Cautionary tale about meds and breastfeeding

Two notes:

1) Tonight I'm putting up a review of the new Peek device for mobile email, and will be running a contest to get two free Peeks. Post your entires from tonight until Sunday night to win.

2) We're on for the Cincinnati meetup on Monday at 11:30-noonish at the Coffee Emporium at 110 East Central Parkway, on the fist floor of the old Emery Theater Building. I'll be there at 11:30, and if past meetups are any predictor, we'll be there until 1:30 or 2. It's kid-friendly, so come alone or with your miniature sidekick.

Now, on to a really serious email from reader Erica about a pretty horrific reaction her son had to something that we assume is safe while breastfeeding. My purpose in putting this up is to encourage all of us to trust our instincts and keep pushing. More thoughts after her story:

"At my 8 week postpartum checkup, my midwife asked me how I was doing. Itold her that I was still bummed out that things weren't going the way I had planned (I had spent nine months planning an all natural home birth and ended up with a c-section due to malpositioning. On top of that, the first few days were hell because my son had a sensitivity to tomato sauce and well, my husband lives off of Italian food, so you can imagine how much tomato sauce we were consuming on an average week. My husband had also just been given a bunch of overtime and was working about 60 hours a week, give or take a few. I was dealing with an overactive letdown, I was in horrible pain from the csection, and things were just overall pretty crappy). I also told her that I was feeling pretty overwhelmed and exhausted. She prescribed me zoloft, telling me that it would make me feel tons better. She also told me that it would be safe for me to take while nursing my son.

Over the next 5 1/2 months, things began to get worse with Ryan. He developed a tremor in his hand... it was like a mini seizure, but it was just his left hand. They ran two EEGs, both came back negative. His sleeping habits went through the floor... We actually took him to the emergency room once when he was 14 weeks old because he had been awake for almost 30 hours. My husband and I were both not only exhausted but pretty freaked out. He'd start to fall asleep while nursing, but as soon as his eyes would shut all the way, he'd pop back up like a jack-in-the-box. He had this insane amount of energy. He wasn't really crying or anything, at least not inconsolably, but he was cranky and fussy and most obviously tired. The ER pediatrician merely told me that he'd sleep when he was tired, though we tried to explain to them that he WAS tired.... that something was wrong. But they were much more interested in laughing at us for bringing in a kid because he wasn't sleeping than trying to figure out WHY he wasn't sleeping.

Well, at 4 1/2 months old, he learned how to roll over. Within 3 days, he was on his hands and knees. Somewhere around a week after that he was crawling. Full-out belly-off-the-ground cross-lateral crawling. Within days after he figured that one out, he was pulling himself up. We thought it was awesome at first... kind of a "Woah! Our kid is super advanced, we should be proud!" sort of feeling, but after a few days we were beginning to realize just how robotic he was becoming. Not to mention how horribly it screwed up his sleep even more than what it already was.

This is what would happen... we would lay him on his back (for anything... diaper change, getting dressed, it didn't matter what it was for) and immediately he was on his belly, up on all fours and either a: crawling across the room or b: pulling himself up on whatever was handy. I'm talking within seconds. There was no thought to it. Robotic truly is the only word that I can come up with to describe it. It was like he was a wind-up-toy instead of a 5 month old baby boy.

I would nurse him to sleep (which I've done since the beginning, no big deal) and as soon as he'd hit the crib, it was the same thing... Flip, up on all fours, pull up on the crib rail and start screaming. If I'd try nursing him back down again, he'd just decide to do acrobatics in my lap... rolling over, climbing all over me, etc. Once we would finally get him to sleep, he'd wake up after an hour and a half or so screaming bloody murder... no fussing first, no grunting, just a full-out scream. Then we would start all over again. And again. And again.

We ended up taking him to the ER again at about 6 months because he started doing the screaming thing even during the day. He'd go through these episodes where he would just scream for 30 - 45 minutes at a time. And then he'd be fine, like nothing ever happened. He had a cat scan and another EEG. Still negative. But I KNEW there was something wrong with my baby.

It finally got to the point where even our old faithful, the car ride, wouldn't help him fall to sleep. He would just scream the entire time. He spent another 26 hours awake, no naps or anything, and I called my mom and asked her if we could "move in" for a couple of weeks because with my husband working the hours he works, I just couldn't deal with this on my own. I thought I was going nuts.

After two days of being at my moms and us painstakingly letting him cry himself to sleep while he was in our arms, my mom asked me about the zoloft. I reiterated the saftey of it that my midwife and Ryan's pediatrician had assured me of, but she told me that I should look it up anyway. So I did. I didn't really find any other experiences like mine, but I did find out that the big "study" they did on zoloft and breastfed infants only consisted of 30 babies... and "most" of the babies didn't show side effects. It didn't say what happened to the minority, nor did it say any percentages. At least not on the site that I found. I told my mom about it and we decided that since I was staying with her, I didn't have to worry about killing my husband, I'd try coming off it to see what would happen.

Within 24 hours, Ryan was a completely new baby. He was playing by himself with his toys. Actually SITTING and playing instead of being wound up and all over the room. Within a week he was sleeping a full 5 - 6 hours at a time and taking full 2 hour naps. By the time I went back home almost 2 weeks later, I could actually take him out of his carseat while he was asleep and get him in the house and down in his crib without waking him up... and he'd actually finish his nap. The tremor has gone away. The screaming has stopped. I am almost positive that he was having nightmares because seriously, it had gotten to the point that it was almost as if he was afraid to go to sleep, which is why he'd just scream and scream and scream when he knew that we were trying to get him to.

Of course, then I ended up with an ear infection and I was prescribed prednisone to help the inflamation, which again the doctor ASSURED me would be safe -- and after the first day of dosage, we were back at square one. Needless to say, I decided to let the ear infection ride itself out and quit taking the meds.

I'm not sure if Ryan is just super sensitive to medication or what, but I have found one other mom online who is having the same problem with her son and she is breastfeeding while on prozac.

I am a hardcore lactivist, and am even taking the steps needed to become a lactation consultant, but I truly believe that with these medications -- if anything like this is going on with breastfed babies, the moms need to either consider switching to formula or finding out if there is any sort of alternative therapy for their ailments. I don't want people who truly have PPD to stop taking their antidepressants, but I think that in some cases (like mine) taking the zoloft was causing me to need the zoloft... I don't think I ever really had PPD, I was just overwhelmed and disappointed because things were so screwed up in the beginning -- add that to the normal crash of hormones and you're left with a sobbing, crying mess of a girl.

Anyway, I'm just trying to get my story out there in case someone else is going through what I've been going through. We're still strugging after coming off of the prednisone but I have faith that all will be well soon. It really upsets me that the doctors and the FDA don't consider stuff like this and that they'll just prescribe anything to anyone, breastfeeding or not. They're so super careful about pregnancies, but they don't seem to think twice about nursing. I guess the biggest thing is just because it's "safe" doesn't mean there won't be side effects. I suppose all the medicines out there are "safe" for us to take as adults, but they still might cause all kinds of crazy issues.... even for us. It's no wonder that they can cause the same problems in our babies.

Thanks a ton, Moxie. I just hope that if anyone sees this, they'll know that they aren't alone. That medicines DO cause side effects in our little ones, no matter what the docs say. It then just becomes an issue of if it's something that a mom can afford to quit taking or not."

OK, my first thought upon reading this was "NOT ONE of these medical professionals thought to examine what erica was ingesting that could be in her milk???" I mean, I think most of us who've nursed have thought about quitting dairy, onions, chocolate, citrus, and any number of food substances if our kids were acting fussy, so the idea that no one thought to question a chemical makes me frankly stunned. And angry that they basically huung Erica and her son and family out to dry for so long.

Also, it makes me really angry that Erica's provider's reaction to her emotional distress was not to help Erica with the source of that distress (her legitimate feelings of disappointment, which all goes back to my idea of a Good Birth from the tips for preventing PPD series, and physical pain, and not enough support at home) but to hand her medication. If you went to the doctor with a mystery physical pain, you'd hope the doctor would try to find and alleviate the source of that pain, instead of just prescribing pain meds to cover it. Her doctor should have tried to help her come up with steps to take to alleviate her problems instead of just covering them.

I feel like she got crushed by the system from a lot of different angles. And I wonder how we can help prevent this from happening to ourselves and our sisters. Thoughts?