Help me wean my 8-month old, please...

July 2, 2006 3:06 PM

Help me wean my baby so I can get back on my antidepressants. She's 8 months old, is eating solids very well, but won't take a bottle (never did)....

I'm terribly depressed and really need to wean her so that I can go back on Wellbutrin. This needs to happen over the next month. I love breastfeeding, but the depression is killing me.

posted by mdiskin to health & fitness (30 answers total)

Give the baby warm chocolate milk in a bottle. Force it alittle around the lips or drop some on your index finger and then let the baby taste it. Trust me, the baby will start drinking the bottle. But you got it do it constantly. Then slowly, give it breast milk in a bottle. Put some honey in the breast milk once it accepts it and that baby will knock out super quick.

Trust me I am mother of a 9 year old daughter and I used to breast feed and she would smack the bottle out of my hand. But nestle quick saved my sanity and she turned out to be a pretty smart terrific kid so far, so don't worry about the sugar.

Good Luck!
posted by milarepa at 3:20 PM on July 2, 2006

My son wouldn't take the bottle but he drinks milk through sippy cups, maybe that will work, just get one that has really small holes so he has to suck.
posted by any major dude at 3:27 PM on July 2, 2006

Put some honey in the breast milk...

IANAD, but I don't think babies are supposed to be given honey. For example:

...As it turns out, NOT giving your daughter honey while she is an infant is an important preventive health measure. It may save her life.
The concern is with infant botulism...

posted by spacewrench at 3:35 PM on July 2, 2006

Have you tried Zoloft instead? So sorry about your problems - PPD really stinks. Breastfeeding is really, really beneficial to moms and babies (decreased cancer risk for moms, immense health benefits for babies), though, so if there's a chance you could take a more milk-friendly antidepressant and be able to continue nursing, please give it a try.
posted by Addlepated at 3:37 PM on July 2, 2006

As stated above, do not give a baby under 12 months honey. I wouldn't start a sugar or chocolate routine either unless absolutely necessary. Your baby may not take straight formula again. But then again, my mother gave me Coca Cola in an occasional bottle as a toddler, and my teeth and health are fine. Lordy.

Have another person other than you give her a bottle. When she sees, feels, and hears you, she wants the breast. Sometimes having another person give the bottle works.

Also, you may try to give formula in a sippy cup with a soft nipple. She may be able to hold it herself with some assistance in a month or two. Or if your pediatrician gives the okay you could dilute white grape juice with spring water, and see if she takes that in a soft nipple sippy cup, or bottle. She still needs formula or breastmilk for the first 12 months. You can feed her organic baby yogurt, cheese, and cereal mixed with formula, if you think she isn't taking enough formula via cup or bottle. But still offer the breast and bottle as often as possible until she likes the bottle. I believe it will happen, my older child didn't like the bottle until he was 10-months old. I wouldn't put anything but breastmilk or formula in a bottle.

I am so sorry that you are depressed.

Sorry for the unsolicited advice, and you may already be doing this, but try to get some vigorous exercise daily, or as much as possible. This may help you get some relief from depression while you are trying to wean your daughter, and begin medication. I have bouts of depression myself, and I find that I am most happy and content when I am working up a good sweat. I also find that PMS moodiness and blues are virtually eliminated when I am working out.

Study: Exercise helps reduce symptoms of depression

Duke University Study: Exercise has long-lasting effect on depression.

Weaning tips at breastfeeding.com
posted by LoriFLA at 4:21 PM on July 2, 2006

Thanks for the advice so far.

1. I thought milk was a no-no for kids under a year?

2. Honey also bad for under 2-yrs old?

3. Wellbutrin is the only drug that works for me (and I've tried many). According to all the docs I've seen, there aren't any milk-friendly antidepressants. Believe me, I love breastfeeding. But the horrible depression is just not beatable -- I'm exercising, I have a nanny for 2 days a week so I can work some and get time to myself... I'm still having a really rough time.
posted by mdiskin at 4:22 PM on July 2, 2006

Excuse my conflicting advice about juice in bottle, I meant to say only give formula or breastmilk in a bottle.
posted by LoriFLA at 4:23 PM on July 2, 2006

Yeah, definitely avoid the honey. Last thing you want is a nine month old with botulism.

If you're going to sweeten the milk, you might try inverted sugar syrup, e.g. Lyle's. Or, you can make your own. It's really easy, though I can't remember the proportion of water and sugar. 2:1? 1:1? 1:2?

We weaned with sippy cups and straw cups. That's what I'd do. Just don't do it all a sudden. I think our daughter needed a week or two to go all-sippy, but she didn't look back after that.
posted by dw at 4:25 PM on July 2, 2006

1. I thought milk was a no-no for kids under a year?

FDA says one year, but I recall our doctor saying you can introduce it between six months and a year. Or you could force formula on her.

2. Honey also bad for under 2-yrs old?

National Honey Board says after 1 is OK. That sounds right. The issue is botulism, and I think it's by one almost everyone has been exposed to that bacterium.
posted by dw at 4:31 PM on July 2, 2006

According to all the docs I've seen, there aren't any milk-friendly antidepressants.

Your doctors are misinformed. I have PPD now, and had it with my previous baby as well. As one PPD'er to another, I really don't want to add to your problems. But... please please please before you wean your baby, look at this.

Breastfeeding can be so beneficial for women with PPD (as well as the baby, of course), and I'd hate for you to give it up just because you're getting poor medical advice.

Zoloft and a support group are helping me greatly. Please e-mail me if you want to discuss this, or give Depression After Delivery (site not working at the moment) a call.

Remember: you're the best mother your daughter can have.
posted by The corpse in the library at 5:21 PM on July 2, 2006

In any event, no matter your decision, I'm glad to hear that you have breastfed your baby for 8 months. That's about 8 months longer than many women I know, and provides a substantial head-start for her. Good luck in getting the help that you need.

By the way, another really great reference source is this page, where Dr. Hale actually measures the amount of medication that's present in the milk rather than saying "Drugs are bad, m'kay?"
posted by Addlepated at 5:38 PM on July 2, 2006

I had the exact same problem (unmedicated PPD though, I just wanted to get out of the house once in a while) -- my eight-month-old refused to take a bottle although she was great with solids. The only thing that eventually worked was consistently trying, at every feed, to get her to take it. One day she just magically figured out how to position her lips around the teat and suck.

We tried the sippy cup and many different teats, formula and EBM, we tried getting other people to feed her, we tried cold turkey and let her go hungry until she took it. But she apparently insisted on taking the bottle on her own terms, when she felt like it. One day when we had temporarily given up I just made a small bottle up and put it in her mouth, and she drank the whole thing. We weren't pushing her and maybe that was the difference; there was no feeling of tension or pressure on her.

Once she took the bottle regularly (which still took about two weeks), she self-weaned from me within about a week. It was almost disappointing how quickly she lost interest.

The best time while she was adjusting was first thing in the morning when she was calm, cheerful and hungry. We'd set her up just as if she was getting her a.m. feed, but hand her a bottle instead. More often than not she'd drink from it. When she did start taking the bottle we had a relatively fast-flow teat on the bottle, so she'd get quick results with little effort, just to get her in the habit. When she had it sorted I put her back on a slower-flowing teat.

Do you read Dooce? She went through this when her daughter was about four months old and wrote openly about her feelings. You could try contacting her via email for some advice, or searching her archives.
posted by tracicle at 5:38 PM on July 2, 2006

Try apple juice in a bottle. I weaned both of mine to juice bottles (they were a bit older, around 14 months - I decided nursing was over when they a) bit and b) walked over, yelled Nurse now! and pulled up my shirt.) and they've turned out fine. Do it gradually - just slowly cut down the amount of nursing you're doing - day by day nurse less and less often, and offer the juice bottle more. I'm assuming that you've started her on solid foods? If not, start right away. That will help a lot, because then a lot of her nursing becomes more for comfort than for nutrition, and you can cuddle her and give her a bottle of juice. I think it took me about 2 weeks to wean my kids and it was much less traumatic for everyone than I had expected.
posted by mygothlaundry at 5:39 PM on July 2, 2006

Sorry for the doublepost - just noticed that there is this thread on Dr. Hale's site which specifically addresses Wellbutrin.
posted by Addlepated at 5:40 PM on July 2, 2006

In any event, no matter your decision, I'm glad to hear that you have breastfed your baby for 8 months. That's about 8 months longer than many women I know, and provides a substantial head-start for her. Good luck in getting the help that you need.

By the way, another really great reference source is this page, where Dr. Hale actually measures the amount of medication that's present in the milk rather than saying "Drugs are bad, m'kay?"

There is this thread on Dr. Hale's site which specifically addresses Wellbutrin.
posted by Addlepated at 5:41 PM on July 2, 2006

Checked the kellymom site, and here's what it says about Wellbutrin (buproprion, right?): "Bupropion has a high milk to plasma ratio, and is excellent for use in smoking cessation programs. It may reduce the milk supply but as yet this is undocumented."

Dr Hale's site (I checked the forums) seemed to find reduced milk issue more anecdotal. No comments so far found on how much of the drug crosses over into the milk. Maybe I can take it and keep feeding? I'd love that. Wellbutrin works for me, while other anti-deps I've tried either dont' work or make things much worse.

corpse -- what is your support group for PPD like?
posted by mdiskin at 5:52 PM on July 2, 2006

I don't have any advice re: the wellbutrin/breastfeeding, but my boss was mentioning once that her daughter refused to take a bottle from her - she could sense that mom and the boob was right there, so why take it from the bottle? The only way she was able to get her to successfully use a bottle (of expressed breastmilk) was for her to leave the house entirely. Is this an option?
posted by cajo at 6:00 PM on July 2, 2006

mdiskin - You can also look into getting Hale's book, which I think is available for sale through that website I linked. I used to have a copy but can't for the life of me remember where it is... I think I loaned it out to someone. Anyway, you could try pumping in preparation for going on the meds in order to get your supply up a bit, in case the Wellbutrin brings it down. There are lots of herbs you can try which will boost supply if it happens (this site has a lot of good information).
posted by Addlepated at 6:13 PM on July 2, 2006

I don't want to add to your stress. But I do encourage you to seek out a second or third opinion. Is there a reproductive mental health program in your area, perhaps at a university hospital? In addition to the studies by pharmacology Dr. Hale, many other studies have shown antidepressants to be safe during breastfeeding. In comparison, abruptly weaning your baby can cause a swing in hormones that might affect your mood. Of course, you should not take medical advice from strangers on the Internet.

As for weaning, can you have someone else offer a feeding? Infants can smell their mothers. Even if you are in the same house, they can smell you. Perhaps a friend or partner could offer a bottle when you are out for an hour. Then you can slowly drop one feeding at a time.

Honey is not safe for children under a year, due to botulism. And I believe chocolate is not safe for under a year, since it causes the heart to race.
posted by acoutu at 6:28 PM on July 2, 2006

I forgot to add that, if your baby won't take a bottle, you could try a sippy cup, toddler straw cup or even a regular cup. It helps to create a distinction that may be more effective with weaning.
posted by acoutu at 6:48 PM on July 2, 2006

corpse -- what is your support group for PPD like?

I just started going. It meets two evenings a month, at a nearby hospital. It has two facilitators -- one is a midwife, I haven't met the other yet -- and whoever wants to shows up to talk. I walked in and saw the table with Kleenex and dark chocolate and knew I was in the right place... Anyway, whoever wants talk just can feel free to talk. The evening doesn't end until everyone's done talking. I can bring my baby (which is vital, because she -- like her brother before her -- refuses all bottles).

It's a chance to find out that I'm not a freak or a bad mom, and that other women have gone through this. I got the names of some therapists who have good histories with PPD, and the phone number of a baby sitter. Oh, and the other women are really funny and enjoyable to talk to.

I found it through Depression After Delivery. [phone], leave a message and they will call you back.
posted by The corpse in the library at 7:20 PM on July 2, 2006 [1 favorite]

I found that I had to change anti-depressants after I stopped nursing (from what I had been taking pre-pregnancy). I don't know if the pregnancy/nursing hormones had anything to do with it or not. But it might be possible that one of the other more milk-friendly antidepressants might work for you now, even if it didn't before.

That said, I wouldn't want to switch to something new either if I knew one specific kind worked for me. But just know that it *might* be possible, if Wellbutrin isn't an option yet.

Good luck. This too shall pass, and all that...
posted by SuperSquirrel at 7:22 PM on July 2, 2006

Have you tried pumping and feeding your breast milk via bottle? If so, with different bottle/nipple setups? My wife breastfed exclusively for 6 months, but pumped in order to get out of the house some. Our daughter took to breast milk via bottle without a problem and when time came to switch to formula it was done in about 4 weeks without a hitch.

As has been mentioned above, you are to be commended for breastfeeding for 8 months. You have done a world of good for your child. Having said that, it is perfectly reasonable to wean at this age regardless of the reason. Some of the advice here is good, but some of it is not, so take advantage of some other sources that may be available to you. The hospital where you delivered may have breastfeeding consultants, there may be a local chapter of La Leche League (and they are not always the breast-feeding extremists they are made out to be), your pediatrician/obstetrician/midwife may know someone who can help.

You mention a nanny two days a week. How do you feed the baby while the nanny is there? Also, two days a week is nice, but not much of a break if you do not have additional support from family and friends. This goes hand-in-hand with the weaning issue, because as I mentioned above, the other caregivers will need to feed the child somehow. Your child may not like it, but once he is hungry enough he will be much more willing to take a bottle/sippy cup/other alternative. As with much of parenting, patience and perseverance is key
posted by TedW at 7:35 PM on July 2, 2006

Nothing substantive to add, but I just wanted to say thanks for looking out for your baby.
posted by chef_boyardee at 7:55 PM on July 2, 2006

I am a nutritionist and definately a baby under 1 year should not have honey or cow's milk. I would try formula from a cup, should be able to use a sippy cup at that age. Don't think anything flavored with chocolate is a good idea either. Hope she will take it ok.
posted by cellar at 8:06 PM on July 2, 2006

Can you wear a breast cup that will catch extra breastmilk, or express or pump some, to put in a sippy cup or Ansa bottle that the baby can hold, explore, and discover how to use on her own terms?

As you wean her, you could start the meds that you need, and maybe only nurse at night, minimizing the exposure. The comfort and coziness of nursing, for mom and baby, are so wonderful.
posted by theora55 at 1:49 PM on July 3, 2006

thanks to everyone.
1. I have only one child and am working from home part-time (I'm a writer). I truly have the best baby ever -- sleeps like a champ, never fusses, and I live in a neighborhood of supportive moms. No problems on the mothering front.

2. She eats food twice a day, which I make myself (organic green veg + organic chicken/turkey as first course; organic oatmeal for babies with organic sweet potato for second course). Sometimes I mix formula in with that oatmeal, and she loves it.

3. Is the issue here that there are no studies (real ones, double-blind, etc) on the effects of Wellbutrin (or other meds) on babies? If the effects are neglible, why are my docs telling me to wean first?

4. I love Dooce and read her daily.
posted by mdiskin at 3:11 PM on July 3, 2006

Could you approach your doctors with some of the information from Dr. Hale's site and see what they say? Ask if they would consider contacting the reproductive mental health program at a research university, too. When I was on medication and needed surgery last year, I found out that some of my doctors were saying I needed to temporarily wean because they simply weren't educated about the effects of the drugs. Some doctors become very risk averse because they don't have the time to be up on all the different medications. Perhaps you could see a reproductive psychiatrist. I found that a community health nurse was trememdously helpful in researching medications used during breastfeeding -- she used Dr. Hale's book, researched publications, contacted a pharmacist at the hospital, etc. Is there a similar resource near you? Maybe a local PPD group would have some leads. Someone else has likely been in the same situation.

I am not trying to push my breastfeeding agenda and I think you have to make the doctor-supported decision that is best for you and your family. However, it would seem logical that, if your medication is safe or very low risk, the baby would benefit from ongoing breastfeeding, you would avoid hormonal shifts from weaning, and you wouldn't have the stress of trying to wean. I think sometimes doctors overlook the stress of such a situation if they aren't well educated about it. It just isn't on their radar.
posted by acoutu at 6:26 PM on July 3, 2006

If the effects are neglible, why are my docs telling me to wean first?

Doctors spend very little time covering breastfeeding while in medical school, I've been told. I had to correct my (former) doctor when she said I had to wean in order to take antidepressants. She just presumed I had to wean, but when I said that she was wrong she did, oh, five minutes of research and confirmed that there are safe meds.

Dr. Hale is _the_ expert on breastfeeding and medications, by the way, if you're wondering why we all keep linking to his studies.
posted by The corpse in the library at 6:30 PM on July 3, 2006

Okay, here's what happened and how, just in case anyone comes here in future...

I went to twice-a-day nursing (first thing in the a.m., last thing at night) for about 10 days. No problem there since in between she was eating like a champ and starting to drink out of a sippy cup with no problems whatsoever.

One week my mother-in-law visited and offered her a bottle of formula while my husband and I went to see a matinee. Baby refused but 20 mins later kept looking down at the bottle with some interest, so my MIL gave it to her and she sucked it down like a champ. From then on.... very easy to feed her with the bottle. I got somewhat engorged on the 2nd day of absolutely no nursing, so I nursed her a bit when she woke up crying that night (usually she sleeps 12 hrs straight) and that eased the discomfort.

Since then, she's loving the bottle and I cuddle her a lot in the morning and at night while she drinks it (during the day I let her drink it in her playpen while I do other stuff, and of course I cuddle her all the time when she's not eating as well). She still eats 2 big meals a day of "real" food and yesterday at her 9-month checkup was where she always is: 90th percentile for height, 50th for weight.

I'm glad I'm taking my medication again, and my depression has definitely eased, but I REALLY miss nursing her. She was getting so easily distracted, though, so she may have stopped nursing by herself at around this point anyway.
posted by mdiskin at 1:29 PM on August 11, 2006