Hi, Lactnetters,
    Mom with long history of migraines, now has 6 day old baby. In the past
she has taken Imitrex( sumatriptan)  via injection, and the drug mentioned in
the subject line, which goes by lots of names, and includes Butalbital,
caffeine and acetominophen. I searched the archives and found some stuff on
the sumatriptan ( Dr Jack, may I quote your posts to her?) to share with her,
as well as the 99 Hale info ( still waiting for my 2000 one in the mail). I
can't find anything in the archives on the Butalbital compound, and the stuff
in the 99 Hale is scant. Perhaps there is no other info out there, any
personal professional experiences, or thoughts I can share with this mom. We
have discussed that this is a balancing of sorts between any  risks of the
meds to the baby and the risks of AIM ( her Pediatrician gives her the PDR
info and suggests pumping and dumping for 24 hours, apparently not sharing
the studies of the risks of AIM, hmmm...) Her usual sequence is a migraine
once or twice a week, for which she takes double doses for two days in a row
of the Butalbital or the Imitrex. Before she became pregnant migraines were
once in three weeks, but they worsened significantly in the second trimester.
I noted the info about propanolol in the archives for prevention, have not
discussed this with her yet. She is engorged, and in pain, which we are
dealing with, and says she fears her lack of sleep will begin to trigger the
migraines. In view of her circumstances, I have suggested that she pump for 5
minutes or less to take the edge off the engorgment pain after feedings, IF
the baby's nursing has not done the job ( baby was 5 ounces about birth
weight on day 5, so does seem to be feeding well at this time). This will
also serve to give her a small backup supply if she gets a migraine ( she is
very tense about this, so I think the mental aspect may be more important
than the physical even but am willing to try just about anything at this
point ) and decides to pump and dump. Any other suggestions/comments?
Judy LeVan Fram, Brooklyn, NY

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