I have been counseling a mother with a 5 month old girl, and we made it
through many things to get to this point! Most significant of these was
that she has OALD, and for her help in discovering this I must thank Marie
Davis again, profusely. Anyway, this mom, to me, is the epitome of
breastfeeding empowerment, the poster child, if you will, for how fantastic
the relationship of nursing mother and child can be.  She weaned her first
to formula at 3 months due to bad advice and mourns that decision to this
day, which I am helping her with.  The current problems are these: 1) she
has finally gone to a psychologist for a long-standing problem with
depression stemming from childhood abuse, which I knew nothing about (the
abuse or the depression).  Her therapist sent her to a dr. who put her on
Paxil, after first spending half an hour berating her (and I do not use
that word lightly, the mom called me in tears about how she says he treated
her) about why she was so adamant about continuing to bf. Due to insurances
and other concerns she cannot switch to another dr. She has concerns about
the Paxil.  I researched it on Lactnet but if anyone has any more sage
advice to give, I would appreciate it. I obviously cannot advise her on
exactly what she should take, because I can't advise on meds, but I want to
give her some ammunition/info she can bring to her next appt. She has put
this off for so long that the depression is on the border of affecting her
mothering, so putting off the treatment is not an option.

Problem 2) is that the baby has a persistent bilateral ear infection that
has not responded to three different meds, amoxicillin (of course),
bactrim, and cephalexin. Hasn't budged and the babe is miserable and unable
to nurse well due to the pain. I mention this in the hopes that perhaps
someone has advice, and also because it has bearing on her mental situation
and stress level.  How can she deal with this dr. who is pressuring her to
wean?  I advised her to pump and give the babe bm in a cup if nursing hurt
too much. Was I on target with that? Someone mentioned Elavin as a good
antidepressant with bf. Comments?  Should she ask the doc if he has Dr.
Hale's book?

I hope I expressed this fairly clearly. It is extremely complicated, I
realize, but I hope that the gist of it is here and someone of you have
some thoughts.

Cheers

Nancy Kramer
LLL PC
Port Angeles, WA