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Although we now try very hard to avoid prescribing antibiotics unless essentail ( because of the risk that in the future we wont have antibiotics which are as affective against all infections), sometimes they are necessary. The use of antibiotics during breastfeeding often causes disquiet because most of them cause the baby to have loose bowel motions, sometimes tummy cramps, and sometimes vomiting. Is continuing to breastfeed actually causing harm and should feeding be interupted? Do we need pre biotics and probiotics to redress the balance in the baby’s gut?
It is hard to watch a baby in distress but it is important to remember that when we breastfeed during an infection we are also passing antibodies to that infection in breastmilk to protect the baby. Breastmilk contains all the factors to redress the balance and return the baby’s gut to its normal state far better than any probiotics derived from other sources.
But the ultimate choice is that of the breastfeeding mother.
I hope that the information in this factsheet helps make that decision. Please email me if you want to discuss anything : firstname.lastname@example.org
When I was working as an independent pharmacist prescriber my main role was to look at primary prevention of cardio vascular disease – identifying factors which raised the risk of people to have a heart attack or stroke in the next 10 years. I used an online calculator using various data like BMI, smoking status, blood pressure and cholesterol ( https://qrisk.org/three/). I didnt see many breastfeeding patients and we concentrated on the over 50s. But in the process I learned a lot about managing weight and encouraging a healthy diet and portion size, smoking cessation and control of cholesterol. In many cases we managed to reduce the risk with lifetyle changes.
It seems that mothers may now have their cholesterol measure and advised that it is too high. I had 20 -30 minute appoitments to encourage lifestyle change. This isnt possible for GPs with pressures on appointments so often the mothers are offered medication to reduce cholesterol. Until recently the only drug compatible with breastfeeding was cholestryamine. This is fine if there isnt a history of familial hypercholesterolaemia and a much higher risk of a cardio vascular event.
A colleague pointed me to some data on elactancia which had a very different list of references and information on cholesterol in standard artificial formula. Thus began a journey to this factsheet over the past couple of months. It isnt a recommendation, as there are currently no studies on the use of statins during breastfeeding nor the effect on the baby . However, it looks at an evidence base which can prompt discussion with clinicians. I hope it helps.
My thanks to Sam Morris and Amanda Da Costa for their knowledge and support as pharmacists and breastfeeding helpers on the BfN Drugs in Breastmilk Information Service
Many women are aware of the symptoms of bacterial vaginosis – an unusual vaginal discharge that has a strong fishy smell, particularly after sex. However, treatment can cause more confusion. I hope this factsheet clarifies the symptoms, self help and treatment during breastfeeding.
Although it is rare for a young woman to experience a heart attack, transient ischaemic attack or stroke, it does happen. They are usually prescribed anti-platelet drugs and until recently we found difficulty in providing information. However, this is the most up to date information which I have sourced and hope it helps anyone in this most difficult position.
17 November 2021 World Prematurity Day. Sharing the chapter on premature birth and breastfeeding from Breastfeeding and Chronic Medical Conditions. I know there is so much more to add still and I will be writing more over the next few months
Following on from the data on the menopause and braestfeeding, I know many women are advised to limit the duration of breastfeeding in order to protect their own bone density. This sadly often shows a mis understanding of breastfeeding and its importance to the ongoing health of mother and child.
I hope this information taken from Breastfeeding and Chronic Medical Conditions helps
please email me email@example.com if you need more information
I’m seeing increasing numbers of questions form mums in the perimenopause who are still breastfeeding. Maybe they delivered later or maybe they have been feeding to term or maybe lots of other reasons. I remember asking for blood tests to check my hormone levels because I just couldnt think clearly anymore and my memory was poor which wasnt ideal as I was just becoming an independent pharmacist prescriber! My levels had indeed dropped and I went on to HRT. This may not be everyone’s choice or be suitable for them
I have spent many hours this year looking for guideance on HRT and breastfeeding and failed to find any studies or conclusive data. Everything is anecdotal at the moment but I hope this information helps.
As usual please message me on firstname.lastname@example.org if you have a question
I am all too aware of the gaps which many professionals find in their knowledge after training. That is why we all need to undertake CPD. I have written this brief introduction for midwives who see mothers during their pregnancy and after delivery. Midwives are often more accessible than medics, they may be seen as more approachable, they care about as well as for, women throughtout their career, they help to train junior doctors. So I hope this will help them to understand more about how drugs pass into breastmilk and where to seek more information if needed. Happy to provide training via Microsoft Teams if you wish and to answer any emails. Wendy@breastfeeding-and-medication.co.uk.
Hope this is useful but please feedback if you need more, less, more details, any changes. And dont for get the books!
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.