Monday, May 5, 2008

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.
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