Breastfeeding question

[margiehubbell]

HI,
My cardiologist insisted that I stop breastfeeding because he told me it was too hard on my body and that I was making myself worse by continuing. I knew he wasn't a big fan of breastfeeding but he had never told me before that it was too hard on my body and that I had to stop immediately. My
EF=64 in march! I thought I was close to normal, but I have had some trouble with SOB, fatigue, and palpitations. My cardiologist ran some tests and told me that my heart, although not normal, is still doing fine. Have you ever heard of telling someone they have to quit breastfeeding for the woman's health?
Thanks Margie

[LauraNP]

I have found in general that cardiologists dont know much about breastfeeding. I have never heard or read evidence that what he told you is true.

[miachic]

Did he tell you to stop possibly because of your meds? I breastfed my son and although I felt a lot more tired than I think I should have (which later found out I had a thyroid problem too), I was so grateful that I had been able to nurse him. That bond we had was so needed for me to recover emotionally from everything. If you are still nursing, I would highly recommend you speak to your obstetrician, pediatrician as well as a lactation consultant. If your medications aren't going to harm the baby, I would say continue to breastfeed if you feel you want to. Just my 2 cents.

[margiehubbell]

My cardiologist put me on new med to calm my heart palpitations, this is one that I can not breastfeed while on. He told me that there was no reason to breastfeed since Lucy is now 16mo and she can eat and drink on her own, like I didn't know that. It is basically just for comfort. He tried to guilt me for nursing her while on my meds, even though they have all been cleared by the pediatrician and ob. It was getting time to stop anyways, but I didn't like being told to stop. I had never heard of it being for the health of the mother.
Thanks for all your input!
Margie

[JenniV]

My Cardio had no problems with me BFing and he adjusted my meds accordingly.

[agm324]

I was so excited about forming that bond with my first little baby. I got all the stuff I needed and was ready before she born. I got to breastfeed her for all of 5 days! I brought the pump with me to the ER! I was told I could not BF until we knew more about my situation. Once I was settled in a room, they told me I could no longer BF. I continued to pump, pouring the milk down the drain, hoping they would change thier minds..they didn't. I was not able to BF her again. They said it was because of the meds and there was nothing else I could take. HOWEVER, we all know that many doctors are not familiar with this and that choice to not allow me to BF could have been because they were not educated.

[sfekke]

I was so excited about forming that bond with my first little baby. I got all the stuff I needed and was ready before she born. I got to breastfeed her for all of 5 days! I brought the pump with me to the ER! I was told I could not BF until we knew more about my situation. Once I was settled in a room, they told me I could no longer BF. I continued to pump, pouring the milk down the drain, hoping they would change thier minds..they didn't. I was not able to BF her again. They said it was because of the meds and there was nothing else I could take. HOWEVER, we all know that many doctors are not familiar with this and that choice to not allow me to BF could have been because they were not educated.

Just had to respond, because I did the exact same thing. I pumped in the cardio ward, and would try to hide it, because they had told me not to because of the Coreg. I was thinking would if I recover quickly, then I can still breastfeed, when the baby is a few months. It took me a few days to come to terms with it.

My OBs concern was partly the medication, but also because she didn't want any excess strain on my body, just like you Margie, so I got the same feedback about BFings contribution to general fatigue. It would be really interesting to hear from a lactation expert on what is going on biologically in the mother to produce milk, and how this is a "strain" on your system. Therein really lies the answer, and the comment about no studies backing this up is good. Are there studies that show BFing with the right nutrition as not at all linked to heatlh problems?

[agm324]

Ya know, when you are in the hospital, you are thinking you are so alone..but just look how many of us went through the same thing! It is amazing. I too took a long time to come to terms with this. I cried and cried after they told me. They just said it wasn't the end of the world! They would come in and say..did you take your zoloft..crying like this is not good for your heart! WHAT DID THEY EXPECT..yes..I was a LITTLE depressed! Anyway..glad to know I wasn't crazy!

[SusanD]

I just wanted to respond to this post....I have been trying to gather research for a paper for school on breast feeding recommendations and PPCM. I specifically wanted to find the energy requirement and how that might possibly impede recovery ? So far I have been unable to find anything.

My cardio encouraged me to stop. He was mostly worried about my fatigue (his wife was currently breastfeeding and he was seeing the fatigue first hand) but was also cautious regarding the meds. He left the final decision up to me and our pediatrician.

I decided to ultimately stop because of the diuretic (it affected my supply); the concern over the meds AND the fatigue. Dh and MIL were able to take over the night feedings and I got to REST. I really believe it was essential to my somewhat rapid recovery. I was upset at first, but then I realized that I didn't need another worry. I didn't want to constantly be wondering if the meds were indeed being passed on (even in small amounts) to my daughter.

My formula fed baby is sick WAY less than her breast fed counterparts. We are so bonded it isn't even funny.

[agm324]

I am glad you brought that up...I never thought about it..but my daughter was not sick a lot either! She has been sick maybe 3 times in 15 months..and only really sick once! Ya know, that was one thing I did worry about, but after being told I couldn't BF, I just had to stop thinking about it..and I never really realized that she really wasn't a sickly baby because she was formula fed. We are also bonded just as if I had BF her. So, to put your mind at ease about formula feeding...it isn't so bad! I know it is hard to accept and hard to come to terms with, but in the end, it all works out!


Alana

[tbarton]

I breastfed for 18 months after being diagnosed. My first doctors weren't particularly supportive. I kept pushing until I found one that was. I'd already been through LLL leader training at that point so wasn't willing to take no for an answer. ;) When I did wean there wasn't any difference in my fatigue level or any improvement in my heart or anything. Since it took another 18 months to see any improvement, I don't think the breastfeeding had anything to do with it. I'm glad that I knew going in to it that breastfeeding is possible in most circumstances because I probably had at least 20 health professionals tell me no way. When I finally found the 21st, he was like well, of course you can with a puzzled look like why would you even ask? LOL! Most health professionals don't know much about breastfeeding.

Teresa
PPCM since 2002

[chopstickgirl]

This makes me so incredibly angry, I want to scream. I too was told I couldn't bf and i had to stop, when it is a LIE. BF'ING DOES NOT AFFECT YOUR HEART. That is misinformation. My current ob even verified that, as I am still nursing my 18m old and pregnant. I was afraid he too would think that bf'ing would be "hard on my heart" and he said "no not at all". HA.

There *are* meds that are compatible with nursing, and Dr.Fett himself even recommends that PPCM bf if possible, I believe.

I believe that nursing my daughter helped me recover like nothing else. It was something I needed emotionally to keep going, and I don't regret it at all. My EF at dx was 25%, 6mpp was 35%, 12mpp was 50% and hopefully even higher (should find out today!! my 18m pp results!)

So many woman are falsely informed when it comes to this, and I can't stress enough here, DOCTORS ARE NOT GODS. They just aren't. They are NOT going to be our best advocates, for anything. It is up to US. If you want to breastfeed, explore all avenues. Talk to a Lactation Consultant. your PCP, LaLecheLeague leaders, your OB, and your cardio. Cardios are HEART doctors. They have little to no education on breastfeeding (this is the case with most doctors out there) Just bc they have a DR after their name does not mean they know everything about everything, that is just the facts.

*hugs*

[mikeyandBellesmommy]

I had the opposite problem believe it or not. I had Ob's nurses and lactation consultants trying to force me to pump and then breastfeed and I was so sick and felt like I had to try and then when I didn't want to because I could barely walk let alone pump.. they made me feel bad about myself.. FINALLY my cardio spoke up and said she CAN NOT breastfeed.. It was the biggest feeling of relief I had ever had..

I wasn't even allowed at the time to be alone with my daughter in the hospital becuase I was so sick so I was glad the time I spent with her was happy and not me getting all nervous and freaked out while some woman stood above me and forced my screaming daughters face in my boobs (this is what happened for days before my cardio stepped up).. It was awful..

I personally don't think any one is better than the other.. MY daughter and I are very bonded.. she formula fed.. she was 28lbs at one years old and my son was 30. She is healthy happy and smart and so is he..

If breastfeeding is for you then go for it, if it isn't it isn't.. but we do have to remember that our docs DO have our health on their minds.. and I personally would TAKE ANY MEDS to be healthy over NOT taking the proper meds to breastfeed..

This argument has gone on and on and on and on and on, on this board.. because there are tons of differences of opinions on this..

[MiasMom]

I had to respond to this thread because it gives me a chance to give a shout out to all the nurses on this site... ;)

I think I've probably mentioned it before on this forum and will probably mention it many more times to come, but my nurses were my saving grace when I was in the hospital after dx!! I don't know how I got so lucky when I was in the cardiac care unit, but almost all the nurses I had were nurses who regularly shifted back and forth between the Mom/Baby and Cardiac floors! It was one of my nurses who got the OB and cardio to work together so that I could keep breastfeeding. My cardio, who I love, was not necessarily against breastfeeding, but, as my nurse said, he just wasn't in the habit of considering the needs of new moms and their babies when treating his patients. She got the OB to work with him to find safe meds for me to be on and to bargain with him about my fluid restriction so I wouldn't "dry up". The nurses also got me a pump to have in my room in case the doctors ordered any tests that would require me to "pump and dump", got the lactation specialist to drop in a couple of times to make sure I was doing OK and gave me lots of help and advice about breastfeeding. Breastfeeding has been one of the most healing things for me since dx (emotionally, anyway... I'll find out this Friday how things are going physically). I am so, so grateful that it all worked out this way and, although my cardio is a really good guy, I don't think it ever would have happened if it hadn't been for my nurses. NURSES ROCK!!!!!!!:D :D :D

[SusanD]

This makes me so incredibly angry, I want to scream. I too was told I couldn't bf and i had to stop, when it is a LIE. BF'ING DOES NOT AFFECT YOUR HEART. That is misinformation. My current ob even verified that, as I am still nursing my 18m old and pregnant. I was afraid he too would think that bf'ing would be "hard on my heart" and he said "no not at all". HA.

There *are* meds that are compatible with nursing, and Dr.Fett himself even recommends that PPCM bf if possible, I believe.

I believe that nursing my daughter helped me recover like nothing else. It was something I needed emotionally to keep going, and I don't regret it at all. My EF at dx was 25%, 6mpp was 35%, 12mpp was 50% and hopefully even higher (should find out today!! my 18m pp results!)

So many woman are falsely informed when it comes to this, and I can't stress enough here, DOCTORS ARE NOT GODS. They just aren't. They are NOT going to be our best advocates, for anything. It is up to US. If you want to breastfeed, explore all avenues. Talk to a Lactation Consultant. your PCP, LaLecheLeague leaders, your OB, and your cardio. Cardios are HEART doctors. They have little to no education on breastfeeding (this is the case with most doctors out there) Just bc they have a DR after their name does not mean they know everything about everything, that is just the facts.

*hugs*

I feel your anger, I really do. You are right, breastfeeding does not affect the heart per se. But it DOES lead to extreme exhaustion among some new mothers.....which is the total opposite of what is recommended for optimal recovery. If your EF was 25% your Dr. was right to be worried about your recovery and rest.

LaLeche will tell you can breastfeed on your deathbed :rolleyes: and will make darn sure you feel guilty if you don't. I know, I tried. The LL consultant didn't even know what PPCM was, couldn't even pronounce the flippin meds and told me it would be better for both me and my baby if I breastfed. Give me a break. It was better for my baby to have mommy RECOVERED and well-rested than to breastfeed.

I think at this time it is best to give recommendations to new PPCM moms and lay out the drug information, the information about optimal rest and the possibility of diuretics drying up your supply and making things more difficult.........and then let the mom and the pediatrician make an informed and RATIONAL decision together. A decision unaffected by Dr's who mandate that it not be done and a decision also unaffected by the breastfeeding "Nazi's" (sorry, this is my own personal opinion of LL) who would have you breastfeed at all times and will lay on the GUILT if you do not.

I am sorry you were told it wasn't an option. If you were in the hospital on multiple IV meds and on a ventilator then absolutely it is not the best option for you and your Dr. made a great decision. If, however, your doctor totally shut down the doors of communication and told you NO ....then I am sorry for that too. Lots of women here have felt strongly about doing it and did it safely.

Hopefully in the future we will have more research to guide our practice. Until then we just have to do our best to inform our patients and ourselves and go on from there.

[mallardmcmahon]

I too had issues with stopping BFing. I stopped cold turkey when I went to the ER and then realized I would be there a few days and couldn't nurse. For me, it was a bit of a relief but also sad. I nursed my older son until he was 9 mos old but it was very taxing. I do not make a great deal of milk even with fenugreek, lots of water, rest, etc. Once I knew I would be on meds that might possibly be passed to my newborn, I could not even think of taking that risk. Different doctors told me different things about whether meds would be in the breast milk. I also knew that there was no way I could recover with the added stress of BFing. Once I was home, I needed sleep much more than my son needed my breast milk at four weeks. BFing is SUCH a personal decision that it's hard to tell anyone what the right thing to do is.

I must say that I now have one BF child and one formula-fed child and there is NO difference to me in the way we have bonded. And that's after having the issue of not being able to do anything more than hold Jonathan while seated for 6 weeks after my MI. He is happy and healthy and I feel fine with MY decision.

Good luck and know that many of us been there too and it'll all work out in the end.

[SusanD]

I too had issues with stopping BFing. I stopped cold turkey when I went to the ER and then realized I would be there a few days and couldn't nurse. For me, it was a bit of a relief but also sad. I nursed my older son until he was 9 mos old but it was very taxing. I do not make a great deal of milk even with fenugreek, lots of water, rest, etc. Once I knew I would be on meds that might possibly be passed to my newborn, I could not even think of taking that risk. Different doctors told me different things about whether meds would be in the breast milk. I also knew that there was no way I could recover with the added stress of BFing. Once I was home, I needed sleep much more than my son needed my breast milk at four weeks. BFing is SUCH a personal decision that it's hard to tell anyone what the right thing to do is.

I must say that I now have one BF child and one formula-fed child and there is NO difference to me in the way we have bonded. And that's after having the issue of not being able to do anything more than hold Jonathan while seated for 6 weeks after my MI. He is happy and healthy and I feel fine with MY decision.

Good luck and know that many of us been there too and it'll all work out in the end.


My breast fed child gets sick maybe once a year. I think she had an ear infection one time. On the other hand, I have friends that exclusively breast fed and two of her kids have tubes in their ears and they are constantly sick.

I think if someone makes a decision to breastfeed or not to breastfeed, the decision should be made like I mentioned above: in a RATIONAL way, with all the information laid out, the pediatrician's thoughts and with the support of her family. She should also know that if she decides to formula feed , the world will not END and the baby will be FINE.

These people who act like your baby will be obese, diabetic, un-bonded, full of hatred towards you and sick all the time just make me SO ANGRY ! :mad: We have enough on our plate (like trying to figure out if we are going to live or die !) without the guilt of breastfeeding.

[heidiross]

I only breastfed for a short time, but now I am a lactation counselor. Tell me how that works??:confused: I was taught and do so just support and and let the mom make the descision. I have one of the Mother's Milk and Meds books. Very informative and I usually show any meds that my patients have questiuns about.

Both my kids breastfed for a short time. Yep I was just feeling awful, and having 9lb kids. Justin came home on oxygen, more stress. Then the day he gets it off I find out I have PPCM. But both my children suffer allergies and asthma. Travis had numerous earaches, Justin did not.

[naturalmama1012]

I am still BFing my 2nd PPCM baby at 12 months, I was also told with the first that I could not BF... this is misinformation. If you were extremely weak, doing very poorly, and severely compromised, I could see it being a strain, but even with an EF of 35% I was BFing and have had a fine recovery. My cardiologist has been very supportive and was careful to use meds compatible with BFing.

My pediatrician said that the docs that say no, don't really know very much about BFing or peds so they just say that to cover their you-know-whats....

[LauraNP]

I was just told on Tuesday that I probably shouldn't BF because I'm going to be on lasix for a few days postpartum.

Whatever.

I told her that I had looked up all my meds and I knew that enalapril was safer in BF than lisinopril.. just for her reference.. I love my doctors but this time I have taken a little bit more control about things than last time.

[heidiross]

Ok Lasix is reported as an L3, they dont know the amounts, but the amount transferred would not produce any effects to the baby, but there is a theory that it could suppress milk production. Lisinopril is an L4 which means they dont know,not enough studies, and enalapril is an L2 and studies show that if the baby would have to drink 850ml a day to ingest 2micrograms of the med.

[lilyjack]

I think I've posted about this before, but I was initially told to stop breastfeeding when I was diagnosed because there were no meds safe for breastfeeding. It made me very upset (on top of everything else) because I had to stop breastfeeding my daughter at 5 weeks due to latching problems and I really wanted it to work with my son. I was so excited when he turned out to be a good nurser, and then four days later they tell me to quit. :(

My salvation was my primary care physician. When he came to visit me in the ICU, I told him I wanted to breastfeed. I had the maternity ward loan me a breast pump and I pumped the whole time I was in the ICU just in case my doctor changed his mind. My PCP returned to his office and researched *every* cardiac medication used to treat cardiomyopathy and found the ones that were approved for breastfeeding. Then he called my cardio and told him about it. My cardio came in and apologized to me and told me about the safe meds. He then advised me that my recovery could be slower if I breastfed, and asked if I would consider stopping after 2-3 months if I wasn't improving. I thought that sounded reasonable. As it turned out, breastfeeding, even with a good nurser, just wasn't for me, so I decided on my own to quit after two months. But I was grateful for the chance.

[Kim]

I was told my body was to weak to breastfeed. My EF was 15%. I think this was the hardest thing to accept. I cried for weeks. It still makes me upset. My son is doing fine on formula and we are well bonded but I just wanted to breastfeed so bad. I got to for the first 2 days but as I started getting distressed with PPCM he refused to eat they think he could taste the stress chemicals in my body.

[LauraNP]

Ok Lasix is reported as an L3, they dont know the amounts, but the amount transferred would not produce any effects to the baby, but there is a theory that it could suppress milk production. Lisinopril is an L4 which means they dont know,not enough studies, and enalapril is an L2 and studies show that if the baby would have to drink 850ml a day to ingest 2micrograms of the med.

Thanks! What does your book say about Coreg vs Toprol?

[MOMOF4]

I Am New To This Site And Do Not Know If You Got Your Answer On Toprol.
I Was Diagnosised With Ppcm After The Birth Of My 4 Child. ( She Was My First Daughter And I Joke About Her Giving Me Heart Problems Already ! :) )
I Was On 40mg Of Lasik And 50 Mg Of Toprol And Was Able To Nurse. I Was Also On Potassium .
Luckily I Was Only On Toprol For One Month.
Hopefully This Answers Your Worries.
Jen

[heidiross]

Toprol is L3, milk/plasma rating is high, so amount is low but,doctors should administer under close supervision, watch baby for hypotension, weakness and bradycardia, same as us.

Coreg is also an L3, there is data available on the tranfer of this into milk. It has a high lipid solubility so some may transfer. So some caution is advised as with any other beta-blockers.

Hey girls, just a thought here. I am trying to get my hours for lactation consultant, maybe if I keep this up I can use this website for some time. Keep asking, anything about breastfeeding.

NO, I am not a breastfeeding nazi.;) Hey I bottle fed mine. As all of you, my doc told me to stop breastfeeding when I was put on Lasix, then accupril, and coumadin and birthcontrol.

[SusanD]

Toprol is L3, milk/plasma rating is high, so amount is low but,doctors should administer under close supervision, watch baby for hypotension, weakness and bradycardia, same as us.

Coreg is also an L3, there is data available on the tranfer of this into milk. It has a high lipid solubility so some may transfer. So some caution is advised as with any other beta-blockers.

Hey girls, just a thought here. I am trying to get my hours for lactation consultant, maybe if I keep this up I can use this website for some time. Keep asking, anything about breastfeeding.

NO, I am not a breastfeeding nazi.;) Hey I bottle fed mine. As all of you, my doc told me to stop breastfeeding when I was put on Lasix, then accupril, and coumadin and birthcontrol.

I wish you would have been around 7 years ago. Seriously. You understand that there is more to advising a PPCM mom on breastfeeding than just the meds. Her financial situation, social support (is her Dh going to help with some of the feedings and can they afford a pump ? etc) and her level of illness are critical factors to consider.....but these are usually ignored by LaLeche.

I think you could really market yourself to high risk perinatologists offices and such. Just a thought for you.

[heidiross]

Thanks Susan, I am trying to get my IBCLC, yep more initials Right now I thought I had enough Heidi Ross, RN, CLC.... soon RNC, thenmayybe IBCLC can we keep up??? Sorry lack of sleep. Worked last night, and kids are going to Colorado tomorrow to see my former inlaws. I paid, long story.

That would be something that would be interesting to do, as the lactation consultant at the hospital I work at is trying her own business with private consulting, she also goes through peds. She sees a perinatologist, she wants to get pregnant, but she has another laundry list of problems. I am going to follow her for awhile, when I can. She works days, and me nights.

Thanks again!!!!! You make me feel good after a hard night at work. I hope I dont offend anyone here, but Hispanics with little American culture, give me the NO LECHE. we all call it the no leche syndrome. So in my broken Spanish, very broken, I try to explain that yes they have colostrum, very good for baby........ then to hear after, See no leche. I want to pull my hair out. and if the young ones are fine with what they are doing a grandma will come shove a bottle in the baby's mouth and tell us no leche.:cool:

That is why I am not a breast feeding nazi:D Any other culture will listen and try, if they feel it is not working I will gladly give a bottle.

[sfekke]

Hi Heidi,

Here's a sort of off-PPCM topic nursing question. I had a problem with sore nipples with both of mine. My nipples were bleeding by the end of day one with each, despite being pretty sure and having great help insuring they latched on correctly. Fro the first 3 wks with my non PPCM baby, I pretty muched screamed in pain when she latched on. Then I was fine, but I'm lucky there was no infection.

Then my Mom tells back in the early 70s she and her friend did something to toughen their nipples about a month before they were due. I think they may have used rubbing alcohol - sounds a little horrific. But I think I may just be birthing hard suckers - small mouths run in my family. Do you know of any medically safe method for toughening nipples before birth?

Thanks,
Sarah