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Public Health England Study and Medication during Breastfeeding

71% of 500 women who responded to a PHE study,  think breastfeeding will limit the medication which can be taken! So lots of work for me still to do then. Could professionals buy a copy of Breastfeeding and Medication to reassure women?

Statements like this on the NHS site arent going to help – more about manufacturer protecting themselves? Not taking risks? Could be better worded as it just isnt true. Breastfeeding mothers with depression get treated every day and their babies are fine!

“Breastfeeding: As a precaution, the use of antidepressants if you’re breastfeeding isn’t usually recommended. However, there are circumstances when both the benefits of treatment for depression (or other mental health conditions) and the benefits of breastfeeding your baby outweigh the potential risks. If you’re treated with antidepressants when breastfeeding, then paroxetine or sertraline is normally recommended.”

The Start for life page https://www.nhs.uk/start4life/breastfeedingto which the chat box  https://www.messenger.com/t/Start4LifeBreastFeedingFriend/  links identifies the BfN Drugs in breastmilk helpine which I run as a resource. But they dont fund it – it is run on a voluntary basis and they didnt ask permission to see if I can deal with additional work. But I will keep doing my best to support mothers who need medication whilst breastfeeding

 

https://www.theguardian.com/lifeandstyle/2017/mar/23/less-than-half-of-women-breastfeed-after-two-months-survey-finds

” Almost three-quarters of women in England start breastfeeding after giving birth but less than half are still doing so two months later, according to NHS and Public Health England data.

PHE recommends exclusive breastfeeding for the first six months, as does the World Health Organisation, because it boosts a baby’s ability to fight illness and infection. But a comparison of initial breastfeeding rates and those after six to eight weeks in the final quarter of 2015 found that they were 40% lower for the latter (44% compared with 73%).

A survey of 500 mothers commissioned by PHE found that fears about breastfeeding among women included that it could be painful (74%), prevent them taking medication (71%) and be embarrassing in front of strangers (63%).

The PHE’s chief nurse, Viv Bennett, said: “We can all help women feel comfortable breastfeeding their baby wherever they are. Creating a wider culture of encouragement and support will help make a mother’s experience all the more positive.”

PHE has launched an interactive breastfeeding friend chatbot, accessed through Facebook messenger, to provide personal support for breastfeeding 24 hours a day. Bennett said it would help women through the “crucial” initial period, after which things generally became easier.

A study published in the Lancet last year found the UK had the lowest rate of breastfeeding in the world, with only one in 200 women breastfeeding their children after they reach their first birthday.

The WHO recommends that breastfeeding form part of a baby’s diet up to two years of age. As well as reducing the likelihood of babies getting diarrhoea and respiratory infections, breastfeeding also lowers a mother’s risk of ovarian and breast cancer and burns about 500 calories a day.

The PHE survey found that many women were not only embarrassed about breastfeeding in front of strangers, but also their partner’s family (59%) and around siblings and wider family members (49%).

The results, published on Thursday, suggested high-profile figures who promote breastfeeding can have a positive influence on other mothers. Just under half of respondents said the example of household names such as The Only Way is Essex star Sam Faiers, broadcaster Fearne Cotton and actor Blake Lively, who have recently championed breastfeeding on social media, had inspired them to do so themselves. About two-thirds (64%) said they felt more confident to breastfeed in public because of celebrity mums.

Other concerns raised by more than half of women were not being able to tell if their baby was getting enough or too much milk and that it could potentially place restrictions on the mother.

Jacque Gerrard, the director for England at the Royal College of Midwives, said:Any initiative that goes towards helping mothers start and sustain breastfeeding for longer is positive as we know the health benefits from being breastfed last a lifetime.”

Breastfeeding and Medication

If you see breastfeeding mothers who need medication maybe you need to buy this book

https://www.amazon.co.uk/Breastfeeding-Medication-Wendy-Jones/dp/0415641063/ref=sr_1_1?ie=UTF8&qid=1489435817&sr=8-1&keywords=breastfeeding+and+medication

Training for Pharmacists

harmacists can access evidence based training for free  rather than read material which is non evidence based and developed by the formula industry

https://www.academia.edu/26421451/The_pharmaceutical_care_of_breastfeeding_mothers?auto=download

 

Pharmacists can be as guilty as doctors in being influenced by the companies and inadvertently pass on negative messages about breastfeeding as described in this article Education and training of healthcare staff in the knowledge, attitudes and skills needed to work effectively with breastfeeding women: a systematic review

There are days when I despair at the information provided by my fellow professionals about infant feeding. Come on guys do some CPD on supporting breastfeeding mothers – it is a health issue and can save the NHS millions of pounds a year let alone morbidity and mortality of mothers and children.

Breastfeeding is a natural ‘safety net’ against the worst effects of poverty … Exclusive breastfeeding goes a long way toward cancelling out the health difference between being born into poverty and being born into affluence … It is almost as if breastfeeding takes the infant out of poverty for those first few months in order to give the child a fairer start in life and compensate for the injustice of the world into which it was born.

JAMES P. GRANT, EXECUTIVE DIRECTOR OF UNICEF (1980-1995)

 

https://www.unicef.org.uk/wp-content/uploads/sites/2/2012/11/Preventing_disease_saving_resources.pdf

Blog – Breastfeeding for Dads and Grandmas

Blog Breastfeeding for Dads and Grandmas

Blog – why mothers medication matters

blog why mothers medication matters

The History of Child Nutrition

THE HISTORY OF CHILD NUTRITION OVER THE PAST 200 YEARS

Not exactly a factsheet but explains how we reached the point in support of breastfeeding

Codeine ( or co-codamol) and Breastfeeding

It seems that more people ask about the use of codeine than any other drug. The changes in guidance following the MHRA report in 2013 and 2015 seem to cause much confusion. We need to be aware as mothers that if we take codeine and our babies become sleepy (sleep longer or more frequently) then this is a sign that we may have the metabolism that concentrates the drug in breastmilk and should stop taking the drug. It takes 15 hours to be clear from the system but unless the baby shows signs of breathing difficulties it isnt a reason to panic . If there are breathing difficulties medical help should be sought urgently.

The oral bio availability of dihydrocodeine is 20% due to substantial first pass metabolism. The half life is quoted as 3.5-5h (Martindale). The metabolism of dihydrocodeine is not affected by individual metabolic capacity as the analgesic effect is produced by the parent drug compared to codeine which is a pro drug. Bisson DL, Newell SD, Laxton C, on behalf of the Royal College of Obstetricians and Gynaecologists. Antenatal and Postnatal Analgesia. Scientific Impact Paper No. 59. BJOG 2019;126:e115–24.

Opioids should only be used if paracetamol plus ibuprofen/naproxen/diclofenac are providing insufficient pain relief or are contra indicated.

Dihydrocodeine has a cleaner metabolism and as such is preferred as the opiate painkiller (It is known as co-dydramol when combined with paracetamol) . This generally requires a prescription. In some areas codeine is still prescribed to breastfeeding mothers, in others it is totally forbidden. In this fact sheet I have tried to provide the full research history so that you can make an informed decision about what is right for you and your baby. We should also be alert to the fact that codeine is very addictive to us as adults so longterm use unless under medical supervision should be avoided

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