Question: More frequent Migraines, nursing mother?
Answer:
Full Question:
I am a 28 year old female with a history of
migraine x 2-3/month with intermittent episodes of more frequent attacks, up to
3-4x/week. I take Zoloftx50mg/day for postpartum depression (under control),
Fioricet for migraine attacks, and I have a prescription for Hydrocodone
acetaminophen with codeine 5/500 for particularly severe attacks, as the
Triptans are out because I am breastfeeding my 7 month old. I have had two MRIs
in the past 4 years, the most recent one showing a miniscule (almost
undetectable and possibly attributable to a film developing issue) white matter
lesion, and I have been seeing a chiropractor once a week in addition to seeing
my GP for this condition.
Recently (3 weeks) my migraines have increased in frequency, and when I'm not
having a full-blown migraine, I still have a dull headache, but always on the
left side of my head, as the migraines always are. In the same recent timeframe,
I had 3-4 episodes when both eyes started twitching and they closed
involuntarily for maybe 1/2 a second, but I recall feeling as though I had
fallen asleep for just that moment, but I never totally lost consciousness. At
other times, my left eyelid just twitches. All of these episodes occur during a
migraine attack. Also, I have a very slight drooping of the left eye, a small
lump on the left side of my neck tucked at the base of my skull, and I have
periods of confusion whereby I am actually aware that I'm confused by a simple
task (ie, unloading the dishwasher and putting something in the wrong place
three times in a row, and being surprised I did it but do it again and again).
All told, it's disconcerting, and I'm not sure which symptoms are classic
symptoms of migraine and which warrant further testing, and what kind of
testing. Can you advise me as to what to do? Erin.
Answer:
Dear Erin;
It's time to get to an actual Migraine specialist. We can't know if you're to this point or not, but there are times when nursing mothers have to sit down with their doctors and weigh the benefits of nursing against the debilitating effects of untreated Migraines. We also can't second guess your doctor's prescribing, but you might be interested in this info on the meds you're taking so you can discuss it with a doctor:
- Zoloft: Pregnancy Category C; Lactation, safety unknown.
- Fioricet: Pregnancy Category C; Lactation, probably safe.
- Acetaminophen with hydrocodone: Pregnancy Category C; Lactation, safety unknown.
- Triptans: Pregnancy Category C; Lactation, safety unknown.
It's worth talking with your doctor about some of the tiptans with a short half-life. Some women use them successfully with the proper timing so they're out of their systems before their next nursing. If you need it, there's a link below to our directory of recommended specialists.
Good luck,
Teri Robert and John Claude Krusz
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Published March 6, 2006
