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.
Codeine should only be used if paracetamol and 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 (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
Delighted to see the second of my babies published – UK and US versions and Kindle edition
Many mothers take norethisterone to delay periods before holidays or even their wedding. Others use it to stop heavy bleeding and wish to continue to breastfeed
This is a blog which I wrote for the new Human milk page Tailor made for Tiny Humans http://human-milk.com/
Wendy Jones Blog – Breastfeeding for Dads and Grandmas
I’ve just spent the Christmas holidays with my daughters, their partners and 3 grandchildren, two of whom are still being breastfed (21 months and 6 months). Having just had a new book published called Breastfeeding for Dads and Grandmas it made me think how different our holidays were in a very pro breastfeeding family than they might be in other families?
The son in law who has yet to have children, is totally comfortable with sitting next to his sisters in law as they breastfeed (on occasion let it all hang out!) and has been immeasurably supportive to his own sister. She was going to “give breastfeeding a go” but is now as committed as our family and doesn’t understand why anyone would feed in any other way.
However, the number of emails and Facebook messages from mothers suffering from anxiety since Christmas has reached unbelievable levels – on average 3 a day every day. Why might that be I wondered?
I suspect that for many other mothers spending longer than usual in close proximity to the extended family can be stressful. The emotions seem to run at fever pitch in the Festive Season – everyone wants it to be perfect. Most of us spend too much, eat too much, drink too much, don’t exercise as much and generally suffer from “liverishness” as my Grandma used to term it (usually with an added “everyone could do with a good dose of syrup of figs!”).
Nevertheless in this hot pot of emotion, parents try to manage their babies needs for quiet to feed or sleep, not to be cuddled by Great Aunt Ethel when they want Mum, don’t want to eat the rich offerings of solids suitable for babies (really?).
Inevitably the subject of infant feeding gets raised at some point during the visit. In our very pro-breastfeeding house the mums were supported. But what if you are with mother-in-law who formula fed your partner and makes no secret of her distaste of breastfeeding? How does your partner feel? How do you feel/ Desperate to keep the peace he might seem to agree with his mother. Neither of you wants to get into an argument but you are both secure in your decision to breastfeed. It is difficult isn’t it? If the baby cries you hear the comment “is he hungry again? Your milk can’t be good enough”. You are feeding quietly “what again? Surely you can’t have enough milk”. Feeding late at night/overnight/co-sleeping “When my children were babies they were in bed by 6pm and we didn’t hear from them again till 8am”. And Heaven forfend that you should dare to continue breastfeeding into toddlerhood!
It is no surprise that come January these new mums are anxious and more than a little depressed. Being a mum isn’t easy, these babies don’t read the books and don’t abide by any rules. Each baby is an individual and will reach his/her milestones in their own sweet time. Cherish every milky moment, every snuggle, every smile as all too soon they will grow up. When you feel that someone is criticising you smile sweetly, acknowledge the comment but then LET IT GO. This is your baby, you make the decisions. The advice on timing of feeds, weaning, sleeping has all changed dramatically in the fast 35 years (I know because I have been a mum in this time and gone on to support lots of others). It’s ok to breastfeed for comfort as well as nutrition, there is no such thing as using the nipple as a dummy, it is ok to co sleep if you want, it’s equally ok not to if you choose, it is also ok to ignore the advice of your mother, mother in law or Great Aunt Ethel!
Oh, cleaning and scrubbing will wait till tomorrow,
But children grow up, as I’ve learned to my sorrow.
So quiet down, cobwebs. Dust, go to sleep.
I’m rocking my baby. Babies don’t keep.
Song for a Fifth Child (Babies Don’t Keep)
by Ruth Hulburt Hamilton