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Late term/post partum preeclampsia ?

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Expand view Topic review: Late term/post partum preeclampsia ?

Re : Late term/post partum preeclampsia ?

Post by patty » Wed Aug 19, 2009 12:12 am

Could the six hour nap just be a coincidence since it only happened this once? Pediatricians are not experts on breast feeding and IMHO giving formula was bad advice since there are SEVERAL bp drugs that are safe and compatible with breastfeeding not just one or two. Labetalol is generally considered safe but if your lo is having a bad reaction( I personally had a bad reaction to labetalol too but the opposite it wired me up and made me feel like I had bugs crawling in my hair so they decided I was allergic to it) there are lots of others you can try and I know it is frustrating since so many of them have side effects but you will find one that works well. The reference to Thomas Hale was a great one and he is the foremost expert on medicines in mothers milk I would follow those links and check out his forum about bp med you can't post but there are lots of threads with good info you can read. I have nursed all of my 5 children for at least 2 years and had to take bp meds with most all of them while breastfeeding. Currently I am still nursing my 15 month old and taking propranolol(inderal) for bp. It is a catagory L2( which is great for breastfeeding as most drugs are L3's) for nursing so really good choice and from what I read very little passes into breastmilk. Metoprolol is another one I have taken postpartum while breastfeeding. Check out this link that list the different drugs and gives their ratings from Kellymom http://kellymom.com/health/meds/aap-approved-meds.html#Heart I second the advice to contact a lactation consultant and call your ob and get them to find a drug that will work for you. Good Luck!

Re : Late term/post partum preeclampsia ?

Post by catherine » Tue Aug 18, 2009 10:25 am

Hi Lindsay and welcome to the forums. Many congratulatiions at the safe arrival of your son!

Lots of us have been in your shoes, committed to nursing and yet obligated to take the medications to protect our own health. Obviously, you need more help and support with regards to the best medication for you. I nursed my daughter after my experience of preeclampsia and HELLP with some Procardia on board. The only thing that bothered me was the horrible metallic aftertaste.... but I guess it kept me drinking my water!! There are a range of medications for treated elevated BP after preeclampsia, and I fear that you may have to push to find one that is effective and tolerable for both of you.

Two things:

you can afford to be patient. If you son is responding so significantly to the labetalol in your breastmilk, then obviously you have to pass on nursing for a couple of days to flush it from your system... but that shouldn't be the deathknell to your breast feeding plans if you take the long view. Seek advice from a lactation consultant, there may be one associated ith your hospital, about what to do to manage interruptions. Don't despair, there are moms of preemies and neonates with medical issues who have had to deal with similar "pauses", and who have managed to develop longstanding nursing relationships. Lucy and I didn't meet until she was nearly a week old, and she didn't even get a chance to nurse until she was 10 days. She turned out to be my most accomplished (never raised even a blister, never bit) and longest (16 months and only because I reclaimed my boobs and personhood for a few months before delivering the next one) nurser.

You need to remember that you are still immediate post-partum at two weeks out. The risk of post-partum preeclampsia doesn't wane completely until at least 6 weeks, so you remain somewhat in the danger zone and your meds may be very necessary. If I were in your shoes I'd want to try everything before I opted to go off the meds. Prolonged elevated BPs aren't good for anyone. A balancing act is perhaps required. I'm thinking that your worst case senario is having to go back on the Procardia... baby will be happy, but could you handle the side effects?

Re : Late term/post partum preeclampsia ?

Post by blubugggin » Tue Aug 18, 2009 07:08 am

Wow what a great forum and topic... Since the delivery of my first beautiful son on August 2nd, 15 days ago I have been living and breathing this! And the one word to describe the entire experience is FRUSTRATED!!!!!!!

I had a non eventful pregnancy. I worked up until Friday and had the baby on Sunday. I had remarkable swelling at the end of the pregnancy with normal bps and no proteinuria. During delivery my bp was 200s/100s which I attributed to the pain. Returned to normal the next day. I stayed the extra day in the hospital to get the hang of breastfeeding, only to find my bps were elevated. I went home thinking that it was attributed to exhaustion and pain.

Sooooo my OB has been attempting to manage my bp outpatient. Procardia made me sick; dizzy, lightheaded, hot and cold flashes, etc. So just changed my bp meds to labetalol. I am breastfeeding and after one dose I noticed a remarkable change in the baby. Sleeping 6 hours at a time, barely eating, etc. All this time I have asked my m.d. is this safe? All the literature I have read says that it is not!!!! Called the pediatrician and was told to start baby on formula and continue to pump and save milk to keep my milk in.

I am so frustrated!!! I am committed to breastfeeding. I feel like stopping my bp meds. All this time I have been compliant with the regimen prescribed and going into the m.d.s office every 3 days to have my bp checked. Being prescribed medications when I have verbalized my concern that I am breastfeeding and its effect on the baby.

What do you all think. I could relate to your wifes story and can only imagine how you feel. My husband is very concerned as well. I had no complications for 10 months and thought that this would be the time for recooperation!

Re : Late term/post partum preeclampsia ?

Post by khailibowen » Sat Sep 16, 2006 02:19 am

Okay, read some posts and somebody already posted about Hale's book. That really is THE book to look at when deciding whether to take a drug or not while breastfeeding.

Re : Late term/post partum preeclampsia ?

Post by khailibowen » Sat Sep 16, 2006 02:15 am

I took that bp med for 12 weeks after delivery and pumped/breastfed the whole time. If she is very concerned she should ask her doctor specifically for a drug that is compatible. A lot of meds say they aren't because they are being cautious as new information is always being learned. She can even ask the pharmacist what s/he thinks about it. They will usually have the most up-to-date information. She can also call the local lactation consultant and she should have a copy of Hale's book about meds and breastfeeding (that might even be my first call). On that, I will post to my local AP group because I know a few people who have that book and see what they say then post back.

Re : Late term/post partum preeclampsia ?

Post by heather j » Sat Sep 16, 2006 10:17 am

I was mad with my husband after all of the hospital stuff (bp meds, too); I guess it helps to have someone to be mad at even if it's unfair and misdirected - you poor husbands! I believe I told my dh the same thing; in fact, after I was readmitted I blamed him and told him I didn't want him to visit me. I know...shameful and cold. But I was a different person during those days postpartum and he forgave me ;). My situation was like Caryn's; I transfered care to an internist and was weaned off meds by four months postpartum. All of my labs normalized, but I still had the high pressures. I'm glad you've convinced her, however reluctantly, to take her meds!

Re : Late term/post partum preeclampsia ?

Post by caryn » Sat Sep 16, 2006 12:13 am

Yes -- it is still possible to have elevated bp because of damage from the pregnancy, even with no proteinuria and good bloodwork. Postpartum my proteinuria resolved much more quickly than did my bp -- about four months faster. It is also possible that this pregnancy "unmasked" chronic hypertension... watchful waiting to see how her bp behaves will let you know. Mine took longer than is usual to resolve, which my care providers believe is an indicator of future problems with chronic hypertension.

Postpartum I transfered care to an internist, who monitored my bp and weaned me off the meds once bp had dropped sufficiently. A perinatologist would likely also be able to provide such care, and would likely be better placed to counsel you and your wife with respect to any possible underlying disorders which might have triggered the bp and the cerebral "events", and about any future pregnancies you might plan.

I'm glad to hear your wife is taking her medication. I understand perfectly her concern about possible effects on the baby -- but none have really been found yet as I understand things, and lasting high bp does damage the body, and seizures are just no fun at all...

Re : Late term/post partum preeclampsia ?

Post by fatherof4 » Fri Sep 15, 2006 10:41 am

Received word back on the lab results today. The physicians office said the blood and urine tests were "perfect". Her BP
has not improved, in fact, it was a little higher yet....She's upset with me and that I've won (since she reluctantly started taking the Labetalol), saying I'm only concerned with myself...Physician's office says we should see someone who can diagnose and treat this condition....Is it still possible to still be pp pe with "perfect" lab results?

Re : Late term/post partum preeclampsia ?

Post by anathor21 » Thu Sep 14, 2006 03:07 am

Hello and welcome... Guess I'm slow to get to the forum today [:)]

Congratulations on your new baby.

Like so many others, we too experienced post partum PE. Our last pregnancy my wife held on very well throughout her last couple months with a diagnosis of mild PE. However, about a week post partum, her BP shot up, and she started having visual disturbances etc (sounds a lot like your story actually). She too was prescribed labetol, and also read the insert and became concerned about the potential breast feeding risks. After discussion with our doctors (both our OB for DW's side of things and our baby's doctor) we were far more comfortable having my wife take the medication than risk further PE complications. We did not notice any adverse effects on Isaac or any impact to her ability to sucessfully breastfeed.

Obviously each of our situations is unique. However, I do suggest that you consider carefully the risks of allowing the symptoms your wife is experiencing to untreated - remind her that the medication is not just to treat what she is experiencing, rather it is to prevent a far worse event that can occur if untreated.

"Toughing out" what she is experiencing may seem like a good idea, but may be a more dangerous course of action - often times it is hard to really appreciate the importance of the preventative side of these treatments, especially since we cannot really feel the high blood pressure.

Re : Late term/post partum preeclampsia ?

Post by sweetiesuzy » Thu Sep 14, 2006 11:24 am

Congratulations on the birth of your new baby! I am concerned about your wife at this point though from what you have shared with us. I experienced preeclampsia with three of my pregnancies and went on to exclusively breastfeed two of my children and I pumped and fed for 6+ weeks with my last child. I took labatelol with all three pregnancies as well as post partum while I was breastfeeding. I have had no effects from this with any of my children. The first 6 weeks following a preeclamptic pregnancy are still very risky. You can develop high blood pressures which can lead to seizures. Caryn has posted lots of solid medical information for you which is valuable in making an educated decision. I seriously urge your wife to talk to your provider about treatment options. I would hate to hear of anything happening to her.

Congratulations again and good luck.

Hugs,

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