Headache, colds, flues, high blood pressure, digestive problems? What medicines can you use during pregnancy or during breast feeding? When not feeling well, a young mother has many second thoughts before taking some pills because she is afraid that the treatment is not safe for her baby, as it might be affected by transmitted substances through her breast milk. Ask your doctor and you will find that there are drugs considered safe, others are administered with caution and a third category, of contraindicated drugs. There seem to be a common myths and beliefs. 66 percent of women that are breastfeeding and need drugs for a certain health problem decide to stop breastfeeding without a documented reason. What a pity! Before taking such a drastic decision it would be better to understand what is allowed and what is not.
Transfer of Drugs/Meds into Breast Milk
It is very important to know that once passed into milk, drugs do not stay there forever, because the mother slowly eliminates the drug’s substances through physiological methods (urine, bile, sweat), thus meds concentration in milk tends to decrease gradually. Even when the nursing program is not fixed (baby is fed on demand and not by schedule), the time between feedings should be increased, so the concentration of drug in milk tends to considerably decrease gradually with time. If the medication is taken immediately after breastfeeding, the presence of the drug at the next breastfeeding will be reduced. Doctors say that “only 1-2% of drug effect is transmitted to the child“. However, depending on the drug, it may be the case where this can or cannot affect the baby’s health.
What to do for Breastfeeding Safety in Case of …
Respiratory diseases, fever, headaches – If a cold has caused an increase in body temperature (fever), the safest substance to use is paracetamol. In case of coughs and sneezes, the mother’s face should be covered with a medical mask which protects the baby from tiny saliva drops, while suckling. For a stave nose is ideal to use aerosol, whose active substances are not able to pass into milk in significant quantities. Constipation – If the bowel is lazy, the best laxatives are the “sweet” ones (lactose, paraffin oil or grease), as they do not alter milk production. Gastrointestinal problems – Drugs containing active ingredients such as domperidone and loperamide may be taken without any problems. Radiography, computed tomography, magnetic resonance imaging – They have no effect on infant’s health. This is valid also for local anesthesia, such as those made by the dentist or dermatologist. Scintigraphic eczemas – Cause a transportation of radionuclides into mammary glands. Thus the mother should stop breastfeeding for a period of time determined by doctor, depending on the administered substance. Breast implants – If the mother has prosthesis breast, the ability to breastfeed depends on the type of prosthetic used. If it is an aesthetic implant, glandular tissue is not altered and breastfeeding can continue. If the surgery altered mammary gland structure (usually due to a partial or total removal/mastectomy), breastfeeding is not possible.
Medication for Chronic Diseases vs. Breastfeeding
A special chapter of “Breast feeding safety” is consisted by important maternal drugs used to treat major chronic diseases. In these cases, it is up to both a specialist and pediatrician to assess the situation and give advice. Anemia – Although safe for babies or children, iron supplements may cause an “upset stomach”. Your doctor should evaluate the situation and, considering each case, the possible alternatives. The quantity of iron can be increased through proper diet and nutrition.
Diabetes – Insulin can still be taken by women who are breastfeeding. Even if it passes into breast milk, this substance is destroyed in the gastrointestinal tract of the infant.
Epilepsy – Most epilepsy medicines can be taken even during breastfeeding, as they have no dangerous side effects for little one.
Hyperthyroidism – Thyroxine hormone-based treatment may be followed even during breastfeeding, because do not harm is caused to the baby.
Cardiovascular Diseases – Administration allowed treatment because these substances pass only in trace amounts in breast milk. This is true for treatments for hypertension. Thrombophlebitis – Some anticoagulants can be taken without problems during breastfeeding, because they flow into breast milk in insignificant percentage and are destroyed in the gastrointestinal tract of the baby.
The general rule is that it’s always better to take meds after breastfeeding. To limit the flow of active substances in milk to a minimum and reduce child’s exposure to potential side effects of drugs taken by the mother, it is very important that these pills to be taken immediately after breastfeeding, so you get a longer period before the next breastfeeding. If the baby is showing signs that he wants to suckle again shortly after you have taken the med, you should fulfill his desire (of course only if the drug is not part of those considered hazardous).
Caveats / Notes: –
Breastfeeding is contraindicated in mothers with HIV. – Mothers carrying hepatitis B or hepatitis C may breastfeed if the infection is not active or recent. – For mothers undergoing anti-tumor treatments, with medicines containing radioisotopes (substances that help the release of radiations in the body), breastfeeding is not allowed. – The active ingredients of many drugs designed to treat depression and acute psychosis contain lead and lithium, pass into milk and may interact with baby’s nervous system and may cause behavioral disturbances. Medication in Breast Milk – Safety Chart Although many medications are safe to use when you’re breastfeeding, most meds will get into your milk to some degree and may even your milk quality or supply. To be safe, check with your doctor before taking any kind of medication, even over-the-counter ones.