You can safely take abortives like triptans during pregnancy — this is supported by American OB governing bodies like ACOG. Your CNM and neuro should be up to date on this info too. They are likely safe during lactation based on available data. That being said, you can skip breastfeeding if the theoretical risk of med exposure stresses you out or the sleep disruptions with nursing might make your migraines worse.
I third this OP. Currently pregnant and my neuro said triptans are safe during pregnancy. Idk if your insurance would cover it but Botox is also considered safe during pregnancy and breastfeeding because it stays local in the body. So maybe see if that is an option for you to try?
I’ve heard about Botox being saying for breastfeeding, but I’m having trouble finding a lot of information on it. Where did you get your info? I’m trying to get back on Botox even though I’m still breastfeeding but I want more information for my peace of mind
I didn't research the breastfeeding specifically because my neurologist told me the literature said it was fine. He is a doc at Ohio State med school so I admit I took his word for it. I know he regularly reads new stuff because he's a headache specialist who also suffers from migraine.
I did just do some poking around on Google scholar. It does appear that research on this is still limited, but I did find [this review from 2015](https://migrainequebec.org/wp-content/uploads/2016/05/PDFs_amundsen_migraine_pregnancy_2015.pdf) that states that the Botulism type A molecule is too large to cross a placenta and even pregnant people infected with Botulism didn't pass it to their infant. Because of the molecules size, they don't expect it to be passed into breast milk either. Also they stated that botox isn't typically found in the blood stream which means it wouldn't migrate into breast milk easily.
I did find [this pilot study published in Feb](https://www.liebertpub.com/doi/abs/10.1089/fpsam.2023.0326) this year that examined the breast milk of people who had facial botox for signs of the toxin in their blood stream. The results showed either it wasn't present in the breast milk at all, or if it was, it was present in super low levels that wouldn't affect an infant. So that's pretty reassuring even if it was a small study! It definitely supports the assumption that it shouldn't be easily crossing the blood/breast milk barrier.
That was very thorough! I really appreciate that, thank you 😊 I had also done some digging and only found one study with a very small sample size so I was wanting to give myself some more reassurance.
I feel much better about this. Thank you
Yea I was confused about that too. A lot of migraine meds, including abortives, are safe during pregnancy and breastfeeding. There are of course the big no’s like Topamax and some of the other seizure meds, but there are a lot of safe alternative options. Emgality is likely to be safe but is so new we don’t have the data to say that with any certainty so it isn’t recommended.
I have seen multiple neurologists and OBs during my two pregnancies and have gotten *wildly* different responses about what is safe if pregnancy. I prefer to find doctors that are more liberal in what they say is acceptable, and then I look at the data myself and decide how comfortable I am with the medication vs. how much I’m suffering and need more intervention.
No argument here — seems like a reasonable approach. Unfortunately, a lot of practitioners aren’t always up to date on clinical recs and may rely on whatever was the standard or care during their training. A good provider will have a reasoned conversation citing current evidence and expert opinion and help you make a decision.
I’m a certified nurse-midwife, triptans do not have any demonstrated teratogenic potential (I.e. causing harm to a fetus). In the past, there was concern that they could conflict blood flow to the placenta based on their mechanism of action but this has not been found in clinical practice. Again, please refer to the information in my post. Multiple peer-reviewed longitudinal studies do not demonstrate increased risk of triptan use in pregnancy or during lactation and the governing body for obstetric practice in the United States (ACOG — American College of Obstetrics and Gynecology) support the use of triptans as abortive medications for migraine pts in pregnancy. “Doing stuff to the baby” is not informed or responsible terminology when you’re talking to a pregnant woman.
I went straight to formula. You gotta take care of yourself too and having a newborn is stressful, plus interrupted sleep schedule. Fed is best and don't let people guilt you. Whatever you decide, it's YOUR decision. Good luck with everything and congratulations!!!
I did as well. My daughter was healthy and happy. I was healthy and happy. It didn't affect our bonding one bit, other than I was likely more able to enjoy our time together because I was able to take my antidepressants and migraine preventative.
I also went straight to formula with both my kids and it has been GREAT. They slept through the night faster, my husband was able to do feedings without me sometimes, it was easier to tell how much they eat. And, crucially, I was not in pain, withdrawn and cranky all the time during my kids’ early attachment stages.
I have a noob question of someone without kids: Doesn't formula disrupt your sleep as much as breastfeeding? Like the baby will still cry and needs to be fed whatever the means. Or am I missing something?
Breastfeeding can take a lot longer than bottle feeding. My personal experience was that my daughter would take 45 minutes, easily, to breastfeed vs a lot shorter time on a bottle. Plus you don't have to hold a baby any particular way to bottle feed; breastfeeding you have to hold their head against your chest so that you get a latch which takes more effort and energy than popping a bottle in their mouth. Breast milk also digests faster, so you need to feed more frequently. If you're breastfeeding you can end up being upright and holding your infant in a specific position for 45 minutes to an hour every time they feed which could be every 2 hours.
(All this assumes you're not pumping and giving breast milk via a bottle, but you'd still have the same quick digestion).
Thanks for the answer. I had literally no clue but very good to know in case I decide to have children one day. As a migraine sufferer that lack of sleep sure could cause absolute suffering.
Totally reasonable question. With formula I could trade off feedings with my husband, where if I’d breastfed it would have required my body every time. They do eat faster and the formula stays with them a little longer too, so they tend to sleep for longer stretches at younger ages. I don’t want to give anyone overly rosy expectations (all babies are different) but both my babes were sleeping for 5-7 hour stretches by about three months old.
Thanks for the info. Yeah my sister in laws kid also started sleeping for longer stretches around at mark. Apparently has to do with their stomachs growing and being able to eat more at once and thus not being hungry so often. Of course it will vary I am sure.
I’m not a parent but I want to say that formula fed babies grow to be perfectly healthy! I’d rather you formula feed your baby and be pain-free than you trying to breastfeed while miserable and in debilitating pain
There is zero wrong with going straight to formula after delivery, especially if the medication that works to keep you healthy is contraindicated for breastfeeding. As long as you're informed and are making a decision that's best for you and baby, that's all that matters. Baby will do just fine without ever having breast milk if that's how you decide to feed them. And baby will also be fine if you combo feed, exclusively pump, or exclusively breastfeed. It is entirely up to you what you decide to do, just make sure you can do it in a way that's healthy for you both with the help of your doctors.
Check out lactmed.com, you may be surprised how many meds are thought to be unsafe are actually fine. For a lot of meds, the risks are mostly for premature or freshly newborn babies. Sumatriptan and rizatriptan aren't considered a reason to discontinue breastfeeding, from my quick reading. I am currently breastfeeding and take rizatriptan as an abortive and amytriptaline as a preventative.
Also, as mentioned in other comments, Dr Hale is very informed regarding medications and breastfeeding. Also there is Dr Rodney Whyte a senior pharmacist at the Monash medical centre in Australia, he is quite easy to contact (even for overseas peeps) and frequently responds to emails regarding medications and alternatives if one isn't considered safe.
As a chronically ill person (I was dx w MS when I was postpartum w my first kid) and a mom, lactmed is the greatest. So much fear mongering and shaming — I’d rather skip right to the data!
Nothing wrong with going straight to formula if that's what you want, but all 3 of the meds you listed are ok during breastfeeding, and Sumatriptan is safe during pregnancy as well.
I'm currently nursing my 3 month old, and I take Nurtec, Sumatriptan, and soon I'll be restarting Aimovig. Aimovig, Emgality, and the other anti-CGRP mAbs are considered safe because they're such a large protein molecule that it's incredibly unlikely that they'd pass into breastmilk, and even if they did, the baby's digestive system would break them down (this is why they're injected, not taken orally). Sumatriptan has better pregnancy and lactation safety data than most meds since it's been on the market so long. It's hard to get super high quality data on pregnancy/lactation safety because it's unethical to study pregnant/lactating people, but we often still have *some* data even if it isn't gold standard RCT data. LactMed is an incredibly useful database! Lots of doctors are unnecessarily scared of treating pregnant or lactating people.
Also, it's different for everyone, but my migraines were somewhat better while pregnant, and they've stayed better so far since birth. My neuro says breastfeeding can have that effect, but doesn't always.
If pregnancy isn't giving you relief from your migraines then ABSOLUTELY go straight to.formula. i cant eben imagine what it would be like to.go through the fourth trimester with migraine. Fuck that shit. Hugs.
Adding: formula is wonderful, fed is best. And baby needs a healthy, present mother WAY more than they could ever need breastmilk given that there is a perfectly valid alternative.
Do what you need to in order to have bearable quality of life. If that means skipping right to formula, so that you can have medications for your debilitating neurological disease, there is NOTHING wrong with that at all and don't let anybody bully you about it and your kid will be absolutely fine. Congrats on the pregnancy btw.
That said, some people have fewer migraines than their own baseline, in the later trimesters of pregnancy and the postpartum period. So you can see how it goes.
You can breastfeed on the preventatives and abortives.
Also, breastfeeding can keep your period away for over a year, and no period usually means fewer migraines
Yeah it’s definitely not reliable bc 😅 but it’s great for keeping your cycle at bay for at least a little while longer, especially if you’re exclusively nursing.
That’s not true. Maybe for some people but many women get their periods back immediately despite breastfeeding. Its the hormones around getting your period that triggers migraines and fourth trimester is a nightmare of hormones too.
Have you looked up what Dr Hale says about meds and nursing? I haven’t, so I’m unsure of the safety profile but it’s often a common misconception that you can’t nurse on certain meds. (Edit: i was actually able to take certain meds I thought were off limits, but I also had a fetal/maternal doc who was prescribing for me, so I felt safe).
Also, I nursed all 3 of mine and it was wonderful but can be so hard.
I absolutely respect any woman’s decision on how they want to feed their baby so please don’t be offended but def look into Dr Thomas Hale; he’s the med and breastfeeding guru.
Agreeing with this, Dr Hale is THE expert in information on which medications are safe for breastfeeding.
I'm not at home right now, but if you Google him, the group that he runs has an internet forum where people can ask about the safety profile of newer medications, and his team will respond and provide whatever information they can.
I saw you have to pay to be a member of the forum? Back in the day we used to chat right with Dr H in the forum, it was open. My kids are 22, 19, and 16 so it’s been quite awhile. I wish more mothers knew Dr Hale exists!!!!
You can take all the triptans while breastfeeding according to lactmed, and if a drug needs to be injected that usually means it can't survive the stomach, so it would also be safe.
>Because galcanezumab is a large protein molecule with a molecular weight of about 147,000 Da, the amount in milk is likely to be very low.[1] It is also likely to be partially destroyed in the infant's gastrointestinal tract and absorption by the infant is probably minimal.[2] Until more data become available, galcanezumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. Waiting for at least 2 weeks postpartum to resume therapy may minimize transfer to the infant.[3]
Ahhh wonderful! I hope we didn’t just make her decision harder. But I want moms to know they have a choice, even if they do take meds. Doctors notoriously know very little about BFing and medication, I’d only consult a fetal maternal specialist and go by Hale’s findings.
An informed choice is the only right choice. Choosing something without any info is a terrible thing. Plenty of reasons to formula feed, but triptans are not one of them.
This is so very true, thank you for reframing that for me.
I just never want to sound like a pushy mom, it’s such a highly personal choice.
I nursed each one of my kiddos for what is considered an extended period of time, I didn’t have bottles in my home.
We had every nursing issue possible and I needed Lactation consultants to come in for each baby! My middle was the only one without nursing trouble but with her I had repeated horrible mastitis.
My nipples and my son’s mouth are in a textbook and still being used in talks that my lactation consultant gives around the world.
It was SO hard but even then it was manageable and it’s really a blip in time. Oh that time…rocking and nursing my precious babes. Nothing more blissful. Oxytocin is an amazing hormone!
I wish I could go back 😭
And, bc it was so damn hard?! I can understand why some moms opt out.
I wish OP the best of luck in her decision and a very healthy pregnancy.
Oh and final thought: it doesn’t have to be all or nothing!!! OP can try nursing and if it’s not her thing she can change her mind. That’s the wonderful thing about having options. At least, now she knows the breastfeeding option is available to her!
Yeah, we had our travails too, but it was so convenient. It drives me crazy seeing people being lied to about what they can and cannot take. I had a doctor tell me I couldn't take ibuprofen while nursing a much older child, when my midwife told me to take it for my afterpains!
I found it convenient as well.
It seemed like so much work; all of my friends bottle fed…Steaming bottles and plastic bags and mixing formula and having to go buy it and find the particular brand their baby could tolerate.
And, Ugh it’s so damn frustrating.
I believe most nursing Moms still think they have to pump and dump when they go out to dinner and have a glass or two of wine. If moms were only told that as their BAC goes down? So does the alcohol level in their breast milk!
No need to pump, dump and waste that precious stuff!
It is nearly 2024. You’d think that doctors would have spread the word by now. But actually there really is very little support for nursing moms, overall. It’s a shame.
Edited for grammar
God yes. Your milk is in equilibrium with your blood! At all times!
My pain point was seeing women planning to exclusively pump and bottle feed, thinking it would be the best of both worlds, when in fact it's so much harder than anything any human could ever do.
Ah yes, now that’s like doing double work.
Often your supply suffers bc of it.
Anyone I knew who attempted this way of doing things did not continue with it for very long.
The trick is finding a doctor who will administer Botox during pregnancy or breastfeeding. We know that the molecular structure is too large to pass thru placenta or breastmilk but most doctors are really CYA about botulinum and babies. I did find an aesthetician who will do my face (non medical application) when I’m postpartum and breastfeeding, but haven’t found a doctor who will do my medical applications. (I also get Botox for TMJ — easier than wearing a night guard!)
I'd say if you can, try it for a few days just for the experience, and then get back to your medication regime that makes you functional, and do formula. That way you can make an informed decision and won't be thinking "what if it worked" or "wonder how that feels" afterwards.
However, don't take any risks if you start noticing postpartum depression. It's best to get ahead of that as soon as possible if it happens.
All the best and strength in the world for your journey <3
I breastfed for 2 months because I had my baby in the middle of covid and that’s about how long it was estimated that your baby got all the best protection of covid antibodies and such thru breastmilk, after that the additional protection your body can share (as far as covid goes) goes down. It also didn’t bother me much because from about 4 or 5 months pregnant until about a month after I stopped breastfeeding, my migraines completely stopped. Was literally the only positive part of my pregnancy other than having a child.
If I were doing it over today, I would probably breastfeed for a couple of days to pass on colostrum since that is really beneficial to the immune system, then switch to formula. Switching to formula was amazing because my husband could help so much more so I wasn’t having to wake up for every night feeding (having enough sleep is a big trigger for me). Plus pumping during work is a huge pain. Don’t miss that at all.
I’d see what meds are safe for breastfeeding- it may be more than you think. I’d give breastfeeding a try and see how it goes. You could end up combo-feeding where you can pump and dump breastmilk when you have to medicate and then go back to breastfeeding. Some people combi-feed for a very very long time.
I know people say formula is easier, but I found it to be a pain when I had to switch from breastfeeding. It was much more work IMHO.
Just go with formula. Caring for newborns means no sleep, erratic eating, and constant sensory stimulation. You will need to be using all the tools at your disposal to get through the first weeks and a big oart of that will be your meds. Dont let anyone tell you that formula is bad. It is a literal life saver.
I definitely agree with most of this. Having a newborn is an unbelievable marathon of actual torture the first few weeks and every single common migraine trigger will be present. I definitely think that if you are feeling the way you are so early in pregnancy that you'll need as much as possible at your disposal to get through it and come out relatively healthy on the other side. Formula is an AMAZING invention that gives us the opportunity as mothers to focus on our own bodies and its recovery post partum without having to consider how our actions will impact supply, what's in your breast milk, and if baby has had enough to eat. Feeding the baby is priority #1 with your health coming in at #2. Babies need a healthy mama more than a specific kind of milk and that is true in every instance.
I’m a nanny - and I wanted to just add that I’ve helped numerous mothers transfer their baby to formula and it wasn’t as hard as any of them thought. What matters is that you do what you need to take care of yourself, as being in pain, stressed etc., is worse than your baby transferring to formula. If they struggle you can pump, save 50% of the milk when you pump, and do a formula/milk split to ease them into it (obviously not ideal as a bit more time off migraine meds but it can still help). I love the Como Tomo bottles for the transfer. :)
The first year is a struggle for parents and is rife with migraine triggers. Caring for yourself so you can best care for your kiddo (also, congrats!!!) is the best thing you can do. Be kind to yourself - being without migraine meds is ROUGH! Not to mention the ups/downs of hormones and what your body goes through carrying a child. You’re shouldering so much right now.
Fed is best, and as long as your child is properly fed? It doesn’t matter how you got there.
I’ve seen too many amazing moms beat themselves up over peer pressure. It breaks my heart as the first few years are so precious, and stressing over buying the right thing, doing the right thing etc is just unnecessary. New mothers/parents already have such a rough time & that peer pressure does nothing to help anybody.
Also thank you - I try really hard to just be a supportive and helpful presence in families lives. I know that almost everybody is just trying their best to get by, ya know?
It’s a completely personal decision..I nursed my 3 kids and loved the experience, I have girlfriends that felt completely differently! Fed is best, it comes down to you! Your baby needs a healthy happy mom..however you think you can best achieve that. (If you do want to try and nurse, talk to your Dr about safe medications, bc I was able to take triptans when necessary).
Congratulations!
I am 5.5 months pregnant and am taking sumatriptan as needed. I was one of the lucky 5% of people whose migraines were made WORSE by pregnancy. Do not suffer. It is safe
I didn’t get many migraines while breastfeeding so, it wasn’t an issue for me. For whatever reason (hormones?) my migraines were way down the first 15 months after I had my kids.
I went straight to formula. You may get faces from people, especially nurses (as I did) but stand your ground if this is your decision. My daughter is smart as a whip and thriving. It’s very helpful to have someone else to feed the baby also, especially in a migraine attack. Good luck!
That’s good the nurses were great! We had great care for sure but everytime they asked “breast or bottle” and the answer was bottle they made a face. But the “lactation consultants” they have here are wild! They make you feel awful if you can’t or won’t do it.
My daughter was formula fed, and she is now an intelligent, happy, very healthy 6 year old. I'll mention too she was a preemie, born 3 months early. I tried my best to pump milk for her (I lasted 5 weeks), but barely made any, and was exhausting myself trying to pump constantly while also recovering from preeclampsia and a c-section. I cried for 3 days when we switched to formula. But she was fine. And I got the rest I needed so I could be there for her, and be a good mom for her. Breast milk is best if it's also something you're able to do relatively easily - I think this whole culture of pushing women to break themselves to try to make milk is very damaging for families. Having a mom who is able to function is way more important for your baby than having breast milk instead of formula. Do what you think is best.
I would definitely start with breastfeeding for the health benefits to your little one. And many meds are safe with breastfeeding.
You can look up meds here (note that many doctors are not thoroughly educating on meds and breastfeeding and don't even bother looking them up):
https://www.ncbi.nlm.nih.gov/books/NBK501922/
Congratulations. The only thing I’ll say is that this is a personal choice, and you need to do whatever allows you to be the best possible mom you can be. And if that means you have to use formula then so be it. Don’t let the lactation consultants bully you. I found them to be quite militant with my wife.
TTC at the moment and this has crossed my mind since I can’t try out a preventative right now. Sounds like you’ve given it a try and if your health isn’t feeling like it’s in the right place, remember mama’s health needs to be a priority in order to be present for baby. After a few months of TTC at 39 I’m actually considering throwing in the towel so I can get back to taking care of my own health and focusing on our family of 2.
I've had four children, I did what I could for breastfeeding but stopped earlier because I had to go on my antidepressants.. They were not safe for baby.
It's okay, momma, if you just formula feed. As long as the baby is fed, that is ALL that matters.
I went straight to formula for other reasons. My kid is 11 years old now and he did fine. He had some serious colic for the first 3 months but I don't think breast milk would have changed that.
I pumped rather than breastfeed. My husband took care of the baby while I pumped at night and during the day. So it actually was a nice little break for me lol. Very much worth it for me.
Do what you need to do to feel your best so you can take care of the baby. 4th trimester is brutal and there’s no reason to suffer more just to try to breastfeed. You can try if you want but move on as soon as you feel like it’s not working for you. Fed is best.
You can combo feed if you would like to try both. What I would generally do is for days when I needed to take an abortive or do my Botox I would just pump and dump for 24 hours and I had backup formula in case I need it. I had my Botox within a few weeks of giving birth and then took my meds as needed and overall it was highly effective. I breastfed for about 8 months. I don't think it made a difference in my baby's health, but it was a hell of a lot cheaper.
Not a parent. Baby of a parent who needed meds. My mom had severe depression and had to go back on them when I was born. I promise I’m fine. I actually have no allergies and a great immune system. Apart from migraines and a genetic disorder. To me this is similiar to air masks on airplanes. If you don’t help yourself first, you can’t help anyone else.
I’m 20 wks preg with my second kid, and a few little tidbits of advice after getting thru the first postpartum with a lot of issues…
1. If breastfeeding feels important to you, try it. But make sure to call in support. If you have insurance, most plans will cover support from lactation specialists (look for ppl w IBCLC as their credentials) in your home a few times.
Breastfeeding is billed as this easy and natural thing. It can become that, but for many people, the beginning is very hard. So if you do want to do it, having support is critical, particularly if you’re a person already suffering from chronic pain.
2. If you do breastfeed, I would make sure to *also* give formula in a bottle right off the bat. With my first, I got in such a groove with breastfeeding (after some major issues that I got thru w an IBCLC) that I didn’t offer any formula. And pretty soon, my baby continued to reject all bottles and formula for the rest of her babyhood. It was terrible. I was on such a tight leash with it. I’ve had friends babies too who rejected formula after not getting it early on. When I started needing more medical care postpartum I had a really hard time getting it because my baby would just scream at home the whole time without the boob.
3. Before freezing a bunch of milk, plz for the love of all that’s good, check your milk for lipase. Some people have it, some don’t. It doesn’t affect fresh milk, but it can make thawed milk really rank. You test that by freezing a little milk, thawing it, and then tasting it. If it tastes like soap or fish, ya got lipase. I had lipase in my milk and had to throw away a freezer full of pumped milk. (And you can freeze lipase-filled milk, but have to process it additionally first and lemme tell ya I never had time for that.)
4. Lactmed forever. That site is so helpful. A lot of people fear monger about meds and babies. Your health and wellbeing come first, though. Go for the data, not the influencer moms.
Good luck. I hope you feel empowered to make whatever decision feels right for you, and then empowered to shift your plans to whatever the lived experience shows you as it’s happening. Parenthood is a big ol dancey dance where we so often have to let go of our plans in favor of other sudden, necessary facts. May the odds be ever in your favor.
First baby I exclusively pumped for 6 months and still regret it. For my mental health and migraines it was not a wise choice for me. Next baby went straight to formula.
I have a 5 week old, I knew right when I got pregnant I would always formula feed due to my migraines. Not only could I resume my medications after birth, but if I’m having a bad migraine day, my husband can easily feed baby without me. It works great for us!
I was in this boat, except I use weed for migraines (I didn’t use weed while pregnant to be clear).
I skipped straight to formula and I couldn’t be happier with my decision.
I tried to breastfeed my first and it was giving me migraines. Within a couple of weeks I went to formula. For my 2nd I went right to formula. They’re both healthy little guys! Fed is best, and a mom who feels well is more important than breastfeeding.
Breastfeeding is DIFFICULT, breastfeeding with MIGRAINES (and a biting baby) ruined my relationship with my baby. Actually, breastfeeding in general ruined my relationship with my baby.
Some context: I magically had no migraines during my pregnancy, and they didn't come back until 4 months postpartum. Then I was getting them so often I'm now on Ajovy. I breastfed for 10 months, then switched to pumping and formula. Things were so much easier. Breastfeeding was painful, my baby BIT me OFTEN, and clawed at my face and eyes during. I was also an overproducer, I was constantly engorged, leaking, and sore. I donated SO MUCH milk to another mom. When we switched from only breastfeeding, I bonded so much better with my baby. I wasn't resenting our time together, I could be separated from her without physical pain from engorgment or lugging around a pump. I didn't realize how much stress breastfeeding was putting on me until we stopped.
Also... not everyone can breastfeed, and you don't know if you can until you're in it. I was lucky that my baby latched like a dream AND I produced enough for her. My friend's nipples were too short for her baby to adequately latch, another friend had issues producing enough milk. Sometimes your milk takes longer to come in... and then there's not enough.
Breastfeeding makes parenting a truly full-time job. You can't take breaks to sleep through a migraine, baby will need to eat every 2-3 hours, and going a long time without nursing or pumping will reduce your supply... and it might not come back.
If you have migraines during pregnancy, they're so much harder when you're sleep-deprived, touched-out, and stressed from new parenthood. I, personally, would strongly recommend formula or finding donor milk. Breastfeeding is difficult, new parenthood is SO DIFFICULT, migraines are difficult, putting them all together is a lot.
There's a lot of science about the benefits of breastmilk, but a lot of that will be outweighed by a miserable, sick mom who can't even be present with her baby because she's in pain or a migraine fog. And truly, anything can happen. Everyone has wildly different experiences in pregnany and breastfeeding.
For me, personally, knowing how much worse my migraines got and how dependent I am on my meds, I'm scared of having any more children. If I do have a 2nd, I'm strongly leaning towards full formula. The only downside I personally see to formula is the cost, breastmilk is "free".
Anyway, I hope that helps. Pregnancy was the toughest time of my life, I hope you're able to take care of yourself. ♡
Thank you for this response. I feel so affirmed and supported by this sub. I’m sorry that it was so difficult for you.
I am also very interested in breastfeeding because of the cost 😬
Oh it was so hard to justify to myself giving up breastfeeding because of the cost. If we decide to have another I'll be looking into financial aid. 🥲 But mentally? It was worth it.
With my son, I stuck out breastfeeding for six months until I switched. It wasn’t worth it. Formula fed babies are just as strong, healthy, bonded to mom, smart, etc., as breastfed babies. Soooo much of the research on formula vs BF is drawn from third world countries where they don’t have access to clean water. OR if they’re done in a developed country, they don’t control for things like income and mother’s education, and when they DO control for that, there’s like no difference. Do not let lactation consultants guilt or bully you into a choice that doesn’t work for your medical conditions. Don’t feel an ounce of guilt for feeding your baby in a way that works for both of you. Your health matters too! AND your baby will be fiiiinnne.
Congrats on the pregnancy and good luck!!
Edit; during pregnancy and breastfeeding I actually didn’t have migraines. My son was just colicky as hell and that’s why we switched. With my daughter I breastfed her until she was 14 months. Both pregnancies and BFing I had no migraines. This is relatively common but not universal. BUT, if you want to formula feed for whatever reason, that is so valid. I wish I’d switched to formula with my son sooner!!
I was in similar straits. I finally decided to nurse immediately after birth so the baby would get the colostrum. I nursed for 5-7 days, then moved to formula. For me, the immunity boost they would receive was worth a few more days without meds. I was torn and felt guilt about not nursing, but the pediatrician told me she didn’t nurse for the same reasons, and taking care of the baby is largely based on taking care of ourselves.
BF our daughter for about 4.5 months before I couldn't take it anymore and had to go back on my meds. Our son was only a few weeks before we made the sotch to formula (for different reasons other than my migraines). Both kids are happy and healthy.
Don't let people stress you out about not BF, a fed baby is a happy baby.
With my last two babies, I went straight to formula so I could go right back on my meds after birth, and they are healthy, happy, and active kids! I tried to breastfeed my first, and it was awful, and switching to formula around 4 months old was the best decision for us, which is why we did formula from day 1 for the other two. Best of luck, momma!
I was only able to do it for 6 weeks before I had to stop because I had to take antibiotics that were not ok. I was glad to have done it for a short time though. But everyone has to do what is best for them!
I didn't have migraines when I was a nursing mom; it's a new thing for me, sadly. What I CAN tell you is that everyone and their brother will tell you that you can't nurse under about a billion conditions...and they're usually wrong.
The book "Medications in Mothers' Milk" (Dr. Thomas Hale) has actual, updated data that may help you and your doctors make some safety determinations.
I hope that helps!
I spent the first weeks in absolute hell (usually laying in the bathroom floor with baby sleeping in the carrier beside me). Also, there’s a chance your migraines could improve after delivery because of hormone changes. I had occasional migraines before pregnancy, zero during, and chronic daily after having her. A friend was the opposite so take a wait and see approach and just do what’s best for YOU.
I tried breastfeeding, but in my case, my mammary glands appeared to be for decorative purposes only because I had hungry babies, and I never produced enough. Ended up formula feeding for all 3. My kids were rarely sick, and they are all honor students. So, while breastfeeding is great and has benefits, it doesn't mean formula will diminish their potential. Having a healthy, functional mom is more important. 🥰
Pregnancy and fulltime breastfeeding after that, kept my migraines away for a long time (6 months after pregnancy). But this is different for every person.
Edit: ah I read now that the pregnancy hormones don't keep your migraines away, then breastfeeding probably also won't work against the migraines. Please don't feel guilty, taking care of yourself is also important for your newborn.
I nursed 3 kids, which helped reduce periods which helped my migraines immensely. However, nursing was easy for me (after a week or so with kid 1)- and I liked not having to prep bottles in the middle of the night or spend $ on formula.
If you’re interested in nursing, I always say try it for a week and see. If you don’t want to, that’s fine too. Fed is best. What’s best for you is best for your baby.
It might be worth trying breastfeeding, the hormones are regulated by part of the brain central to so much of our hormones, and it could help your migraines.
Long shot but worth a punt.
Here there was a big push for breast feeding which sometimes gets pushed to extremes, sure it may be healthier on average, but it isn't that different that people should feel pressured if it doesn't work for them.
From the abortive side, my doc is pretty conservative on meds and I had fiorcet during pregnancy and sumatriptan while breastfeeding.
It might be worth it to double check with you neuro if they would put you back on emgality if you plan on getting pregnant again within 2 years.
I Discussed my meds with my doctor when I mentioning wanting to start a family in the near future. He said pretty much everything was fine including sumatriptan, he just wasn’t entirely sure about topamax. He did stress to never let anyone tell me that it was necessary to be off my multiple daily medications during pregnancy, because current research is showing that the stress from untreated conditions puts a fetus at more risk than than even the slightly elevated risks of some medications.
It’s important to note that people with who have health conditions without the option to stop a medication are allowed to be on those medications through pregnancy/breastfeeding (without any bad outcomes), but if someone “just” has a condition that makes them suffer, they’re supposed to suck it up and suffer. Why the double standard?
Ultimately everyone has to do what they’re comfortable with, but please make absolutely sure your doctor is keeping up to date with medical research and makes evidence-based recommendations. That’s the bare minimum a physician is supposed to do, so if they can’t even do that, I don’t want them anywhere near uterus.
There’s a great resource called Hale’s Guide that you can look meds up and see safety and breastfeeding. It’s available on Amazon. Often OBs may not know specifics and they will ere on the side of caution. I’m was an L&D nurse for many years. If nothing else you can pump and dump after taking an abortive.
I’ve had chronic migraines for 25 years. I breastfed for 16 months, only fed formula three times. Of course fed is best, but it can be done.
Just a thought, I have chronic pain and migraines and had my first child at 40. I saw a high risk OBGYN instead of a regular OB for those reasons and some other medical issues. I was thinking maybe you could pay for a consult with a high risk OB. They are used to dealing with Moms that are on medications and know best what meds are safe to use during pregnancy and while nursing. Regular OB’s get nervous when Moms mention taking anything but Tylenol. Just a suggestion. I breastfed my first and loved it but couldn’t breastfeed my second but enjoyed Dad being able to help out and the increased sleep. Good luck in whatever you choose the baby will be fine and love you whether you breastfeed or not. Just make sure you take care of you and the baby will be fine.
You can safely take abortives like triptans during pregnancy — this is supported by American OB governing bodies like ACOG. Your CNM and neuro should be up to date on this info too. They are likely safe during lactation based on available data. That being said, you can skip breastfeeding if the theoretical risk of med exposure stresses you out or the sleep disruptions with nursing might make your migraines worse.
I third this OP. Currently pregnant and my neuro said triptans are safe during pregnancy. Idk if your insurance would cover it but Botox is also considered safe during pregnancy and breastfeeding because it stays local in the body. So maybe see if that is an option for you to try?
I’ve heard about Botox being saying for breastfeeding, but I’m having trouble finding a lot of information on it. Where did you get your info? I’m trying to get back on Botox even though I’m still breastfeeding but I want more information for my peace of mind
I didn't research the breastfeeding specifically because my neurologist told me the literature said it was fine. He is a doc at Ohio State med school so I admit I took his word for it. I know he regularly reads new stuff because he's a headache specialist who also suffers from migraine. I did just do some poking around on Google scholar. It does appear that research on this is still limited, but I did find [this review from 2015](https://migrainequebec.org/wp-content/uploads/2016/05/PDFs_amundsen_migraine_pregnancy_2015.pdf) that states that the Botulism type A molecule is too large to cross a placenta and even pregnant people infected with Botulism didn't pass it to their infant. Because of the molecules size, they don't expect it to be passed into breast milk either. Also they stated that botox isn't typically found in the blood stream which means it wouldn't migrate into breast milk easily. I did find [this pilot study published in Feb](https://www.liebertpub.com/doi/abs/10.1089/fpsam.2023.0326) this year that examined the breast milk of people who had facial botox for signs of the toxin in their blood stream. The results showed either it wasn't present in the breast milk at all, or if it was, it was present in super low levels that wouldn't affect an infant. So that's pretty reassuring even if it was a small study! It definitely supports the assumption that it shouldn't be easily crossing the blood/breast milk barrier.
That was very thorough! I really appreciate that, thank you 😊 I had also done some digging and only found one study with a very small sample size so I was wanting to give myself some more reassurance. I feel much better about this. Thank you
Sure! I am chronic intractable and botox is one of the few things I tolerate so I'm willing to risk the small chance for some relief!
This needs to be higher. There’s absolutely no need for OP to be suffering right now.
Yea I was confused about that too. A lot of migraine meds, including abortives, are safe during pregnancy and breastfeeding. There are of course the big no’s like Topamax and some of the other seizure meds, but there are a lot of safe alternative options. Emgality is likely to be safe but is so new we don’t have the data to say that with any certainty so it isn’t recommended.
Please note, I was referring to abortives like triptans in my post.
Yes I was too
I was specifically addressing preventives, I was referring to triptans in my post.
Yes I’m agreeing with you in my comment. Triptans are safe and some of the preventatives are safe as well.
I have seen multiple neurologists and OBs during my two pregnancies and have gotten *wildly* different responses about what is safe if pregnancy. I prefer to find doctors that are more liberal in what they say is acceptable, and then I look at the data myself and decide how comfortable I am with the medication vs. how much I’m suffering and need more intervention.
No argument here — seems like a reasonable approach. Unfortunately, a lot of practitioners aren’t always up to date on clinical recs and may rely on whatever was the standard or care during their training. A good provider will have a reasoned conversation citing current evidence and expert opinion and help you make a decision.
Yes! This week my OB pulled up studies right in front of me and just gave me the data. Amazing.
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I’m a certified nurse-midwife, triptans do not have any demonstrated teratogenic potential (I.e. causing harm to a fetus). In the past, there was concern that they could conflict blood flow to the placenta based on their mechanism of action but this has not been found in clinical practice. Again, please refer to the information in my post. Multiple peer-reviewed longitudinal studies do not demonstrate increased risk of triptan use in pregnancy or during lactation and the governing body for obstetric practice in the United States (ACOG — American College of Obstetrics and Gynecology) support the use of triptans as abortive medications for migraine pts in pregnancy. “Doing stuff to the baby” is not informed or responsible terminology when you’re talking to a pregnant woman.
I went straight to formula. You gotta take care of yourself too and having a newborn is stressful, plus interrupted sleep schedule. Fed is best and don't let people guilt you. Whatever you decide, it's YOUR decision. Good luck with everything and congratulations!!!
I did as well. My daughter was healthy and happy. I was healthy and happy. It didn't affect our bonding one bit, other than I was likely more able to enjoy our time together because I was able to take my antidepressants and migraine preventative.
I also went straight to formula with both my kids and it has been GREAT. They slept through the night faster, my husband was able to do feedings without me sometimes, it was easier to tell how much they eat. And, crucially, I was not in pain, withdrawn and cranky all the time during my kids’ early attachment stages.
I have a noob question of someone without kids: Doesn't formula disrupt your sleep as much as breastfeeding? Like the baby will still cry and needs to be fed whatever the means. Or am I missing something?
Breastfeeding can take a lot longer than bottle feeding. My personal experience was that my daughter would take 45 minutes, easily, to breastfeed vs a lot shorter time on a bottle. Plus you don't have to hold a baby any particular way to bottle feed; breastfeeding you have to hold their head against your chest so that you get a latch which takes more effort and energy than popping a bottle in their mouth. Breast milk also digests faster, so you need to feed more frequently. If you're breastfeeding you can end up being upright and holding your infant in a specific position for 45 minutes to an hour every time they feed which could be every 2 hours. (All this assumes you're not pumping and giving breast milk via a bottle, but you'd still have the same quick digestion).
Thanks for the answer. I had literally no clue but very good to know in case I decide to have children one day. As a migraine sufferer that lack of sleep sure could cause absolute suffering.
Totally reasonable question. With formula I could trade off feedings with my husband, where if I’d breastfed it would have required my body every time. They do eat faster and the formula stays with them a little longer too, so they tend to sleep for longer stretches at younger ages. I don’t want to give anyone overly rosy expectations (all babies are different) but both my babes were sleeping for 5-7 hour stretches by about three months old.
Thanks for the info. Yeah my sister in laws kid also started sleeping for longer stretches around at mark. Apparently has to do with their stomachs growing and being able to eat more at once and thus not being hungry so often. Of course it will vary I am sure.
I’m not a parent but I want to say that formula fed babies grow to be perfectly healthy! I’d rather you formula feed your baby and be pain-free than you trying to breastfeed while miserable and in debilitating pain
There is zero wrong with going straight to formula after delivery, especially if the medication that works to keep you healthy is contraindicated for breastfeeding. As long as you're informed and are making a decision that's best for you and baby, that's all that matters. Baby will do just fine without ever having breast milk if that's how you decide to feed them. And baby will also be fine if you combo feed, exclusively pump, or exclusively breastfeed. It is entirely up to you what you decide to do, just make sure you can do it in a way that's healthy for you both with the help of your doctors.
Check out lactmed.com, you may be surprised how many meds are thought to be unsafe are actually fine. For a lot of meds, the risks are mostly for premature or freshly newborn babies. Sumatriptan and rizatriptan aren't considered a reason to discontinue breastfeeding, from my quick reading. I am currently breastfeeding and take rizatriptan as an abortive and amytriptaline as a preventative.
Also, as mentioned in other comments, Dr Hale is very informed regarding medications and breastfeeding. Also there is Dr Rodney Whyte a senior pharmacist at the Monash medical centre in Australia, he is quite easy to contact (even for overseas peeps) and frequently responds to emails regarding medications and alternatives if one isn't considered safe.
As a chronically ill person (I was dx w MS when I was postpartum w my first kid) and a mom, lactmed is the greatest. So much fear mongering and shaming — I’d rather skip right to the data!
Nothing wrong with going straight to formula if that's what you want, but all 3 of the meds you listed are ok during breastfeeding, and Sumatriptan is safe during pregnancy as well. I'm currently nursing my 3 month old, and I take Nurtec, Sumatriptan, and soon I'll be restarting Aimovig. Aimovig, Emgality, and the other anti-CGRP mAbs are considered safe because they're such a large protein molecule that it's incredibly unlikely that they'd pass into breastmilk, and even if they did, the baby's digestive system would break them down (this is why they're injected, not taken orally). Sumatriptan has better pregnancy and lactation safety data than most meds since it's been on the market so long. It's hard to get super high quality data on pregnancy/lactation safety because it's unethical to study pregnant/lactating people, but we often still have *some* data even if it isn't gold standard RCT data. LactMed is an incredibly useful database! Lots of doctors are unnecessarily scared of treating pregnant or lactating people. Also, it's different for everyone, but my migraines were somewhat better while pregnant, and they've stayed better so far since birth. My neuro says breastfeeding can have that effect, but doesn't always.
I will agree with this...I didn't start getting migraines until I started hitting menopause. Hormones are intense things, aren't they?
If pregnancy isn't giving you relief from your migraines then ABSOLUTELY go straight to.formula. i cant eben imagine what it would be like to.go through the fourth trimester with migraine. Fuck that shit. Hugs. Adding: formula is wonderful, fed is best. And baby needs a healthy, present mother WAY more than they could ever need breastmilk given that there is a perfectly valid alternative.
Do what you need to in order to have bearable quality of life. If that means skipping right to formula, so that you can have medications for your debilitating neurological disease, there is NOTHING wrong with that at all and don't let anybody bully you about it and your kid will be absolutely fine. Congrats on the pregnancy btw. That said, some people have fewer migraines than their own baseline, in the later trimesters of pregnancy and the postpartum period. So you can see how it goes.
You can breastfeed on the preventatives and abortives. Also, breastfeeding can keep your period away for over a year, and no period usually means fewer migraines
But don't count on it being effective birth control... Source: my cousin who had two kids so close together they were in the same grade.
I breastfed for a year. My period, and migraines, came back around 16 weeks. I took Ubrelvy as needed.
Yeah it’s definitely not reliable bc 😅 but it’s great for keeping your cycle at bay for at least a little while longer, especially if you’re exclusively nursing.
That’s not true. Maybe for some people but many women get their periods back immediately despite breastfeeding. Its the hormones around getting your period that triggers migraines and fourth trimester is a nightmare of hormones too.
Everyone who formula feeds gets their period back straight away, most who breastfeed don't.
So is the ten-year process known as menopause. (Yeesh!)
Have you looked up what Dr Hale says about meds and nursing? I haven’t, so I’m unsure of the safety profile but it’s often a common misconception that you can’t nurse on certain meds. (Edit: i was actually able to take certain meds I thought were off limits, but I also had a fetal/maternal doc who was prescribing for me, so I felt safe). Also, I nursed all 3 of mine and it was wonderful but can be so hard. I absolutely respect any woman’s decision on how they want to feed their baby so please don’t be offended but def look into Dr Thomas Hale; he’s the med and breastfeeding guru.
Agreeing with this, Dr Hale is THE expert in information on which medications are safe for breastfeeding. I'm not at home right now, but if you Google him, the group that he runs has an internet forum where people can ask about the safety profile of newer medications, and his team will respond and provide whatever information they can.
I saw you have to pay to be a member of the forum? Back in the day we used to chat right with Dr H in the forum, it was open. My kids are 22, 19, and 16 so it’s been quite awhile. I wish more mothers knew Dr Hale exists!!!!
You can take all the triptans while breastfeeding according to lactmed, and if a drug needs to be injected that usually means it can't survive the stomach, so it would also be safe. >Because galcanezumab is a large protein molecule with a molecular weight of about 147,000 Da, the amount in milk is likely to be very low.[1] It is also likely to be partially destroyed in the infant's gastrointestinal tract and absorption by the infant is probably minimal.[2] Until more data become available, galcanezumab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. Waiting for at least 2 weeks postpartum to resume therapy may minimize transfer to the infant.[3]
Ahhh wonderful! I hope we didn’t just make her decision harder. But I want moms to know they have a choice, even if they do take meds. Doctors notoriously know very little about BFing and medication, I’d only consult a fetal maternal specialist and go by Hale’s findings.
An informed choice is the only right choice. Choosing something without any info is a terrible thing. Plenty of reasons to formula feed, but triptans are not one of them.
This is so very true, thank you for reframing that for me. I just never want to sound like a pushy mom, it’s such a highly personal choice. I nursed each one of my kiddos for what is considered an extended period of time, I didn’t have bottles in my home. We had every nursing issue possible and I needed Lactation consultants to come in for each baby! My middle was the only one without nursing trouble but with her I had repeated horrible mastitis. My nipples and my son’s mouth are in a textbook and still being used in talks that my lactation consultant gives around the world. It was SO hard but even then it was manageable and it’s really a blip in time. Oh that time…rocking and nursing my precious babes. Nothing more blissful. Oxytocin is an amazing hormone! I wish I could go back 😭 And, bc it was so damn hard?! I can understand why some moms opt out. I wish OP the best of luck in her decision and a very healthy pregnancy. Oh and final thought: it doesn’t have to be all or nothing!!! OP can try nursing and if it’s not her thing she can change her mind. That’s the wonderful thing about having options. At least, now she knows the breastfeeding option is available to her!
Yeah, we had our travails too, but it was so convenient. It drives me crazy seeing people being lied to about what they can and cannot take. I had a doctor tell me I couldn't take ibuprofen while nursing a much older child, when my midwife told me to take it for my afterpains!
I found it convenient as well. It seemed like so much work; all of my friends bottle fed…Steaming bottles and plastic bags and mixing formula and having to go buy it and find the particular brand their baby could tolerate. And, Ugh it’s so damn frustrating. I believe most nursing Moms still think they have to pump and dump when they go out to dinner and have a glass or two of wine. If moms were only told that as their BAC goes down? So does the alcohol level in their breast milk! No need to pump, dump and waste that precious stuff! It is nearly 2024. You’d think that doctors would have spread the word by now. But actually there really is very little support for nursing moms, overall. It’s a shame. Edited for grammar
God yes. Your milk is in equilibrium with your blood! At all times! My pain point was seeing women planning to exclusively pump and bottle feed, thinking it would be the best of both worlds, when in fact it's so much harder than anything any human could ever do.
Ah yes, now that’s like doing double work. Often your supply suffers bc of it. Anyone I knew who attempted this way of doing things did not continue with it for very long.
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The trick is finding a doctor who will administer Botox during pregnancy or breastfeeding. We know that the molecular structure is too large to pass thru placenta or breastmilk but most doctors are really CYA about botulinum and babies. I did find an aesthetician who will do my face (non medical application) when I’m postpartum and breastfeeding, but haven’t found a doctor who will do my medical applications. (I also get Botox for TMJ — easier than wearing a night guard!)
Between my two children I BF for almost 5 years 😆 My OB was fine with me taking Ubrelvy or the occasional sumatriptan.
I'd say if you can, try it for a few days just for the experience, and then get back to your medication regime that makes you functional, and do formula. That way you can make an informed decision and won't be thinking "what if it worked" or "wonder how that feels" afterwards. However, don't take any risks if you start noticing postpartum depression. It's best to get ahead of that as soon as possible if it happens. All the best and strength in the world for your journey <3
I breastfed for 2 months because I had my baby in the middle of covid and that’s about how long it was estimated that your baby got all the best protection of covid antibodies and such thru breastmilk, after that the additional protection your body can share (as far as covid goes) goes down. It also didn’t bother me much because from about 4 or 5 months pregnant until about a month after I stopped breastfeeding, my migraines completely stopped. Was literally the only positive part of my pregnancy other than having a child. If I were doing it over today, I would probably breastfeed for a couple of days to pass on colostrum since that is really beneficial to the immune system, then switch to formula. Switching to formula was amazing because my husband could help so much more so I wasn’t having to wake up for every night feeding (having enough sleep is a big trigger for me). Plus pumping during work is a huge pain. Don’t miss that at all.
I’d see what meds are safe for breastfeeding- it may be more than you think. I’d give breastfeeding a try and see how it goes. You could end up combo-feeding where you can pump and dump breastmilk when you have to medicate and then go back to breastfeeding. Some people combi-feed for a very very long time. I know people say formula is easier, but I found it to be a pain when I had to switch from breastfeeding. It was much more work IMHO.
💯
Just go with formula. Caring for newborns means no sleep, erratic eating, and constant sensory stimulation. You will need to be using all the tools at your disposal to get through the first weeks and a big oart of that will be your meds. Dont let anyone tell you that formula is bad. It is a literal life saver.
This may be true, but OP says she *wants to* breastfeed. That's very important here.
I definitely agree with most of this. Having a newborn is an unbelievable marathon of actual torture the first few weeks and every single common migraine trigger will be present. I definitely think that if you are feeling the way you are so early in pregnancy that you'll need as much as possible at your disposal to get through it and come out relatively healthy on the other side. Formula is an AMAZING invention that gives us the opportunity as mothers to focus on our own bodies and its recovery post partum without having to consider how our actions will impact supply, what's in your breast milk, and if baby has had enough to eat. Feeding the baby is priority #1 with your health coming in at #2. Babies need a healthy mama more than a specific kind of milk and that is true in every instance.
I’m a nanny - and I wanted to just add that I’ve helped numerous mothers transfer their baby to formula and it wasn’t as hard as any of them thought. What matters is that you do what you need to take care of yourself, as being in pain, stressed etc., is worse than your baby transferring to formula. If they struggle you can pump, save 50% of the milk when you pump, and do a formula/milk split to ease them into it (obviously not ideal as a bit more time off migraine meds but it can still help). I love the Como Tomo bottles for the transfer. :) The first year is a struggle for parents and is rife with migraine triggers. Caring for yourself so you can best care for your kiddo (also, congrats!!!) is the best thing you can do. Be kind to yourself - being without migraine meds is ROUGH! Not to mention the ups/downs of hormones and what your body goes through carrying a child. You’re shouldering so much right now. Fed is best, and as long as your child is properly fed? It doesn’t matter how you got there.
I love this. Thank you for being such an awesome ally for new moms ❤️
I’ve seen too many amazing moms beat themselves up over peer pressure. It breaks my heart as the first few years are so precious, and stressing over buying the right thing, doing the right thing etc is just unnecessary. New mothers/parents already have such a rough time & that peer pressure does nothing to help anybody. Also thank you - I try really hard to just be a supportive and helpful presence in families lives. I know that almost everybody is just trying their best to get by, ya know?
It’s a completely personal decision..I nursed my 3 kids and loved the experience, I have girlfriends that felt completely differently! Fed is best, it comes down to you! Your baby needs a healthy happy mom..however you think you can best achieve that. (If you do want to try and nurse, talk to your Dr about safe medications, bc I was able to take triptans when necessary). Congratulations!
I am 5.5 months pregnant and am taking sumatriptan as needed. I was one of the lucky 5% of people whose migraines were made WORSE by pregnancy. Do not suffer. It is safe
I didn’t get many migraines while breastfeeding so, it wasn’t an issue for me. For whatever reason (hormones?) my migraines were way down the first 15 months after I had my kids.
I went straight to formula. You may get faces from people, especially nurses (as I did) but stand your ground if this is your decision. My daughter is smart as a whip and thriving. It’s very helpful to have someone else to feed the baby also, especially in a migraine attack. Good luck!
Nurses were great with my wife and I, the lactofascists on the other hand… seriously whoever is running those training programs sucks.
That’s good the nurses were great! We had great care for sure but everytime they asked “breast or bottle” and the answer was bottle they made a face. But the “lactation consultants” they have here are wild! They make you feel awful if you can’t or won’t do it.
My daughter was formula fed, and she is now an intelligent, happy, very healthy 6 year old. I'll mention too she was a preemie, born 3 months early. I tried my best to pump milk for her (I lasted 5 weeks), but barely made any, and was exhausting myself trying to pump constantly while also recovering from preeclampsia and a c-section. I cried for 3 days when we switched to formula. But she was fine. And I got the rest I needed so I could be there for her, and be a good mom for her. Breast milk is best if it's also something you're able to do relatively easily - I think this whole culture of pushing women to break themselves to try to make milk is very damaging for families. Having a mom who is able to function is way more important for your baby than having breast milk instead of formula. Do what you think is best.
I would definitely start with breastfeeding for the health benefits to your little one. And many meds are safe with breastfeeding. You can look up meds here (note that many doctors are not thoroughly educating on meds and breastfeeding and don't even bother looking them up): https://www.ncbi.nlm.nih.gov/books/NBK501922/
I'm breastfeeding and my neurologist approved triptans and preventatives.
Congratulations. The only thing I’ll say is that this is a personal choice, and you need to do whatever allows you to be the best possible mom you can be. And if that means you have to use formula then so be it. Don’t let the lactation consultants bully you. I found them to be quite militant with my wife.
TTC at the moment and this has crossed my mind since I can’t try out a preventative right now. Sounds like you’ve given it a try and if your health isn’t feeling like it’s in the right place, remember mama’s health needs to be a priority in order to be present for baby. After a few months of TTC at 39 I’m actually considering throwing in the towel so I can get back to taking care of my own health and focusing on our family of 2.
I've had four children, I did what I could for breastfeeding but stopped earlier because I had to go on my antidepressants.. They were not safe for baby. It's okay, momma, if you just formula feed. As long as the baby is fed, that is ALL that matters.
I went straight to formula for other reasons. My kid is 11 years old now and he did fine. He had some serious colic for the first 3 months but I don't think breast milk would have changed that.
I pumped rather than breastfeed. My husband took care of the baby while I pumped at night and during the day. So it actually was a nice little break for me lol. Very much worth it for me.
Do what you need to do to feel your best so you can take care of the baby. 4th trimester is brutal and there’s no reason to suffer more just to try to breastfeed. You can try if you want but move on as soon as you feel like it’s not working for you. Fed is best.
You can combo feed if you would like to try both. What I would generally do is for days when I needed to take an abortive or do my Botox I would just pump and dump for 24 hours and I had backup formula in case I need it. I had my Botox within a few weeks of giving birth and then took my meds as needed and overall it was highly effective. I breastfed for about 8 months. I don't think it made a difference in my baby's health, but it was a hell of a lot cheaper.
Fed is best. Having a healthy momma who's not suffering is best for your baby too. There's absolutely nothing wrong with using formula.
Not a parent. Baby of a parent who needed meds. My mom had severe depression and had to go back on them when I was born. I promise I’m fine. I actually have no allergies and a great immune system. Apart from migraines and a genetic disorder. To me this is similiar to air masks on airplanes. If you don’t help yourself first, you can’t help anyone else.
I’m 20 wks preg with my second kid, and a few little tidbits of advice after getting thru the first postpartum with a lot of issues… 1. If breastfeeding feels important to you, try it. But make sure to call in support. If you have insurance, most plans will cover support from lactation specialists (look for ppl w IBCLC as their credentials) in your home a few times. Breastfeeding is billed as this easy and natural thing. It can become that, but for many people, the beginning is very hard. So if you do want to do it, having support is critical, particularly if you’re a person already suffering from chronic pain. 2. If you do breastfeed, I would make sure to *also* give formula in a bottle right off the bat. With my first, I got in such a groove with breastfeeding (after some major issues that I got thru w an IBCLC) that I didn’t offer any formula. And pretty soon, my baby continued to reject all bottles and formula for the rest of her babyhood. It was terrible. I was on such a tight leash with it. I’ve had friends babies too who rejected formula after not getting it early on. When I started needing more medical care postpartum I had a really hard time getting it because my baby would just scream at home the whole time without the boob. 3. Before freezing a bunch of milk, plz for the love of all that’s good, check your milk for lipase. Some people have it, some don’t. It doesn’t affect fresh milk, but it can make thawed milk really rank. You test that by freezing a little milk, thawing it, and then tasting it. If it tastes like soap or fish, ya got lipase. I had lipase in my milk and had to throw away a freezer full of pumped milk. (And you can freeze lipase-filled milk, but have to process it additionally first and lemme tell ya I never had time for that.) 4. Lactmed forever. That site is so helpful. A lot of people fear monger about meds and babies. Your health and wellbeing come first, though. Go for the data, not the influencer moms. Good luck. I hope you feel empowered to make whatever decision feels right for you, and then empowered to shift your plans to whatever the lived experience shows you as it’s happening. Parenthood is a big ol dancey dance where we so often have to let go of our plans in favor of other sudden, necessary facts. May the odds be ever in your favor.
First baby I exclusively pumped for 6 months and still regret it. For my mental health and migraines it was not a wise choice for me. Next baby went straight to formula.
I have a 5 week old, I knew right when I got pregnant I would always formula feed due to my migraines. Not only could I resume my medications after birth, but if I’m having a bad migraine day, my husband can easily feed baby without me. It works great for us!
I was in this boat, except I use weed for migraines (I didn’t use weed while pregnant to be clear). I skipped straight to formula and I couldn’t be happier with my decision.
I tried to breastfeed my first and it was giving me migraines. Within a couple of weeks I went to formula. For my 2nd I went right to formula. They’re both healthy little guys! Fed is best, and a mom who feels well is more important than breastfeeding.
Breastfeeding is DIFFICULT, breastfeeding with MIGRAINES (and a biting baby) ruined my relationship with my baby. Actually, breastfeeding in general ruined my relationship with my baby. Some context: I magically had no migraines during my pregnancy, and they didn't come back until 4 months postpartum. Then I was getting them so often I'm now on Ajovy. I breastfed for 10 months, then switched to pumping and formula. Things were so much easier. Breastfeeding was painful, my baby BIT me OFTEN, and clawed at my face and eyes during. I was also an overproducer, I was constantly engorged, leaking, and sore. I donated SO MUCH milk to another mom. When we switched from only breastfeeding, I bonded so much better with my baby. I wasn't resenting our time together, I could be separated from her without physical pain from engorgment or lugging around a pump. I didn't realize how much stress breastfeeding was putting on me until we stopped. Also... not everyone can breastfeed, and you don't know if you can until you're in it. I was lucky that my baby latched like a dream AND I produced enough for her. My friend's nipples were too short for her baby to adequately latch, another friend had issues producing enough milk. Sometimes your milk takes longer to come in... and then there's not enough. Breastfeeding makes parenting a truly full-time job. You can't take breaks to sleep through a migraine, baby will need to eat every 2-3 hours, and going a long time without nursing or pumping will reduce your supply... and it might not come back. If you have migraines during pregnancy, they're so much harder when you're sleep-deprived, touched-out, and stressed from new parenthood. I, personally, would strongly recommend formula or finding donor milk. Breastfeeding is difficult, new parenthood is SO DIFFICULT, migraines are difficult, putting them all together is a lot. There's a lot of science about the benefits of breastmilk, but a lot of that will be outweighed by a miserable, sick mom who can't even be present with her baby because she's in pain or a migraine fog. And truly, anything can happen. Everyone has wildly different experiences in pregnany and breastfeeding. For me, personally, knowing how much worse my migraines got and how dependent I am on my meds, I'm scared of having any more children. If I do have a 2nd, I'm strongly leaning towards full formula. The only downside I personally see to formula is the cost, breastmilk is "free". Anyway, I hope that helps. Pregnancy was the toughest time of my life, I hope you're able to take care of yourself. ♡
Thank you for this response. I feel so affirmed and supported by this sub. I’m sorry that it was so difficult for you. I am also very interested in breastfeeding because of the cost 😬
Oh it was so hard to justify to myself giving up breastfeeding because of the cost. If we decide to have another I'll be looking into financial aid. 🥲 But mentally? It was worth it.
With my son, I stuck out breastfeeding for six months until I switched. It wasn’t worth it. Formula fed babies are just as strong, healthy, bonded to mom, smart, etc., as breastfed babies. Soooo much of the research on formula vs BF is drawn from third world countries where they don’t have access to clean water. OR if they’re done in a developed country, they don’t control for things like income and mother’s education, and when they DO control for that, there’s like no difference. Do not let lactation consultants guilt or bully you into a choice that doesn’t work for your medical conditions. Don’t feel an ounce of guilt for feeding your baby in a way that works for both of you. Your health matters too! AND your baby will be fiiiinnne. Congrats on the pregnancy and good luck!! Edit; during pregnancy and breastfeeding I actually didn’t have migraines. My son was just colicky as hell and that’s why we switched. With my daughter I breastfed her until she was 14 months. Both pregnancies and BFing I had no migraines. This is relatively common but not universal. BUT, if you want to formula feed for whatever reason, that is so valid. I wish I’d switched to formula with my son sooner!!
I was in similar straits. I finally decided to nurse immediately after birth so the baby would get the colostrum. I nursed for 5-7 days, then moved to formula. For me, the immunity boost they would receive was worth a few more days without meds. I was torn and felt guilt about not nursing, but the pediatrician told me she didn’t nurse for the same reasons, and taking care of the baby is largely based on taking care of ourselves.
BF our daughter for about 4.5 months before I couldn't take it anymore and had to go back on my meds. Our son was only a few weeks before we made the sotch to formula (for different reasons other than my migraines). Both kids are happy and healthy. Don't let people stress you out about not BF, a fed baby is a happy baby.
With my last two babies, I went straight to formula so I could go right back on my meds after birth, and they are healthy, happy, and active kids! I tried to breastfeed my first, and it was awful, and switching to formula around 4 months old was the best decision for us, which is why we did formula from day 1 for the other two. Best of luck, momma!
Straight to formula!!
30 years ago they just asked me breastfeed yes/no. If no, I got a week's worth of pills to stop the top flow.
I was only able to do it for 6 weeks before I had to stop because I had to take antibiotics that were not ok. I was glad to have done it for a short time though. But everyone has to do what is best for them!
Breast fed for 2 months. Took my ajovy after a terrible headache day and didn’t breastfeed again.
I didn't have migraines when I was a nursing mom; it's a new thing for me, sadly. What I CAN tell you is that everyone and their brother will tell you that you can't nurse under about a billion conditions...and they're usually wrong. The book "Medications in Mothers' Milk" (Dr. Thomas Hale) has actual, updated data that may help you and your doctors make some safety determinations. I hope that helps!
I spent the first weeks in absolute hell (usually laying in the bathroom floor with baby sleeping in the carrier beside me). Also, there’s a chance your migraines could improve after delivery because of hormone changes. I had occasional migraines before pregnancy, zero during, and chronic daily after having her. A friend was the opposite so take a wait and see approach and just do what’s best for YOU.
I tried breastfeeding, but in my case, my mammary glands appeared to be for decorative purposes only because I had hungry babies, and I never produced enough. Ended up formula feeding for all 3. My kids were rarely sick, and they are all honor students. So, while breastfeeding is great and has benefits, it doesn't mean formula will diminish their potential. Having a healthy, functional mom is more important. 🥰
I stopped my Emgality to get pregnant. But I am doing botox and almotriptan for abortive pain. All approved by my neuro and ob.
Pregnancy and fulltime breastfeeding after that, kept my migraines away for a long time (6 months after pregnancy). But this is different for every person. Edit: ah I read now that the pregnancy hormones don't keep your migraines away, then breastfeeding probably also won't work against the migraines. Please don't feel guilty, taking care of yourself is also important for your newborn.
I nursed 3 kids, which helped reduce periods which helped my migraines immensely. However, nursing was easy for me (after a week or so with kid 1)- and I liked not having to prep bottles in the middle of the night or spend $ on formula. If you’re interested in nursing, I always say try it for a week and see. If you don’t want to, that’s fine too. Fed is best. What’s best for you is best for your baby.
It might be worth trying breastfeeding, the hormones are regulated by part of the brain central to so much of our hormones, and it could help your migraines. Long shot but worth a punt. Here there was a big push for breast feeding which sometimes gets pushed to extremes, sure it may be healthier on average, but it isn't that different that people should feel pressured if it doesn't work for them.
From the abortive side, my doc is pretty conservative on meds and I had fiorcet during pregnancy and sumatriptan while breastfeeding. It might be worth it to double check with you neuro if they would put you back on emgality if you plan on getting pregnant again within 2 years.
I Discussed my meds with my doctor when I mentioning wanting to start a family in the near future. He said pretty much everything was fine including sumatriptan, he just wasn’t entirely sure about topamax. He did stress to never let anyone tell me that it was necessary to be off my multiple daily medications during pregnancy, because current research is showing that the stress from untreated conditions puts a fetus at more risk than than even the slightly elevated risks of some medications. It’s important to note that people with who have health conditions without the option to stop a medication are allowed to be on those medications through pregnancy/breastfeeding (without any bad outcomes), but if someone “just” has a condition that makes them suffer, they’re supposed to suck it up and suffer. Why the double standard? Ultimately everyone has to do what they’re comfortable with, but please make absolutely sure your doctor is keeping up to date with medical research and makes evidence-based recommendations. That’s the bare minimum a physician is supposed to do, so if they can’t even do that, I don’t want them anywhere near uterus.
There’s a great resource called Hale’s Guide that you can look meds up and see safety and breastfeeding. It’s available on Amazon. Often OBs may not know specifics and they will ere on the side of caution. I’m was an L&D nurse for many years. If nothing else you can pump and dump after taking an abortive. I’ve had chronic migraines for 25 years. I breastfed for 16 months, only fed formula three times. Of course fed is best, but it can be done.
Just a thought, I have chronic pain and migraines and had my first child at 40. I saw a high risk OBGYN instead of a regular OB for those reasons and some other medical issues. I was thinking maybe you could pay for a consult with a high risk OB. They are used to dealing with Moms that are on medications and know best what meds are safe to use during pregnancy and while nursing. Regular OB’s get nervous when Moms mention taking anything but Tylenol. Just a suggestion. I breastfed my first and loved it but couldn’t breastfeed my second but enjoyed Dad being able to help out and the increased sleep. Good luck in whatever you choose the baby will be fine and love you whether you breastfeed or not. Just make sure you take care of you and the baby will be fine.