I think I said before that Whitney's going to have the lion's share of commentary in this blog, but this is one issue where I'm roused out of my usual lethargy.
Before I was pregnant with my daughter, I was taking Effexor -- and toward the closing months of the pregnancy, the issue was raised as to whether I wanted to take it up again after she was born. Given the colossal stress I was going through during the pregnancy and a pretty logical fear of post-partum depression, I said yes.
Whenever I go on a new prescription drug, I research it online and fly it past my husband since he's a pharmaceutical chemist. One thing I've learned over my years of happy-pill taking is that most of the current breed of psychotropics are relatively new to research and to the marketplace, and that nearly none of them have been subject to comprehensive study in patients under 18, much less patients under 2. To me, that equals this: If I have a third arm growing out of my back in 30 years, fine. If my child has one growing out of *hers* because of my meds, not fine.
Anyway. When I decided to start up with Effexor again, that closed the door to breastfeeding as far as I was concerned. There was one nurse on my maternity ward who tried to get me to change my mind. She busted out a copy of Dr. Hale's book and looked up Effexor. At the time, Hale gave it a "B" for risk. "See, it's okay!" she sang. Meanwhile, I was thinking there are two, if not three, levels of acceptability above a B. Reading more closely, all he said was that it hadn't been proven that Effexor had adverse effects on infants. To me, that's like the shoe salesman in the 1940's saying it's okay to put your feet in the x-ray machine. Or the factory boss in the early 1900s saying it's okay to use radioactive paint (and lick the brush) to make glow-in-the-dark clocks.
We don't really know much about the latest round of psychotropics. We kind of understand the mechanics, we observe the side effects in adults, but we are still incredibly far away from predicting what will work for who -- and given that most of these drugs have been on the market for 15 years or in some cases considerably less, we still know relatively little about long-term effects.
As a diagnosed clinical depressive, I'm willing to assume those risks so that I can function on a daily basis. I'm not willing to gamble on my daughter, and I'm not convinced that the benefits of breast milk outweigh ramifications of which I am 0% unaware. For all I know, Zoloft will make me drop over dead someday. I can live with that. I wouldn't be able to live with that happening to her, ESPECIALLY WHEN THERE IS AN ALTERNATIVE AVAILABLE.
I hemmed and hawed with that nurse -- for all I knew, she'd be the one in the delivery room with me. But after I filled out the paperwork on admission and it was obvious that I was not choosing breastfeeding, she avoided me. My hospital put big splashy cards on the bassinets of babies who were being breast-fed. Had I been wired another way, it might have offended me. I feel for women in my shoes who ARE wired like that.
Do what you want, militant breastfeeders -- it's your choice. But assuring someone that taking a psychotropic and breastfeeding has been proven to be safe is a LIE. You wouldn't give Effexor to a newborn? Well, if you're breastfeeding and taking Effexor, or Paxil, or even Zoloft, you are.
Okay, I'm out for probably another six months until some other topic comes up that I can get all worked up about.
Posted by at February 20, 2003 11:04 AM