Books to buy

Do you want to buy a copy of one of my books? They are all available on Amazon which is probably easiest. Or direct from the publishers Routledge, Pinter and Martin, or Praeclarus Press. I’m not going to available as much in the future to answer questions so maybe now is the time to buy the books so you have answers 24/7 365 days a year.

Perinatal mental health and Breastfeeding

I have recorded the presentation which I have frequently given about perinatal mental health and breastfeeding. It should be used after listening to ” How drugs get into milk”

How do drugs get into breastmilk?

as it contains the pharmacokinetic data of drugs prescribed for perinatal mental health including SSRIs, anti anxiety medication and anti psychotics. It also includes research studies about the links between mental health and breastfeeding.

I hope this may increase prescriber’s knowledge as well as empower peer supporters and parents.

How do drugs get into breastmilk?

I have recorded this powerpoint to help everyone understand how drugs pas into milk and by appreciating this how we can evaluate the information within specialist sources. I hope it is useful CPD for professionals. The information is in all my books if you want to read more.

If you have a question please message me

Mirtazapine and breastfeeding

Another medication used during breastfeeding for anxiety and depression is mirtazapine. It may be used where other SSRIs have not been effective or tolerated. Mirtazapine may be also be seen as an option where insomnia is a symptom of  anxiety or depression.

The baby should be observed for signs of drowsiness and ineffective feeding.

Care should be taken with co sleeping because it is likely to cause drowsiness in the lactating mother. Falling asleep in chairs or on sofas should be regarded as an even greater risk

LactMed summarises that “Limited information indicates that maternal doses of up to 120 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months.” In practice the normal dose is 15mg taken at night.

Professionals may find the RCGP Perinatal mental health toolkit a useful resource

The information in this factsheet is taken from my book Breastfeeding and Medication. Please message me with queries or the references used.

Mirtazapine and breastfeeding factsheet

Sertraline and breastfeeding

Especially over the past year of the pandemic many mothers are asking about the compatibility of sertraline during breastfeeding. It has been a hard time for everyone with the incidence of anxiety and depression continuing to rise. As access to IAPT and IESO is more difficult the prescription of medication is inevitable.

Sertraline is the first choice medication for breastfeeding mothers as virtually none gets into milk and that we have a high level of experience with it over many years.

Unfortunately many doctors are, in my experience, still recommending that mothers should stop breastfeeding in order to take it. This may be that they think life would be easier if someone else could help with care of the baby or that the mother may get more sleep. Sadly, this doesnt always happen and the loss of oxytocin may also lower mood further.

There is often an assumption that pressure to breastfeed can lead to depression but in my experience pressure to stop breastfeeding in order to take medication may increase depression and may also stop mothers accessing professional help to avoid having that discussion.

This link to the RCGP perinatal mental health toolkit may be useful for professionals and parents

RCGP perinatal mental health toolkit

This factsheet contains information from my book Breastfeeding and Medication. Please message me for references used or with any questions.

Setraline and breastfeeding factsheet

Breastfeeding and chronic medical conditions contains chapters on anxiety and depression

Covid Vaccine and Breastfeeding

I have been inundated with questions about the vaccine against Covid 19 and breastfeeding. Initially the recommendation was that it shouldnt be given until a mother had stopped breastfeeding (which caused consternation in the front line workers who needed it so badly to protect themselves and their families as well as patients ). This was revised by the MHRA and JCI once the first urgency of licensing the vaccines was past.

The information is that either the Pfizer/BioNtech or Astra Zenica/Oxford vaccines can be administered to a breastfeeding mother. I wrote this update for BfN which contains links to all the other information including InfantRisk

However, there are still queries from mothers who have been unsettled by poor information circulating on social media. I hope to allay these fears but ultimately the decision which you make is that which feels right for you.

  1. No there havent been any studies on the transfer through milk to babies but one is currently being undertaken by Imperial College using the milk of mothers before and after vaccination.
  2. It is not possible to interrupt breastfeeding for a period to minimise the transfer of milk. Vaccines do not have a half life like drugs.
  3. We have no reason to believe that the COVID-19 vaccine transfers into milk any more than any other vaccine which we use. What transfers are antibodies which the mother has made. We look forward to hearing whether these offer any protection to the baby. We know that antibodies after the mother has had COVID do transfer and protect.

I hope that this helps to answer some of the frequently asked questions and that all those having the vaccine stay safe and well as they work so hard to protect and treat the rest of us.

Heart emojis meaning: A guide to using the symbols and when to use them
Thank you NHS

Breastfeeding after CT and MRI scans

Virtually every day I get messages from mothers and health visitors querying whether mothers can continue to breastfeed after CT and MRI scans. I was told that the national guidelines had been updated some years ago to align with RANZR guidelines . Sadly this doesnt seem to have been adopted by all radiology departments from my experience.

I was lucky enough to work with Dr Gabrielle Cronin on this paper which was published recently in the Irish BMK

Most mothers are advised to stop breastfeeding for 24 hours but there is no evidence for this as most contrast media are not orally bio available and have half lives which do not justify this duration.

More information

RANZR guidelines

ADHD and Breastfeeding

I have shared the chapter on ADHD from my book Breastfeeding and Chronic Medical Conditions multiple times this week. Many mothers seem to be diagnosed in later life and are concerned about breastfeeding. Hope this is a useful link.

More information Breastfeeding and ADHD factsheet

If this is useful maybe you need the book available on Amazon. I published on Kindle to try to make this more affordable and available to mothers and breastfeeding supporters as well as professionals

Fibromyalgia and Breastfeeding

Fibromyalgia is incredibly difficult to deal with when you have a baby. The most effective intervention is CBT. Please read this factsheet which is a chapter from my book Breastfeeding and chronic medical conditions available on amazon.

Breastfeeding and Fibromyalgis factsheet

Mirtazapine and Breastfeeding

With the developing COVID situation more mothers are struggling to sleep and being prescribed mirtazapine for anxiety and depression associated with poor sleep. This is the information I used in Breastfeeding and Medication.

For more information Mirtazapine and Breastfeeding Factsheet

or maybe buy the book

ADHD and Breastfeeding

Currently there seem to be many questions about treatment of ADHD and breastfeeding. I’m sharing the chapter from my book Breastfeeding and Chronic Medical Conditions which I hope helps

For more information :

Breastfeeding and ADHD factsheet

and maybe you would like to but the book available on Amazon