Following on from the information on miscarriage I decided I needed to carry on talking about the hardest topics for mothers and think about the unthinkable – stillbirth, a baby born sleeping, and how to deal with the subsequent milk supply. I could fervently wish this never needed to be read but I hope that it provides information for mothers, families and professionals in this awful situation.
Constipation in the neonate is a topic apparently rarely discussed in medical sources and may be seen as the domain of the health visitor or midwife. However, many “constipated” babies may be seen by their GP and be the cause of concern for their parents.
This factsheet is designed to provide information for parents and their professionals on what is normal with regard to baby poo and where interventions are required be that referral to breastfeeding expert or medical treatment.
Turmeric is a supplement recommended for the relief of inflammation in many chronic conditions. It is, of course, a spice used in curries.
When taken as a supplement levels are significantly higher than those used for culinary purposes.
This is the information on compatibility with breastfeeding that I found in LactMed
https://www.ncbi.nlm.nih.gov/books/NBK501846/ (the emphasis is my own) :
Summary of Use during Lactation
Turmeric (Curcuma longa) rhizome contains curcuminoids such as curcumin. No data exist on the excretion of any components of turmeric into breastmilk or on the safety and efficacy of turmeric in nursing mothers or infants. Turmeric is “generally recognized as safe” (GRAS) as a food ingredient by the U.S. Food and Drug Administration. Turmeric is generally well tolerated even in high doses, but gastrointestinal side effects such as nausea and diarrhea, and rare allergic reactions have been reported, and it may increase the risk of bleeding in patients taking warfarin and antiplatelet drugs.
Because of a lack of data, turmeric in amounts higher than those found in foods as a flavoring should probably be avoided during breastfeeding.
Turmeric has been used as a galactogogue in India; however, no scientific data support this use. In Thailand it is reportedly used as part of a topical herbal mixture to shorten the time to full lactation and also part of a topical herbal mixture used for breast engorgement. Galactogogues should never replace evaluation and counseling on modifiable factors that affect milk production. In India turmeric is a component of a paste applied to the breasts for sore nipples. Contact dermatitis has been reported after contact of the skin with curcumin-containing products.
References from LactMed https://www.ncbi.nlm.nih.gov/books/NBK501846/
1.Sayed NZ, Deo R, Mukundan U. Herbal remedies used by Warlis of Dahanu to induce lactation in nursing mothers. Indian J Tradit Knowl. 2007;6:602-5.2.Chaudhuri RN, Ghosh BN, Chatterjee BN. Diet intake patterns of non-Bengali Muslim mothers during pregnancy and lactation. Indian J Public Health. 1989;33:82-3. [PubMed]3.Dhippayom T, Kongkaew C, Chaiyakunapruk N et al. Clinical effects of Thai herbal compress: A systematic review and meta-analysis. Evid Based Complement Alternat Med. 2015;2015:942378. [PMC free article] [PubMed]4.Ketsuwan S, Baiya N, Paritakul P et al. Effect of herbal compresses for maternal breast engorgement at postpartum: A randomized controlled trial. Breastfeed Med. 2018;13:361-5. [PubMed]5.Brodribb W. ABM Clinical Protocol #9: Use of galactogogues in initiating or augmenting maternal milk production, second revision 2018. Breastfeed Med. 2018;13:307-14. [PubMed]6.Amuthavalluvan V, Devarapalli J. Indigenous knowledge and health seeking behavior among Kattunayakan: a tribe in transition. Glob J Human Soc Sci. 2011;11. http://socialscienceresearch.org/index.php/GJHSS/article/view/198/161.7.Chaudhari SP, Tam AY, Barr JA. Curcumin: A contact allergen. J Clin Aesthet Dermatol. 2015;8:43-8. [PMC free article] [PubMed]
Collagen seems to be another frequent supplement I get asked about . Collagen is found in connective tissue and can be used during exercise routines but also in the prevention and treatment of wrinkles as well as to strengthen hair I believe.
There are no studies on passage into breastmilk and it would therefore be unethical for me to comment.
Elactancia however, designates it as very low risk:
“A fibrous-protein type which is a component of the mammalian connective tissue forming the attachment fibers of all tissues in the organism (bone, cartilage, tendons, skin, muscles, etc.). It represents one-third of total body’s protein content and is composed by amino acids.
Collagen has a great variety of medical, surgical, nutritional and industrial uses such as grafts, sutures, hemostatic products, subcutaneous implants and fillers, pill and capsule covering, glue and cement manufacturing, parts of musical instrument, cosmetic gels, food, photographic and pharmaceutical industry.
Collagen, because of its fibrous nature, is very difficult to chew and digest. To be used as a food it needs to be boiled and treated with various chemicals that break down the bonds and convert it into the so-called hydrolyzed, denatured collagen or gelatin, which is marketed as powder or tablets for various medicinal or health uses like arthritis, joint pains, weight loosing, anti-aging, strengthening of the hair or nails, improvement of the physical fitness and so on, all of them without any serious scientific basis that would guarantee effectiveness.(MedlinePlus Supplements 2015, Revenga 2015, EFSA 2013, EFSA 2011)
Since the last update we have not found any published data on its excretion in breast milk.
Because of a protein nature it is digested by the gastrointestinal tract and absorbed itself as a form of amino acids as those of any other meat. This prevents both the passage to breast milk as a hypothetical plasma absorption by the nursing infant.
Collagen as a supplement is not necessary at all whenever a healthy and balanced diet is followed. https://juanrevenga.com/2015/09/diga-colage-no-o-la-tonteria-de-los-suplementos-de-este-tipo/”
With the launch of a new beauty cream containing retinol advertised as reducing wrinkles, the questions about beauty products similar to it have increased. Or maybe we all just need something to cheer us up during Lockdown.
There is no research on the use of topical retinols and the best information I have sourced is “Because it is poorly absorbed after topical application, it is considered a low risk to the nursing infant” (Lactmed accessed June 2020 studies referenced below.)
Hale (Medications and Mother’s Milk accessed June 2020 states “Tretinoin is a retinoid derivative similar to Vitamin A. It is primarily used topically for acne and wrinkling and sometimes psoriasis. Used topically, tretinoin stimulates epithelial turnover and reduces cell cohesiveness. Blood concentrations measured 2-48 hours following application are essentially zero.
I have been unable to access the full papers and so would recommend caution
- Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006;24:167-97. [PubMed]
- Zip C. Common sense dermatological drug suggestions for women who are breast-feeding. Skin Therapy Lett. 2002;7:5-7. [PubMed]
- Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II Lactation. J Am Acad Dermatol. 2014;70:417.e1-417.e10. [PubMed].
- Zbinden G. Investigation on the toxicity of tretinoin administered systemically to animals. Acta Derm Verereol Suppl(Stockh) 1975; 74:36-40.
- Lucek RW, Colburn WA. Clinical pharmacokinetics of the retinoids. Clin Pharmacokinet 1985; 10(1):38-62