#Weaning and #Migraine – Treatment Update

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My little man will be 19 months old on the 12th, and with his increasing independence comes a number of changes, both for him and for me.

I’ve been practicing baby-led feeding and baby-led weaning, which means we’ve had fewer struggles than we might otherwise have had along our journey but it also means the weaning process is taking significantly longer than it otherwise might. That being said, my son took the lead on night weaning about four months ago, and I am happy to report that we are now officially done with the 2 a.m. (and 3 a.m. and 4 a.m.) feedings. In fact, we’re down to just two nursing sessions a day: one before nap and one before bed. Neither lasts longer than 15 minutes, and I’m hoping to drop both soon. While this is really good news for me (I can’t wait to have my body to myself again), it is also not so good news.

Hormones change and fluctuate a lot during pregnancy and breastfeeding. They also change when we begin to wean, and again when we finally drop that final nursing session. For some women, this isn’t a super big deal. I’m not one of those women.

As I shared on this blog, my migraines were terrible during the first half or more of my pregnancy. They eased up a little during the third trimester and were largely absent during those first few postpartum months. Then, they kicked in again, and as we’ve progressed through the postpartum period and into the toddler years, they’ve gotten worse. This is due in part to the hot and ever-changing Texas weather and in part to weaning.

Weaning related migraines are nothing new. If you search the internet, you’ll find a large number of women discussing how much worse their migraines got when they stopped breastfeeding. Somehow, though, it was something I wasn’t entirely prepared to experience.

Unfortunately my expectations had little to no effect on reality.

The last eight weeks have brought a migraine more days than not. While I have a lot of non-prescription tools for coping with migraine and a supportive family, it’s become necessary to go back on medication. Thankfully, Kellymom.com, a wonderful resource for nursing mothers and their doctors (my neurologist even references this site), offers a pretty in-depth look at almost all of the common migraine and pain medications. Taking both the website’s information into account and the age of my son (babies older than 3 months usually aren’t as affected by medication in mothers’ milk as much as younger babies), my neurologist and I have crafted a new plan. For those who wonder:

  • I’ve started amitriptyline as a preventative. As of now, I’m only on 10 mg once a day, but I’m working myself up to 30 mg. We’ll reevaluate my progress when I go back for a follow-up at the end of the month. I’m still taking 400mg of Magnesium as a preventative as well.
  • I have prescriptions for a tablet version of Prodin for use as an abortive. I also have a few samples of a Zomig nasal spray, though I haven’t used it yet. (Triptans generally don’t work for me, and I figured I would wait to try this until I’m completely done weaning, just because it makes me more comfortable. Despite the fact that I’d heard somewhere that triptans were no-nos when breastfeeding, Kellymom.com actually says Zomig is “moderately safe.”)
  • I also have Fioricet and Promethazine tablets and a nasal spray version of Toradol for use as rescues.

I haven’t used most of these medications yet, as I try to avoid medications as much as possible. I have taken two of the Fioricet tablets, but so far I’ve experienced little relief. I’m hoping the amitriptyline will bring help. If it doesn’t, I believe we’re going to try a calcium channel blocker, which is one of the only preventatives I haven’t tried yet. If that doesn’t work, we’ll wait until my son has decided to completely give up nursing and then try a few other things. I trust that eventually either time or a medication will help.