I was perusing science-based parenting blogs this morning, and came across a blog focused on postpartum depression. As someone who has suffered PPD after each of my pregnancies, this was very interesting to me, and I was even more interested to see a couple of recent posts on balancing breastfeeding with the treatment of PPD. The initial one is here, and there is also a follow-up post here.
My psychologist finally figured out this last summer what was at the root of my struggles with depression and anger -- untreated ADD. Taking stimulant medication significantly improved my quality of life and my ability to function as a mom. It was very difficult to adjust to being off the medication during pregnancy, and I have been looking forward to getting a chance to take it again. However, the medication I was taking, an amphetamine derivative, is contraindicated during breastfeeding. It tends to concentrate in breast milk and would result in a nursling, especially a young one, getting far too much of the medication. It might be possible for me to take an alternative methylphenidate based medication, such as Ritalin, since the amount secreted in breast milk is far lower than with the amphetamines, but there is not good information on whether or not this would actually affect a young nursling or not. I do plan to discuss this option with my ARNP, but I am not sure that I am comfortable exposing a nursling to even low doses of stimulants. Finding accurate information to aid in the decision is difficult, as so much of the affects of medication while breastfeeding are unknown. Even experts disagree. Some who are strong advocates of breastfeeding view the benefits as outweighing the risks of nearly any medication, with only a few rare exceptions, while others view the possible risks of many medications as being potentially more significant than the risk of not receiving breastmilk. For many medications, there is little to no good research on milk transfer rates or possible affects on baby.
I could avoid the whole issue by remaining off the medication for a year or so to enable breastfeeding, but that would affect my ability to mother not only the baby but all my children, as well as affecting my adequacy as a homeschooling teacher. Would we all survive? Yes, we've done it before and we're doing it now, but now I know how much different things were when I was on a medication that got to the root of the problems I was having. Providing external structure through meal plans and a pre-planned easy to use curriculum will likely help, but it will likely all be much more of a struggle than I would have it I were taking a medication that I know works.
At this point, I don't even know which way I'm leaning. Still thinking through all my options, and trying to figure out what will be best for the whole family.