First day with a baby AND a migraine.

[Karenn]

I used to get migraines fairly regularly and haven't had one since I got pregnant, until today! The one today is really making up for the last 18 months! I've done some research, and found that Imitrex is "probably safe" to use while breastfeeding. I've also got a call into my doctor. Still, I'm looking for more information. Has anyone taken it while nursing? Any other suggestions? I took tylenol and Dr. Pepper :) today, but it didn't seem to do a whole lot for me.
Thanks!

[August Mom]

I can really feel for you, Karen. I also have a history of terrible headaches but have been relatively headache-free since I became pregnant. Pre-DS, my doctor treated my headaches with Anaprox which is now available over-the-counter as Nanaprox in Aleve. I used to take 3 Aleve caplets or tablets to equal my prescribed dose of Anaprox. I asked DS's ped whether it was safe to take Aleve while breastfeeding. His initial reaction was "yes" it's in the same category as Advil and Tylenol. Then, he checked a program on his Palm Pilot. Aleve was rated as "safe" but with the caveat that there had not been sufficient testing. It might be worth a discussion with your pediatrician. Unfortunately, I can't shed any light on whether Imitrex is safe while breastfeeding. I usually consult Dr. Sears on questions such as this, but I'm not sure what medication is in Imitrex. Here's the Dr. Sears site for your reference, though: http://www.askdrsears.com/html/2/T028500.asp#T028508

[cara1]

While Imitrex is still not techically listed by the FDA as "safe" while nursing, Imitrex has done some post-marketing studies with nursing mothers indicating its safety. The half-life is about 6 hours, so you can try not nursing for that amount of time, and pump off the next "batch" (i.e., pump and dump) to be doubly safe.

[COElizabeth]

Karen,

I've been researching medication and lactation myself and happened upon the following link:
http://headaches.about.com/library/weekly/aa-bfeeding.htm

I can't vouch for the source, but it did explain some of the terminology like half-life and what it means for nursing and it was specifically about migraines. HTH.

Elizabeth
Mom to James
9-20-02

[Karenn]

Elizabeth,
Thank you! This is exactly the kind of information I was hoping for! I was lucky yesterday and my migraine when away after only a few hours. I'm thinking maybe the Dr. Pepper helped after all. I talked to the lactation consultant and between what she said, and the article you found, I think I'm going to hold off on the immitrex. Maybe I can get by on Dr. Pepper and Tylenol for the next few months. :)

[nitaghei]

I feel your pain - truly!! I had really bad migraines through my pregnancy (always have had migraines, since I was a kid; had transformed migraine for 5 years). My neuro gave me Darvocet as being safe during pregnancy and BF'g. Darvocet is a general analgesic and has worked reasonably well for me.

I'm a true non-responder to the triptans - so I no longer try them. The only thing that reliably works for me is DHE - which is Category X for pregnancy and BF'g.:'(

My impression is that there isn't a whole lot of research about the half-life of the various triptans (Imitrex and its progeny). The suggestion to "pump and dump" is good - though I would do it longer to be on the safe side.

BTW - is your doctor a neuro? If not, I would definitely recommend seeing a neuro at a headache clinic - they are about the only people who can give you accurate, current information about medication and migraines- since there is so much new research.

Nita
mom to Neel, 01/05/03
dog mom to a cocker and a PWD

[Tracey1]

Oh, I feel for you - taking care of a baby with a migraine can be rough! My migraines also went away during pregnancy, but resumed when dd was 3 months & the first was a doozy! I had asked my OB, who said that I shouldn't take Imitrex while I was nursing so I suffered through that first one (throwing up and the baby's screams magnified about x100 in my head!). The next time, I just couldn't deal with it, so I took the Imitrex but pumped and threw away all my milk for about 6 hours!

Eventually, I did some more research and decided that it was fairly safe to take. It's a decision you'd want to research and make for yourself, of course, but I found the AAP guidelines to be helpful. They list Sumatriptan (Imitrex) as a "Maternal Medication Usually Compatible With Breastfeeding" with no reported signs or symptoms in infants or effects on lactation.
http://www.aap.org/policy/0063.html

If the Dr.Pepper and Tylenol works, I would stick with that. Nothing would even touch them for me, so I did use Imitrex conservatively (maybe 1-2 pills/month) for about 4 months while I was nursing. I really made sure that I 'needed' to use it and then took the least amount that I could get by with.

HTH,

[zen_bliss]

gosh, that reminds me... i've had only 2 migraines while pregnant and dealt with them with cold packs, lavender, a shot of espresso (more to the point than Dr. P, which is also my fave!), hot shower, massage, and rest. it is a whole ordeal to get through that cycle of pain! i like to think that a lifetime of negotiating with pain will come in handy as preparation for birth...

my usual med is midrin. imitrex does not work for me at all, and when i got pregnant, my doctor and i went through a whole list of options of what would be safe for me to take, and the only one she came up with was vicodin. i promptly lost the prescription, which is just as well... i figured i would try anything non-pharmacological i could and try to make it through. i don't know if the same rules apply during BFing, but I'd love to know how others have dealt with this!

[Karenn]

You know, now that I think about it, I did deal with my labor pain the same way that I deal with migraine pain (not the caffiene though :) ) I guess it probably was good "practice."

Thanks everyone, for all the advice and sympathy.