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Breastfeeding and medications

It can happen during the time that a mother is breastfeeding, that the use of medication is necessary. Mothers wonder if the intake of the medication will have an impact on their baby and if so, if this will be harmful. It is good to know that most medications can be taken safely without major consequences for the baby. Unfortunately, not all health care providers are aware of the fact that a lot of medications can be taken during breastfeeding. They rely completely on the warning labels from manufacturers, that quite often will declare that a pregnant or nursing mother should not take the medication. Mothers may feel pressure to wean their baby prematurely when reading such a warning.

Medications in mothers' milk

The amount of drug that will enter the mothers' milk will be much lower than the amount the mother has taken: the body fluid and blood will dilute the drug. Besides that, the uptake in the gut is not always 100%. This means that the mother will get only part of what she takes into her system. Than the dilution over her body takes place. It takes a while before the amount of the drug in the blood reaches its peak level. Most drugs appear only partly in the mothers' milk. Even if a mother nurses at the moment of the peak level, the baby's system will receive a low dose. The infants gut will probably also take up part of the drug. All together, infants will at most only ingest a few percent of the mothers' dose with most drugs.

What to do if you have to take drugs while breastfeeding?

Discuss with your physician if the medication is necessary. Ask if this is the safest medication to take while nursing. If not, ask for alternatives that are also doing the job for your condition. If there is no safer alternative available and weaning is suggested, ask for a second opinion about the safety with a pharmacist or other physician, for instance the baby's pediatrician. After all, the last one should know which medications are safe for infants. Discuss also the weight and age of a baby: in general, the bigger and older the baby, the lesser the concerns. Sometimes short time use of a drug is hardly a problem, while long term use warrants more monitoring of the baby. If a medication should be taken with caution and there is no safe alternative, discuss if it is possible to take the medication while monitoring the infant for adverse reactions. Another possibility is to discuss how long after intake you can nurse the baby to avoid nursing at the moment the amount of the drug peaks in your milk. A consultation with a lactation consultant may help in researching all your options.

Are there drugs that are not compatible with breastfeeding?

Yes, there are drugs that are not compatible with breastfeeding. Sometimes a mother needs to wean her infant from the breast. If the use of drugs is limited in time, it may be possible for the mother to pump her milk in advance and store this so she can bridge the time that she has to pump and discard her milk. To get the baby back to the breast, lots of skin to skin contact, cobathing and trying to nurse the baby when almost asleep may help.

References:

N. Mohrbacher and J. Stock. The Breastfeeding Answer Book. La Leche League International Third revised edition, 2003, Schaumburg, Illinois.
Th. Hale. Medications and Mothers' Milk. 2000 edition. Pharmasoft Publishing, Amarillo, Texas.
American Academy of Pediatrics. The Transfer of Drugs and Other Chemicals Into Human Milk.

Links:

La Leche League
American Academy of Pediatrics
To order a copy of Mothers' Milk and Medication

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© 2003 Nanny Gortzak