Having had to support a mum with a fracture this week told that she could have adequate analgesia or breastfeed but not both I have decided to cut this out if the anaesthesia document so that it stands alone. I continue to be frustrated by the lack of understanding of professionals about normal breastfeeding let alone term or extended breastfeeding even where this is below the 2 years recommended by WHO. I’m going to keep on supporting mothers to challenge poor information using the hashtag #usetheevidence. In 2008 NICE issued a recommendation about using specialist sources on the safety of drugs in breastmilk and not relying on the licensing of drugs whereby virtually no medicine can be prescribed to a lactating mother. Buy a specialist text Breastfeeding and Medication!
Who is the target population?
Hospital doctors, GPs, obstetricians, pharmacists, specialist nurses, dentists and PCT medicine management teams.post op analgesia
Who should take action?
What action should they take?
- Ensure health professionals and pharmacists who prescribe or dispense drugs to a breastfeeding mother consult supplementary sources (for example, the Drugs and Lactation Database [LactMed] or seek guidance from the Specialist Pharmacy Service.
- Health professionals should discuss the benefits and risks associated with the prescribed medication and encourage the mother to continue breastfeeding, if reasonable to do so. In most cases, it should be possible to identify a suitable medication which is safe to take during breastfeeding by analysing pharmokinetic and study data. Appendix 5 of the ‘British national formulary’ should only be used as a guide as it does not contain quantitative data on which to base individual decisions.
- Health professionals should recognise that there may be adverse health consequences for both mother and baby if the mother does not breastfeed. They should also recognise that it may not be easy for the mother to stop breastfeeding abruptly – and that it is difficult to reverse.
I’m trying to build fact sheets on the drugs I am most frequently asked about. One that comes up frequently is propranolol to prevent migraines, to relieve anxiety and to remove symptoms of over active thyroid. Propranoolol can be used by breastfeeding mothers so long as they are not asthmatic.
Lots of people seem to be interested in using CBD oil for chronic pain and/ or for anxiety. Sadly there is no research on the amount that passes through into breastmilk so I am unable to say whether it is safe for a breastfeeding mother to take or not at this time.