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Pain relief when breastfeeding
It is not acceptable to leave any mother in pain because she is breastfeeding nor to suggest that she could have more effective pain relief if she stopped breastfeeding.
I’m often asked about the safety of opioids during breastfeeding so this is a really interesting study
Despite opioids being used first line in emergency settings to treat severe acute extremity pain, there is limited evidence available to inform this practice.
In a study in JAMA (7 November 2017), researchers randomly assigned 416 patients in the emergency department with moderate-to-severe acute extremity pain to one of the following groups: 400mg ibuprofen/1000mg paracetamol; 5mg oxycodone/325mg paracetamol; 5mg hydrocodone/300mg paracetamol; or 30mg codeine/300mg paracetamol[1].
https://jamanetwork.com/journals/jama/article-abstract/2661581?redirect=true
I have written this powerpoint presentation which I hope explains the analgesic ladder and helps professionals to understand the compatibility of analgesics and braestfeeding
- Paracetamol or NSAID
- Paracetamol + NSAID
- Paracetamol+NSAID+Opioid (at the lowest possible dose for the shortest possible time co prescribed with a laxative)
Analgesics and breastfeeding Powerpoint
see also https://www.breastfeedingnetwork.org.uk/analgesics/
https://breastfeeding-and-medication.co.uk/fact-sheet/dihydrocodeine-and-breastfeeding
https://breastfeeding-and-medication.co.uk/thoughts/breastfeeding-and-codeine
https://breastfeeding-and-medication.co.uk/fact-sheet/migraine-treatment-and-breastfeeding
The substance exposed infant
This is an adapted version of a training powerpoint I gave some time ago. I plan to record it over the next few weeks and will upload it to my You Tube channel.
But hope it helpsin the meantime. Happy to answer any questions wendy@breastfeeding-and-medication.co.uk
Breastfeeding and the substance exposed infant

Providing effective, evidence based support for breastfeeding women in primary care
I was only involved in preparing one table of this article but it deserves to be widely shared as an excellent model of support for breastfeeding by all in primary care – doctors, nurses and pharmacists
BMJ article providing effective, evidence based support for breastfeeding women in primary care
Identifying the cause of breast and nipple pain during lactation
so proud and delighted to have worked with Lisa, Carmella and Jane over the past year to have this published in the BMJ today. To find out different practices across the world has been fascinating but I so hope this informs clinical practice
Identifying the cause of breast and nipple pain during lactation

Perinatal mental health and Breastfeeding
I have recorded the presentation which I have frequently given about perinatal mental health and breastfeeding. It should be used after listening to ” How drugs get into milk”
How do drugs get into breastmilk?
as it contains the pharmacokinetic data of drugs prescribed for perinatal mental health including SSRIs, anti anxiety medication and anti psychotics. It also includes research studies about the links between mental health and breastfeeding.
I hope this may increase prescriber’s knowledge as well as empower peer supporters and parents.

Anaesthesia and breastfeeding
I have been working with a small team of anaesthetists for some time to develop guidelines so that breastfeeding mothers can have surgery, pain relief etc and continue to breastfeed as normal. The guideline also recommends support for the mother in terms of pumps, information and her baby nearby – not necessarily in that order.
As we begin World Breastfeeding Week 2020 I am proud to share this guideline and infographic
Guideline on anaesthesia and sedation in breastfeeding mothers https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15179
Infographic guideline on anaesthesia and sedation in breastfeeding women


Lack of stools / constipation in a breastfed baby
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.
Lack of stool/constipation in the breastfed baby

Pharmacokinetics and Passage of Drugs into Breastmilk
This is a set of slides I use in many of my current presentations. It also forms the backbone of most decision making. I hope it helps increase your education. If you wish please email me wendy@breastfeeding-and-medication.co.uk
Pharmacokinetics of the passage of drugs into breastmilk training powerpoint
If you found this useful, maybe you need to buy the book – a good investment !

Candida (thrush) on the breast of breastfeeding mother training powerpoint
This is the presentation I have given most frequently since I co-authored the first thrush leaflet back in around 1999. I hope this helps some of the mis information eg it can be on one breast, thrush means painful feeds, all white tongues in babies are thrush
If you have any questions pleas email wendy@breastfeeding-and-medication.co.uk
Thrush and breastfeeding training powerpoint

Mastitis and Breastfeeding
This is one of the presentations I have given most frequently over the last 20 years since I co wrote the first leaflet for BfN. One of the most common complications of breastfeeding but so little understood. I hope this helps the onging learning of professionals, peer supporters and all those supporting breastfeeding.
Breastfeeding and Mastitis Training
