I think I've been given bad advice about breastfeeding.......?

I've got PND with my second baby. I had Post Natal Psychosis after my first so they're keeping a close eye on me. I'm on medication that they advise not to breastfeed on which is fine and I understand. I have been taking my meds and leaving it for the time recommended before feeding again which I believe to be safe.





Well, I have been having panic attacks in my sleep the last few nights and have been told to take Lorazepam before bed, not to feed during the night and then to express and dis-guard any milk in the morning.





In my mind and from the research done I thought that milk is constantly being filtered and so if I leave it for 6 hrs the milk would be rid of any med and would be safe for bub. Am I right or once the med is present in the milk does it need expressing off and dis-guarding?I think I've been given bad advice about breastfeeding.......?
Virtually all medications leave the breast milk as they leave your blood. There are a few exceptions, but I'm not going to get into that.





The bad advice is that Lorazepam in your milk requires avoiding nursing at all. Lorazepam is given directly to infants at doses higher than that which would be received from mom's milk. So particularly for a baby older than 3 months maternal lorazepam is absolutely no reason to avoid breastfeeding after taking it, etc.





http://toxnet.nlm.nih.gov/cgi-bin/sis/se…


Summary of Use during Lactation:


Lorazepam has low levels in breastmilk, a short half-life relative to many other benzodiazepines, and is administered directly to infants. Lorazepam would not be expected to cause any adverse effects in breastfed infants with usual maternal dosages. No special precautions are required.











I think I've been given bad advice about breastfeeding.......?
I have also been told both: After I gave birth to my son (6 months old) I went out for a birthday party. I drank a few beers and was afraid to breastfeed. I know its not the same as the medication, but I was told that after 6 or so hours, the milk would rid itself of anything bad, but I was also told that I had to ';pump %26amp; dump';. This is a really good question so good luck and sorry I couldnt help.
There is a book called Medication and Mother's Milk this book has almost all medication in it and the recommendations related to breastfeeding. Call around and find someone with this book and get the straight facts from there.


Places to look


WIC, Hospital, Lactation consultant, La Leache League, Pharmacist, Pediatricians office
They prescribe these drugs, and say they are ok during pregnancy, yet not during breastfeeding??? wtf?, more of the drugs passes through the placenta, then through breastmilk.








Honestly, i'd say contact LLL or who-ever you have nearby, and ask them. They'd have more information on drug safety during breastfeeding then the doctor who prescribed the meds.
anything that you take in to your body gets to your milk as you said. But i think it stays in there till you get rid of the first and then after you pump the first time then it should be fine. The same when you have a beer or wine they tell you to pump and dump i would think it would be the same as with the meds. Im not a dr so do what you think is best.
Once it leaves your body it also leaves the milk - nothing ever ';stays'; in breast milk. It is filtered just like your blood. Here is a link to drugs and what their safety level is with breastfeeding. http://www.kellymom.com/health/meds/inde…
You are correct- your body filters your breastmilk. No need to express and discard.
You're right, you HAVE been given bad advice.





I take clonazepam for my anxiety, mostly at night, and I breastfeed throughout the night. I did research, and according to Dr. Hale's book and website, very very miniscule amounts actually make it into your breastmilk. It is much much less than 2%. I can even tell that the quantity going into my milk is not significant, by the fact that my son does not (and has not ever) displayed any signs of being given clonazepam (he does not get tired or floppy after breastfeeding).





Clonazepam and Lorazepam are in the same family, just that clonazepam has a much longer half life.





This is what Dr. Hale says about Lorazepam %26amp; Clonazepam:


http://66.230.33.248/discus/messages/56/…





Maybe you can ask the doc to switch you to clonazepam, since this seems to suggest that the longer half life can also prevent panic attacks? That's between you and your doctor though, just a suggestion.





ETA: If you would like to read more, here is a link to Dr. Hale's Breastfeeding and Medications Forum (there is a TON of information here on different drugs, I have found it very useful).





http://neonatal.ama.ttuhsc.edu/cgi-bin/d…











Nicole
You're right, your breastmilk isn't just in a ';holding tank'; ...It is being filtered constantly and depending on the ';toxin'; the amount found in breastmilk lessens with time.





You'd have to find the facts about the actual drug.





The only person I know of on this site that could give you a fully researched intelligent answer is Mystic Eye and I'm not sure she comes on all that often anymore...





I'll star the question and maybe she'll show up.


If not...see what you can find on http://www.kellymom.com





:)





***********





Oh there she is. :)
Yes, you have been given bad advice. It sounds like somebody basically guessed. You should be able to nurse as usual.





';Lorazepam has low levels in breastmilk, a short half-life relative to many other benzodiazepines, and is administered directly to infants. Lorazepam would not be expected to cause any adverse effects in breastfed infants with usual maternal dosages. No special precautions are required.';





http://toxnet.nlm.nih.gov/cgi-bin/sis/se…





http://motherisk.ca/ can advise -- note telephone numbers -- and explain things to your doctor as well.
i thought it stills stays there, but iam no expert.