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What do women want healthcare professional to know about the needs of the perinatal mum with mental health challenges?
I have tried to get this paper published but have failed because I am not associated with a university, have any means of applying for ethics approval or can pay – so sharing it freely in the hope that the voice of the mothers are widely heard.
not a comon conditioon and easy to feel you are alone . Hope this helps. It’s a chapter from my book Breastfeeding and Chronic Medical Conditions
This article was published in the Pharmaceutical Journal June 2021 https://pharmaceutical-journal.com/article/ld/how-to-advise-women-on-the-safe-use-of-medicines-while-breastfeeding but I feel is too important not to be readily available for professionals. It should be part of the what mothers want professionals to know about breastfeeding series. So I have adapted it slightly to be in a pdf format so it can be used more easily
If you use this information please do consider buying Breastfeeding and Medication
I’ve made no secret of the fact that I developed Crohns disease identified back in 1976 when I was just 22 years of age. It has had a massive impact on my life – lots of hospital admissions, 3 bowel resections, lots of medication. It indirectly led to me developing peripheral vascualr disease so that at one time I could only walk 40 yards without pain. It also was responsible for a malignant melanoma which luckily was caught before it spread. It has also affected my liver and spleen so as you can understand it is a big part of my life. But on the positive side it was what caused my passion for breastfeeding as I was nevr fitter than when I was pregant or breastfeeding.
I have attempted to pull all the information on diagnosis, treatment, live vaccines etc into one place into this rather large factsheet (almost a book) which I hope will help professionals support mums using evidence based information.
I have already recorded a video presentation as a facebook live https://breastfeeding-and-medication.co.uk/live-video-2/inflammatory-bowel-disease-and-breastfeeding-facebook-live but am happy if you want me to present to a team – professionals, mothers with IBD. Just message me email@example.com
There is also a facebook page https://www.facebook.com/groups/BreastfeedingIBD with 1.4k members from all round the world.
Hope this helps everyone to use the evidence from research to support breastfeeding mums with IBD. It is a disease I wouldnt wish on my worst enemy and it is hard to deal with when you have young children. Be kind and supportive! #dontsaystoplookitup
Another chapter from my book Breastfeeding and Chronic Medical Conditions today on the treatment of migraines which affect so many people. Migraines are miserable, when you have to continue to deal with a baby or toddler or older child and cant go and sleep in darkened room they can break the best. This factsheet goes through some of the treatments for breastfeeding including sumatriptan. Hope it helps. Maybe time to buy the very reasonably priced book available from Amazon ? https://www.amazon.co.uk/Breastfeeding-Chronic-Medical-Conditions-Wendy/dp/B08HTG6LBK/ref=sr_1_1?dchild=1&keywords=breastfeeding+and+chronic+medical&qid=1622820951&sr=8-1
I am very proud to support all the breastmilk banks in the UK who provide milk to mothers of neonates. I was intensely grateful just over a year ago when my youngest grand daughter was born early, weighing just 3 and a half pounds. My daughter had fed 2 other children and like me is passionate about exclusive breastfeeding. However, she was exhausted trying to pump and stimulate her supply for our little wee scrap to keep her blood sugars up. She was given the gift of a small volume of donated breastmilk which took the pressure off for a few hours to allow her to sleep. Of course this was all during the height of the pandemic and she was seperated from her husband and children. She described it this way: ” It was if the donor mums were holding both of us safe, they were feeding my baby for just a few hours whilst I regained my strength. I can never thank those mums enough for that relatively small amount of milk (24ml), which was worth so, so much to me. By the following morning I had enough milk to provide the supplements through the NG tube“
Milk from donating mothers has to be free of medication which might affect the health of the tiny, vulnerable pre-term. I have drawn up this list but it seems to change regularly . Thank you to every mum who makes the precious donation of breastmilk
In the final of the sheets on antidepressant / anti anxiety SSRIs is fluoxetine. It is often looked on as the least compatible with breastfeeding because of its long half life and greater passage into milk. However, it is often used in pregnancy because there are a significant number of studies https://www.medicinesinpregnancy.org/Medicine–pregnancy/Fluoxetine/. What is perhaps less well known is that if a mother has taken it throughout pregnancy the baby MAY be very drowsy in the first few days after delivery as it withdraws from the higher levels achieved through placental transfer.
My recommendation for any mother taking fluoxetine during pregnancy and wishing to breastfeed is to learn hand expression in preparation https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfeeding-resources/hand-expression-video/ and to maybe discuss antenatal expression of colostrum with the midwife, just in case the baby is sleepy and taking time to latch effectively. Colostrum can raise blood sugars in very small amounts. (This is really helpful info for the red flags of low sugar and in my opinion explains everything well https://www.guysandstthomas.nhs.uk/resources/patient-information/maternity/protecting-your-baby-from-low-blood-glucose.pdf)
So you can breastfeed after delivery if you have taken fluoxetine but you may need a little help and support. Seek this antenatally so you are well prepared.
I would also add that if fluoxetine has been the SSRI that you have used and found effective in the past, then that would make it the first choice in breastfeeding. Some babies are colicky, some are drowsy, some vomit, some have loose diarrhoea – but we cant tell in advance.
I remember the very first study I looked at on fluoxetine some 25 or more years ago that the mother and the baby’s paediatrician thought the baby hadnt changed behaviour when exposed to fluoxetine via his mother’s breastmilk. The baby’s father (also a paediatrician) perceived it as more irritable and on that anecdotal basis back then it was said that fluoxetine made babies irritable. I cant find the report any more but if we had been able to see into the family unit we may have seen a dad trying to help his partner whilst working and feeling stressed himself. Who knows?
I hope this information is useful to anyone taking fluoxetine whilst breastfeeding
A question which is coming up very frequently just now is the use of cyclogest pessaries in pregnacy for mums who are still,breastfeeding. So to save me keep typing ( and to help you, of course) here is the information.
Sadly the incidence of post natal depression and anxiety has increased and even doubled during the pandemic http://New mothers twice as likely to have post-natal depression in lockdown and we know that many find it hard to go to see their doctor or fear that they will be told to stop breastfeeding to take medication. Some prefer a more natural, herbal remedy and will purchase St John’s Wort. This is the information on the compatibility of hypericum with breastfeeding. If you want to discuss your medication and suitability please email me on firstname.lastname@example.org .
I’m really saddened that so many mothers are recommended to stop breastfeeding in order to be treated with medication. There is some evidence that breastfeeding in itself protects the mother
I hope that this factsheet provides some alternatives. The information is taken from Breastfeeding and Chronic Medical Conditions – price reduced so worth buying a copy on Amazon