but luckily I've learned to cope. I did go a few weeks where I think I became a little hypomanic - but it never escalated (I'd say 50% of the time for me hypomania does ramp up to mania for me). And both of the times when I felt hypomanic were definitely brought on by a lack of sleep.

The first happened right after the birth. I didn't sleep at all in the hospital not a wink. I figured I went at least 66 hours with NO sleep. And after that I only got about 3-4 a night for the first week. Which explains why two days after coming home I was out shopping.

The good news is that my daughter has just now started really sleeping through the night (defined as 7 hours between feedings). I think this is pretty good for 10 weeks old. In fact one night she went 8 hours! The bad thing was I was having some insomnia so on the night I could have had more sleep than every I missed out.

I think a cruel joke is that many baby books define "sleeping through the night" as 5 hours between feedings. And since feedings are counted from the beginning of one feeding to the beginning of the next the most you could get in that 5 hours is a baby who is asleep for 4.5 hours. Who's definition of through the night is really 4.5 hours?

I have been really blessed that my husband has helped a lot with the nighttime so that I can get more sleep. I highly recommend for any bipolar new mom that you get help at night whether it is a spouse, mother, or hired night nurse.

At night my husband changes all the diapers and puts her back to sleep after I feed her. In fact for a few weeks he slept in the guest bedroom with the bassinet and would bring her to me when it was time to feed her (I'm breastfeeding so he couldn't really take over nighttime feedings) and then would take her when I was done and get her back to sleep. In the early weeks she sometimes had her days and nights confused so she would sleep more during the day than at night ... so having my husband be responsible at night was really a godsend. During the first three weeks she ate every 2.5-3 hours rounds the clock so the most sleep possible at one stretch was 2.5 hours.

Sometimes I think I should have done formula feeding at night because then my husband could have feed her and formula-fed babies supposedly can go longer between feedings. My initial plan was actually to either use formula or pump and have my husband do at least one feeding at night. However, once she was born I decided I didn't want to do any supplemental formula because so many things I read said that giving a newborn formula can sometimes hinder breastfeeding because the baby might like the formula or bottle more than breast milk. I didn't start pumping until 7 weeks for various reasons and at that point the nighttime sleep had been better.

Looking back if I could do it over again I would have introduced a bottle at night so that I would have gotten more like 5 hours of sleep in a row if my husband feed her. So I guess that is what I will do for Baby #2 - one day.

Antiepileptic Pregnancy Registry

Sorry it's been so long since my last post -- having a newborn doesn't leave much time!

A few weeks ago I got my copy of the AED Registry newsletter and they said they will be releasing UPDATED results on the registry data soon.

You can see the newsletter online at
http://massgeneral.org/aed/newsletter/Winter2007newsletter.pdf