Category Archives: medication

Just Talkin’ Tuesday 08.11.09: Breastfeeding & PPD

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Original Photo "the breastfeeding lady 2" by Raphael Goetter @ flickr

Original Photo "the breastfeeding lady 2" by Raphael Goetter @ flickr

When I gave birth to my second daughter I saw my dreams of a normal postpartum smashed upon the rocks just 30 minutes after delivery. A delivery after 42 hours of labor, 36 weeks of pregnancy spent un-medicated but largely depressed and unaware of any potential issue facing us. We fully expected (as any parent) a healthy child, normal delivery. A large part of my smashed dreams tied into the hard reality that I would absolutely not be able to nurse her because she was born with a cleft palate so wide and large that it would be physically impossible for us to do so.

Later that day I was faced with a crucial decision. What kind of formula would I prefer for my daughter? I cried. She wasn’t SUPPOSED to get formula! That evening found me hooked up to a hospital grade pump praying for anything to happen. I barely squeezed out a drop. But I persisted and pumped for her faithfully until she was seven months old. I even researched everything I could in order to try to get her to nurse – books, cleft organizations, the La Leche League, the local Lactation consultants and even going to a training to become a trained Certified Lactation Counselor (which I completed one month AFTER we stopped nursing!) I left no stone unturned! Charlotte and I used SNS, nursing shields, and sheer determination. She eventually nursed for almost five minutes! Those five minutes were so amazing words cannot even begin to describe. In fact, it was tears falling from my face which interrupted the glorious event.(You can read more about our journey here: Breastfeeding Charlotte)

But at seven months, I faced a decision. My desire to continue to give breastmilk to my daughter or my mental health which had deteriorated so much it was adversely affecting my relationship with my husband and other daughter. With a heavy heart, I drove to Wal-mart to purchase formula. I cried the whole way home. Eventually I made peace with the decision. “Hanging up the Horns” or HUTH as it’s called in the world of exclusive pumpers, was a difficult decision. But one I was glad to make as it allowed me to bond with my entire family. I had come to resent Charlotte for all the extra work she required. But now, all I had to do was pour, heat, and I was done. I made strides towards better mental health and so did the rest of the family.

For me, the decision centered around the stress providing breastmilk created. I was also on medication which can be another tremendous issue for new moms. Many mothers don’t want anything crossing over to their infant through their breastmilk. Dr. Thomas Hale, author of Medications & Mother’s Milk, is a wonderful authority on the topic as are the researchers at Motherisk in Canada. When nursing while on any medication, it is important for the infant’s pediatrician to be aware of the medication and dosage amount so baby can be monitored for any adverse reaction. The decision to take medication is a personal one and should be made carefully with the help of professionals. Ask questions. Make sure the prescribing physician KNOWS you are nursing. And do not let them force you into quitting nursing if it is the one thing in which you find comfort. If you are currently struggling with this decision, please read this wonderful essay by Karen Kleiman: Is Breast Really Best?

So let’s get to Just Talkin’ Tuesday already!

Did your Postpartum Mood & Anxiety Disorder affect your nursing decision? Did you decide to formula feed to help improve your mental health? Do you regret your decision? Made peace with it? Did stopping help? Did your desire to nurse increase your desire to seek natural treatment? Speak up! Share!

(Absolutely no bashing for deciding to formula feed will be tolerated here. We respect the decision of all mothers to choose the course of treatment/feeding they feel is right for their families. Any posts discrediting or attacking a mother for her decision to formula feed will not be approved.)

Just Talkin’ Tuesday: The MOTHER’S Act

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LegislationOn February 23, 2001, Melanie Stokes gave birth to a baby girl. Just three months later, she committed suicide. Melanie’s death gave birth to a very dedicated activist – her mother, Carol Blocker. Frustrated with the failure of physicians to appropriately care for her daughter, Carol worked endlessly to keep Melanie’s tragic death from becoming meaningless. Through Carol’s tireless advocacy and work with Representative Bobby Rush (IL), the Melanie Blocker Stokes Act has now become The MOTHER’S Act.

The MOTHER’S Act as it reads in the current version would provide funds for a public awareness campaign, education campaign for caregivers, increase availability of treatment options and entities as well as require the current Secretary of Health & Human Services to conduct a study regarding the validity of screening for Postpartum Mood & Anxiety Disorders.

More and more research is slowly uncovering potential underlying causes and risks related to Postpartum Mood & Anxiety Disorders. More and more women and caregivers are becoming educated as more of those who have survived a PMAD speak up to share our story.

If passed, The MOTHER’S Act would further reduce the stigma surrounding new mothers not ensconced in the Johnson & Johnson glow of infantdom. If passed, the MOTHER’S Act would increase funding for research and possibly open even more doors to understanding the cause and more importantly, the potential for truly preventing Postpartum Mood & Anxiety Disorders. If passed, the MOTHER’S Act has the potential to prevent tragic deaths like that of Melanie Blocker Stokes.

Much of the debate surrounding the MOTHER’S Act has centered on the word “medication.” Medication does not necessarily mean Anti-depressants. It does not mean this is the ONLY way to treat a PMAD. It is merely listed as an option for treatment. And frankly, if one has a doctor with a quicker draw on his/her prescription pad than Billy the Kidd, I’d run away. I’d run away faster than a cheetah.

Another key point of the opposition has been that the MOTHER’S Act mandates screening. In the current version, there is no mandate for screening. The only mention of screening is to require the Secretary of Health & Human Services to conduct a study regarding the validity of screening for Postpartum Mood & Anxiety Disorders. The current standard for screening is the Edinburgh Postnatal Depression Scale, which you can learn more about here.

You can read a copy of the current bill by clicking here.

Go read it. (Don’t worry – it’ll pop up in a new tab/window – I’m cool like that here)

Seriously. Read. The. Bill.

Then read it again.

And then come back here. Be honest.

Unlike this week’s TIME article which failed to present both sides, I promise to allow unedited comments in support of or opposing the bill as long as they are civil. (Any comments including personal attacks will NOT be allowed!)

So let’s get to Just Talkin’ Tuesday already!

TIME Magazine misfires debate on MOTHER’S Act

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Awhile back, I was contacted by Catherine Elton regarding an article which was to examine Postpartum Depression and the Mother’s Act. The email somehow got buried and I did not get a chance to participate in the discussion.

It seems that it would not have mattered if I had been able to discuss my story with her.

Time published the story this week. While the online version has been modified to correct an error with Ms. Amy Philo’s story, you can still see the original version in the hard copy. (Which by the way, I am personally asking you to boycott – even asking if you can take the copy of TIME home from the doctor’s office in order to keep other moms from reading it! And make sure you ASK – because just taking it would be stealing and that’s illegal.)

The original version, entitled “The Melancholy of Motherhood” includes one quote from Carole Blocker, the mother of Melanie Blocker Stokes, a mother who tragically committed suicide after unsuccessful treatment for severe postpartum depression after the birth of her daughter. The quote reflects Ms. Blocker’s confusion as to how someone could oppose the MOTHER’S Act, a bill which is designed to increase public and professional education regarding Postpartum Mood & Anxiety Disorders. Frankly, I’m confused right along with Ms. Blocker.

The only survivor story featured in this article is that of Amy Philo, one of five recipients of an Outstanding Achievement for Mothers’ and Children’s Rights awards from the Citizens Commision on Human Rights or CCHR. CCHR was founded in 1969 by none other than the Church of Scientology, well-known to oppose the entire psychiatric field.

Amy has tirelessly worked against this bill for quite some time now but continues to be tragically misled. Few discussions with her have led to quite the round robin with Amy unable to come up with legitimate research to back up her claims. When asked for said research, Amy refers to her own websites instead of to specific research articles supporting her claims.

I happen to know that Ms. Elton did indeed interview fellow survivors who support the bill. One has to wonder then, why did their stories not make it into the article? Was it length? Was it editing? Or was it intentional? Regardless, the finished piece as published presents a very frightening and deceiptful picture of what new mothers face is this bill is passed. To begin with, the MOTHER’S Act no longer mandates screening. It requires a study to be completed by the Secretary of Health and Human Services (Kathleen Sebelius) as well as funds for an educational campaign for both caregivers and the general public.

I agree that just because a new mother shows emotion she should not immediately be diagnosed as having a PMAD. I also believe that a woman should have free choice when it comes to her treatment decisions and should NOT be judged for those choices. I chose to take Anti-depressants. My first prescription did not work out. But my second one did. Just as with any other medication, sometimes they don’t work so well with your system. So you try another one. You don’t suddenly take your own care into your hands – that’s ridiculous. Would you try to heal a broken leg or diabetes on your own? No? I didn’t think so. So why would you rely solely on self-care when it comes to mental illness? Self-care should be part of the picture but it shouldn’t be the ONLY part of the picture.

I am so tired of being judged and accused of not having informed consent. You know what? When I made my decision to go on Anti-Depressants, I had carried around an informational packet about AD’s & Breastfeeding given to me by the NICU Lactation Consultant with me for a week. I read that thing through and through. I was exclusively pumping for my daughter at the time and did not want to jeopardize her receiving my milk if I ended up having to take something. But I couldn’t function. I couldn’t take care of my family, I couldn’t take care of myself, and a lot of the same thoughts were coming back. Negative, scary thoughts about knives and hurting myself and my family. Yet I wasn’t on anti-depressants. I needed to be able to function. So I made a very informed decision to do so, one I do not regret to this day.

TIME – I am very disappointed in your lack of sharing both sides of this debate. Very very disappointed.

Just Talking Tuesday 07.07.09: Anti-depressants or Not?

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original photo by thegirlsmoma @ flicker

original photo by thegirlsmoma @ flicker

Today’s topic was inspired by a post over at Postpartum Progress: You don’t NEED Anti-depressants, Do You?

In this post, Katherine discusses the lack of stigmatization regarding pharmeceutical treatment for medical conditions in response to a ScienceBlogs post you can find here.

Anti-depressants are stigmatized. Period. Nitro-glycerin or insulin? Not so much. Why? Just as Anti-depressants may work for me, they may not work for you. And if you have the wrong heart condition and take nitro-glycerin, things may not go your way either. But you don’t hear people judging others for being on nitro-glycerin, now do you? And insulin? Many Diabetics require this life-saving medication. Even pain medication after an injury – do you question that prescription? Most don’t and certainly aren’t stigmatized for taking it because let’s face it – a broken leg hurts – something we all understand.

Mental illness hurts too. It hurts the person suffering. It hurts the people around them. And if the right medication is paired with the right therapy, it can make a world of difference. Why then, are we stigmatized or accused of not understanding informed consent for deciding (of our own free will) to take medication as we heal? What makes the scaffolding of Anti-depressants any different than pain medication as a broken leg heals?

So I’m posing a pretty big question today. And I expect there will be a bit of debate about it – which is good…our different opinions are what keep us interesting! Just keep things polite. No hateful, judgemental or fear-centered comments will be approved.

Do/did you or don’t/didn’t you take Anti-depressants? Why? Why not?

And more importantly – IS it your place to tell someone else they absolutely SHOULD not take them if you don’t believe in them or have had a bad experience? Or should you calmly refer them to research that explains the risks vs. benefits and let them make the decision on their own WITH a professional on board?

Let’s get to Just Talkin’!

Tips on Identifying Reliable Health Information on the Internet

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If you’ve landed here as a result of a Google, Yahoo,  Bing, or other search engine, you already know how many results you can get in mere seconds and even sometimes nano-seconds. Thousands! So you wade through the results hoping for reliable and trustworthy information. Unfortunately, not everything out there is reliable and trustworthy. And even if it is reliable and trustworthy, you should ALWAYS check with a professional prior to implementing or stopping any treatment.

Here are some general tips to help you tell the good from the bad (source: Medical Library Association):

1. Sponsorship
  • Can you easily identify the site sponsor? Sponsorship is important because it helps establish the site as respected and dependable. Does the site list advisory board members or consultants? This may give you further insights on the credibility of information published on the site.
  • The web address itself can provide additional information about the nature of the site and the sponsor’s intent.
    • A government agency has .gov in the address.
    • An educational institution is indicated by .edu in the address.
    • A professional organization such as a scientific or research society will be identified as .org. For example, the American Cancer Society’s website is http://www.cancer.org/.
    • Commercial sites identified by .com will most often identify the sponsor as a company, for example Merck & Co., the pharmaceutical firm.
  • What should you know about .com health sites? Commercial sites may represent a specific company or be sponsored by a company using the web for commercial reasons—to sell products. At the same time, many commercial websites have valuable and credible information. Many hospitals have .com in their address. The site should fully disclose the sponsor of the site, including the identities of commercial and noncommercial organizations that have contributed funding, services, or material to the site.
2. Currency
  • The site should be updated frequently. Health information changes constantly as new information is learned about diseases and treatments through research and patient care. websites should reflect the most up-to-date information.
  • The website should be consistently available, with the date of the latest revision clearly posted. This usually appears at the bottom of the page.
3. Factual information
  • Information should be presented in a clear manner. It should be factual (not opinion) and capable of being verified from a primary information source such as the professional literature, abstracts, or links to other web pages.
  • Information represented as an opinion should be clearly stated and the source should be identified as a qualified professional or organization.
4. Audience
  • The website should clearly state whether the information is intended for the consumer or the health professional.
  • Many health information websites have two different areas – one for consumers, one for professionals. The design of the site should make selection of one area over the other clear to the user.

MLA’s guidelines are an excellent starting point and should be used by anyone searching for Medical information on the internet. Many caregivers will also tell you to not search the web for information, especially if you have a Postpartum Mood Disorder. If you have a question and feel overwhelmed with doing research on your own, get in touch with a Postpartum Support International Coordinator, your midwife, or your doctor, and ask for help in doing research. Sometimes you may come across research or news stories that are not applicable to your situation that may cause triggering thoughts or increase your fear and anxiety without justification.

Another great way to check the reliability of a website is to do so through HONcode. HONcode, Health on the Net certifies websites with healthcare information. Their standards are pretty high and they certify on a random basis once a website has been accepted. (I’m currently working on acheiving this certification for this blog myself). Through HONcode, as a patient/consumer, you can download a toolbar or search directly from their site and will only be given websites that have been approved by them. Click here to learn more about the safety process at HONcode.

I also want to take a moment to mention that a good doctor or advocate will be compassionate, understanding, and work with you regarding your desired route of treatment. Good Caregivers and Advocates are able to stay objective and not allow personal experience to cloud their aid to those who seek their help. This does not dismiss advocates who have specialized knowledge of certain types of treatment however – what I mean by this statement is that if you approach and advocate with a question regarding an Anti-Depressant, they should direct you to research regarding that particular medication and encourage you to also speak with your caregiver. They should NOT bash said medication because they’ve had a bad experience with it. If the caregiver or advocate is not compassionate but instead dismisses or attacks your desired treatment methods, it’s time to find another caregiver or advocate for support.

As a Postpartum Support International Coordinator myself, I work very hard to support the journey the mother is on and the treatment route that best fits with her personal philosophy. I encourage the involvement of professionals – including her OB or midwife, a psychiatrist, and a therapist. I also encourage Mom to take time for herself, something we all forget to do from time to time, but is very important for our mental well-being.

So please remember to:

Thoroughly check the source of the information you are reading online using the above guidelines from the Medical Library Association as well as searching via HONcode for your information.

Double-check any information regarding starting treatment or stopping treatment with your professional caregiver prior to implementation.

Make sure your caregiver respects your opinion regarding your body. (You are of course, your #1 expert in this area!) If he/she fails to respect you, although it may be difficult, find another caregiver who DOES respect you!

Take time for yourself as you heal.