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Thread: Weaning & Starting Formula for medical reasons

  1. #11
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    Default Re: Introducing formula - need help!

    Quote Originally Posted by @llli*newmom0301 View Post
    I thought I might be looking in the wrong place for formula advice, but it was worth a shot.
    No, not the wrong place at all. There are others here who have had to wean for medical reasons, I am one. Try mixing the formula with BM and see if that goes down any better.

    I know how hard it is to pump and dump I tried to do it but couldn't keep it up more than a few weeks without much hope of going back to nursing.
    “We are not put on earth for ourselves, but are placed here for each other. If you are there always for others, then in time of need, someone will be there for you.”
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  2. #12
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    Default Re: Weaning & Starting Formula for medical reasons

    Quote Originally Posted by @llli*newmom0301 View Post
    Neurontin. My neurosurgeon, OB, and lactation consultant/mom all said it transfers and they didn't advise BF. It's not worth the risk that I will pass a nerve suppressant to my son through my milk. I feel a little like an outsider on this forum all of a sudden! I BF exclusively and very successfully for about 6 1/2 months, even after returning to work. I didn't stop because I wanted to, but because I felt it was safest for my son. I was hoping to be off of the medication and able to pump for him again, but it doesn't look like that's going to happen and I don't want to wait to switch him to an alternative when it's too late. If I wait and he won't drink formula and I'm out of BM, then what?? I'm getting nervous...
    Here is the info from LactMed on neurontin. I will try and find it in Hale's book as well for you too.

    Gabapentin
    CASRN: 60142-96-3

    For other data, click on the Table of Contents


    Drug Levels and Effects:


    Summary of Use during Lactation:
    Limited information indicates that maternal doses of gabapentin up to 2.1 grams daily produce relatively low levels in infant serum. Monitor the infant for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsant or psychotropic drugs.


    Drug Levels:
    In published reports of anticonvulsant use during breastfeeding, most women were taking a combination of anticonvulsants. Some other anticonvulsants (e.g., phenytoin, carbamazepine) stimulate the metabolism of other drugs including anticonvulsants, whereas others (e.g., valproic acid) inhibit the metabolism of other drugs. Therefore, the relationship of the maternal dosage to the concentration in breastmilk can be quite variable, making calculation of the weight-adjusted percentage of maternal dosage less meaningful than for other drugs in this database.

    Maternal Levels. Four women who were taking gabapentin and were 12 to 21 days postpartum and a fifth who was 97 days postpartum had a single breastmilk sample measured just before nursing 10 to 15 hours after the previous evening's dose. Their average dosage of 1.5 grams daily (range 0.6 to 2.1 grams daily) and their average milk level was 4.5 mg/L (range 1.2 to 8.7 mg/L). The authors estimated that a fully breastfed infant would receive a dosage of 0.2 to 1.3 mg/kg daily at the minimum which is equivalent to 1.3 to 3.8% of the maternal weight-adjusted dosage.[1] A follow-up publication by the same authors found a similar degree of gabapentin excretion into breastmilk in 8 breastmilk samples from 3 additional mothers.[2]

    A woman took gabapentin 600 mg 3 times daily (36.7 mg/kg daily) plus amitriptyline 2.5 mg daily for 6 weeks beginning in the first few days postpartum for chronic back pain. Eight milk samples (6 foremilk and 2 hindmilk) were obtained over 24 hours. Milk levels varied between about 5 and 7 mg/L. Using the average milk level, a fully breastfed infant would receive a dosage of 0.86 mg/kg daily or 2.34% of the maternal weight-adjusted dosage.[3]

    Infant Levels. Three infants who were 2 to 3 weeks of age and one who was 14 weeks of age were breastfed during maternal use of gabapentin in an average daily dosages of 1575 mg (range 600 mg to 2.1 grams daily). Serum levels were measured after the morning nursing before the mothers' morning dose of gabapentin(10 to 15 hours after th prior evening's dose). One infant had an undetectable (<0.12 mg/L) serum level. The other 3 had an average serum level of 0.27 mg/L, which was below the level of accurate quantification for the assay method. The latter 3 infants' serum levels averaged 7.7% (range 4 to 12%) of their mothers' serum levels.[1] A follow-up publication by the same authors found that gabapentin was undetectable (<4 micromol/L) in the plasma of 3 additional breastfed infants.[2]

    An infant whose mother was taking gabapentin 36.7 mg/kg daily breastfed her infant 6 to 7 times daily with some additional artificial feeding at night. At 1.6 months of age, the infant's plasma gabapentin concentration was 0.4 mg/L which was about 6% of the average maternal plasma concentration.[3]


    Effects in Breastfed Infants:
    Three infants who were 2 to 3 weeks of age and one who was 14 weeks of age were breastfed during maternal use of gabapentin in an average daily dosages of 1575 mg (range 600 mg to 2.1 grams daily). One infant's mother was also taking topiramate and lorazepam and another infant's mother was taking clonazepam. No adverse effects were noted in any of the infants.[1] A follow-up publication by the same authors found no adverse reactions among 3 additional breastfed infants whose mothers were taking gabapentin during pregnancy and lactation.[2]<

    An exclusively breastfed 5-day-old infant whose mother was taking gabapentin 1.2 grams and levetiracetam 2.5 grams daily during pregnancy and lactation appeared healthy to the investigators throughout the 6- to 8-week study period.[4]

    An infant whose mother was taking gabapentin 36.7 mg/kg daily breastfed her infant 6 to 7 times daily for most of the first 1.6 months of life with some additional artificial feeding at night. The mother was also taking amitriptyline 2.5 mg daily. At 1.6 months of age, the infant was found to be healthy with a weight between the 10th and 25th percentiles, having been at the 50th percentile at birth. His age on the Denver developmental test was the same as his chronological age.[3]


    Possible Effects on Lactation:
    Relevant published information was not found as of the revision date.


    Alternate Drugs to Consider:
    Dependent on the condition being treated.
    I'm Hillary
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    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


    Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
    Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
    First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma Gandhi
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  3. #13
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    Jul 2010
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    Default Re: Introducing formula - need help!

    Quote Originally Posted by @llli*norasmommy View Post
    No, not the wrong place at all. There are others here who have had to wean for medical reasons, I am one. Try mixing the formula with BM and see if that goes down any better.

    I know how hard it is to pump and dump I tried to do it but couldn't keep it up more than a few weeks without much hope of going back to nursing.
    Exactly! It is literally like you're pouring money down the drain, or throwing away your most valuable possession. I have been pumping and dumping for a month now, and I'm not going to be able to use the milk for at least another month, if ever, so there's no point in continuing to pump. I didn't expect the transition to formula to be so difficult!

  4. #14
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    Default Re: Weaning & Starting Formula for medical reasons

    Quote Originally Posted by @llli*newmom0301 View Post
    I feel a little like an outsider on this forum all of a sudden!
    You're really not an outsider!!! So many moms have had to use formula to some extent, or exclusively. Sometimes it really is the best choice, and the only option- so please stick around to help those moms who need your experience. As the PP said, most of us don't know much about formula. We need people who can help when the answer isn't "just keep nursing."

    ETA: the info from Hillary is very interesting. Any insight on whether or not it would make sense to do some pumping, at the other end of the day from when you take the meds? It seems like you might be able to give some breastmilk without jeopardizing the baby...
    Last edited by @llli*mommal; October 20th, 2010 at 03:10 PM.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  5. #15
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    Jul 2010
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    Default Re: Weaning & Starting Formula for medical reasons

    Quote Originally Posted by @llli*mommal View Post

    ETA: the info from Hillary is very interesting. Any insight on whether or not it would make sense to do some pumping, at the other end of the day from when you take the meds? It seems like you might be able to give some breastmilk without jeopardizing the baby...
    I thought about that. Unfortunately, I have to take it 3 times a day. It apparently is one of those meds that has to build up in your system in order to work, so even if I haven't taken it for a few hours, it is still present.

  6. #16
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    Default Re: Weaning & Starting Formula for medical reasons

    Oh! I forgot to come back and post this...

    If you have an amazon account you can go and log in, find Thomas Hale's Medications and Mother's Milk there and "look inside" there was more good info there about trials they have done. It also has the info on half life, etc etc.
    I'm Hillary
    Wife to Gualberto
    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


    Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
    Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
    First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma Gandhi
    Looking for more information about vaccines?

  7. #17
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    Feb 2007
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    Default Re: Weaning & Starting Formula for medical reasons

    Hopefully you will be able to figure out a way to continue nursing. I was one of those moms who thought I would have to wean DS and we tried to get him onto a hypoallergenic formula (same one as norasmom - really gross smelling and tasting) The moms on another site gave me the advice to try it really cold or really hot, have someone else give it to him, try mixing some sugar into it (he was 9 months at the time, and it was oked by the pediatrician), try giving it to him int he bathtub (odd, but this is actually the best shot I had) since they are generally relaxed then, try giving it to him when he is falling asleep etc. I did not have much luck with mixing it with BM - it seemed to work better when it was straight up. Eventually he did take some, and I ended up not needing to wean, but it was tough in the middle of it since I wanted to continue, but did not think there was a way, and he would not take it.
    Last edited by @llli*lorders; October 21st, 2010 at 07:10 PM.
    DS-11/06- known IGE allergies to dairy, eggs, peanuts, tree nuts, beef, lamb, duck, amaranth, mustard and more...
    Outgrew pork, oats, soy, chickpeas, peas, turkey, chicken, shellfish and wheat. He has now outgrown more than half his food allergies

  8. #18
    Join Date
    May 2007
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    4,160

    Default Re: Weaning & Starting Formula for medical reasons

    Lori those are really good suggestions!!! We still struggle w/ Colby sometimes with him taking the formula. The Rx stuff is beyond beyond foul tasting and smelling. We found heating it up to work, and he likes to take his bottles while I bounce him up and down on my yoga ball. Totally weird, but the rhythm gets him into a sucking pattern and he goes for it big time.

    At least the OP can use the normal brands and should find success with a little time.

    Oh and I am also a mom who breastfed my first for 3 years and my second is on formula. Don't feel like you aren't welcome because all breastfeeding experience is welcome here.

    And I wanted to say that I know what you're going through with the transition, and it does get better!!!
    Lisa

    Mommy to
    Logan 5-23-07
    Colby 12-14-09

  9. #19
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    Default Re: Weaning & Starting Formula for medical reasons

    Quote Originally Posted by @llli*green.momma View Post
    Don't feel like you aren't welcome because all breastfeeding experience is welcome here.
    !!!

    and I sincerely hope that my original post didn't make you feel that way.
    I'm Colleen
    Mama to
    Silas born May 2009 ~ Nursed 18 mos, weaned during pregnancy, unweaned at 24 months, still nursing when he feels like it
    Lola born March 2011 ~ The Mary Lou Retton of toddler nursing
    Married to Brandon
    Using cloth on both bums

    We hibernate together



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