For background you should read the following blog posts:
- Mothering Magazine Publishes Letter Reaming Them for Being So “Anti-drug”
- Open Letter to the Editor of Mothering Magazine – Re: “Beat The Baby Blues” by John Breeding and Amy Philo
Recently John Breeding and I published an open letter to the editor of Mothering Magazine. After reading an unsettling letter to the editor which promoted Katherine Stone’s Postpartum Progress in the next edition of Mothering, I sent out an alert to everyone that they should express their disapproval with the magazine for promoting antidepressants and Zyprexa.
Even though the editor, Peggy O’Mara, had not responded to our letter when John Breeding emailed it to her (for weeks), she did choose to respond to one of the other letters to the editor (within three hours) as follows:
We have not recommended Zyprexa in any of our articles.
My first reaction was, “OMG she is so full of it, yes they did.”
So I set out to find the old article. Unfortunately, I no longer have the hard copy because I gave it away at my speech in April in Austin. I searched for everything online and then I realized that I had probably made a technical mistake. I eventually figured out how it happened – that I had mistakenly come to think of their May 2007 article as one where they recommended Zyprexa. What I found online was a categorical statement that moms can take antipsychotics while breastfeeding and that antipsychotics are required for psychosis. I then remembered that at one point, in disbelief at Mothering’s promotion of antipsychotics for breastfeeding, I went to Thomas Hale’s website and searched for antipsychotics, and found that he was recommending Zyprexa for breastfeeding. Then, over time the two pieces of advice began to merge in my mind as I talked and wrote about them. What can I say, I’ve had a pretty busy 3 1/2 years and rewired lots of brain cells to devote large portions of my mind to the task of cramming for law school finals every semester. My bad.
So this is my fault. Peggy O’Mara was technically correct, they did not specifically recommend Zyprexa. Instead, all that Mothering Magazine has done is recommend antipsychotic drugs, the category – and stated that women should consult Thomas Hale’s book Medications in Mothers’ Milk to see which ones are compatible. Therefore if one wants to pretend that Mothering doesn’t endorse Zyprexa, they can just pretend that Mothering does not endorse Dr. Hale. (That is unless a miracle has occurred and Hale no longer recommends Zyprexa.)
Here are some of the quotes from their magazine. With sentiments similar to those in the featured article titled “Losing It,” which I mistakenly called “Overcoming Postpartum Psychosis” (I’m told that the cover actually had the headline “Victory Over Postpartum Psychosis”), this is an excerpt from the companion 2007 article titled “Alternative Treatments for Postpartum Mood Disorders” by Sarah Fields of Postpartum Support International:
Self-Care: According to Kathleen Kendall-Tackett, PhD, IBCLC, postpartum depression can be eased by use of an “adjunct treatment to help the body heal itself, but not necessarily as primary treatment. With psychosis, medications are necessary to stabilize symptoms.
Kendall-Tackett encourages mothers who want to continue breastfeeding to do so, even through a psychotic episode. To facilitate breastfeeding, she advises: “Mothers need a supportive environment, where mom and the baby can stay together but the baby is safe. Mothers and their care providers also need to know about which medications are compatible with breastfeeding.” The best resource for that is Dr. Thomas W. Hale’s book, Medications and Mothers’ Milk.
What is weird is that the Losing It article is on their website, but I was unable to find the Alternatives article on their website and I was only able to find it reprinted elsewhere.
But it’s not like the Losing It article is necessarily any better than the Alternatives article, with quotes like:
“I told the doctor that I wanted to nurse, and asked him to go to La Leche League’s website for help in allowing me to do so. I quoted a friend, La Leche League Leader Pam Ahearn, who said that “healing begins at the breast.” I suggested the doctor read Dr. Thomas W. Hale’s book, Medications and Mothers’ Milk, as he considered psychiatric drugs for me. When he came back the next day with the book, I began to accept him.”
“The psychiatrist prescribed one dose per day of antipsychotic medication instead of two, to be taken just before bed so that the levels would peak in my bloodstream—and in my milk—as John and I slept.”
If you click on the link from the blog that reposted the Alternatives article, it takes you to: http://www.mothering.com/articles/pregnancy_birth/birth_stories/alternative-treatments-postpartum-mood-disorders.html. What comes up is a page on the mothering.com website that says:
“The page you requested does not exist. For your convenience, a search was performed using the query articles OR pregnancy OR birth OR birth OR stories OR alternative OR treatments OR postpartum OR mood OR disorders.”
The first result of the automated search is a “shopping list for Peggy’s kitchen.”
I don’t know about you but if I wanted to recommend that moms breastfeed on psychiatric drugs, I would prefer to be associated with recommending just one antipsychotic drug over being associated with recommending antipsychotic drugs as a category. But it’s better to be accurate and let everyone know that Mothering seems to be fine with whatever Dr. Hale or Kathleen Kendall-Tackett say.
I’m guessing that the two are just fine with Zyprexa. For instance, Hale and Kendall-Tackett published an article together on treatments that are suitable for breastfeeding moms with PTSD (“Medication Use for Trauma Symptoms and PTSD in Pregnant and Breastfeeding Women”). Here is a quote from this article, which states that Zyprexa is in the “L2” category (“L2: Safer Drug that has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant. And/or the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding woman is remote.”):
Atypical anti-psychotics may also be added to the treatment regimen as an adjunct therapy for partial responders. These medications may help lessen anxiety responses. The medications within this class include risperidone (Risperdal), quetiapine (Seroquel), and olanzapine (Zyprexa). Olanzapine and quetiapine are rated L2. Risperidone has a risk category of L3. All have a C rating for use during pregnancy.
Mothering (Kathleen Kendall-Tackett) also wrote, in September 2010, that moms should use Wellbutrin, Zoloft and Paxil, and “other antidepressants.”
If you can’t read it, that says:
the best drugs for breastfeeding moms
Medications with the least amount of transfer to infants via breastmilk
Bupropion (Welbutrin, Zyban)
Other antidepressants are also compatible with breastfeeding. For a complete list, see Thomas W. Hale’s Medications in Mothers’ Milk (Hale Publishing, 2010), available at www.ibreastfeeding.com.
I responded to Peggy with the quotes from her 2007 articles recommending antipsychotics, but haven’t heard back yet. I guess that I shouldn’t get my hopes up that Peggy will further respond to explain why they endorsed antipsychotics and antidepressants in their magazine.
Anyway, I went to CCHR’s psychdrugdangers database to look at the latest FDA MedWatch reports.
Wellbutrin, as just one example, has terrible adverse events reported for babies exposed via breast milk including things as severe as sedation, anorexia, grand mal convulsion and more.
I could continue combing through all the latest reports but let’s just revisit an old article I wrote for a moment.
Here is a short summary of what I found recently from the FDA MedWatch reports on SSRIs, SNRIs and Zyprexa from 2004-2008. Reports of drug exposure via breast milk which did not have other side effects listed were excluded. If a drug is not listed here it’s because I only made it through the SSRIs and SNRIs and Zyprexa and got tired. Also I wanted to focus on antidepressants since those are more commonly given to moms for PPD. There are many many more psychotropic drugs being given to nursing moms, and Zyprexa is being pushed as “safe” based on a study of 7 babies.
BREAST MILK ONLY EXPOSURE
First here is the information on Zoloft which is the recommended drug for breastfeeding (Prozac is the recommended drug for pregnancy).
Zoloft breast milk exposure (3 reports):
Convulsions / Epilepsy; Developmental Delay; Hypotonia
Other drugs collectively – breast milk only exposure:
SOMNOLENCE: 4 reports from breast milk alone – Prozac, Cymbalta, Lexapro and Wellbutrin
SIDS from breast milk alone – Effexor (2 reports)
Fatigue – 1 report – Paxil
Hyperreflexia – 1 Paxil
Insomnia – 1 Celexa, 1 Paxil
Gastrointestinal Disorder – 2 Paxil, 1 Celexa
Gastroesophageal Reflux Disease – 1 Celexa
Feeding Problem – 1 Lexapro
Weight Decreased – 1 Celexa
Sleep Disorder – 1 Prozac, 1 Wellbutrin
Irritability – 1 Prozac
Kidney Enlargement – 1 Paxil
Rash – 1 Paxil
Fractures – 1 Effexor
Bloody Stools / Rectal hemmorage – 1 Prozac
Pregnancy Only Exposure – Neonatal Deaths / SIDS
SIDS: 5 cases – 1 each for Celexa, Effexor, Lexapro, Wellbutrin, and Zyprexa
Neonatal Deaths: 11 cases – 3 for Celexa, 2 for Effexor, 1 Wellbutrin, 5 Zyprexa
COMBINED Breast Milk and Pregnancy Exposure
SIDS – 1 Lexapro, 1 Paxil
Autism / Sensory Integrative Dysfunction – 1 Zoloft
METHOD OF EXPOSURE NOT LISTED
SIDS – 1 Effexor (also a coma / loss of consciousness report).
I think you get the point. Here is just one more that I recently found. In September 2007 a baby exposed to an antipsychotic drug, Seroquel (Quetapine), only via breast milk died from Sudden Infant Death Syndrome. (To look through the reports for yourself, you can go to this website for the searchable database.)
Here is the data for that baby.
Age: 2 Weeks, Female, Date of Death 9/23/07, case number 6464105, Drug: Quetapine, Effects: Drug Exposure via Breast Milk, Sudden Infant Death Syndrome.