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My Story

this is the background to why I am so passionate about breastfeeding and drugs in breastmilk

Who am I and how did I come to set up this website?

Recently whilst writing the planned book (hopefully coming soon) I decided to update the section on the website about “Who Am I?” It is about how I came to have this passion and to write my books and the inspiration and support of my husband, my girls and my grandchildren.

I hope it explains a little more about what drives me to do this 18 hours a day 365 days a year.

Books to buy

Do you want to buy a copy of one of my books? They are all available on Amazon which is probably easiest. Or direct from the publishers Routledge, Pinter and Martin, or Praeclarus Press. I’m not going to available as much in the future to answer questions so maybe now is the time to buy the books so you have answers 24/7 365 days a year.

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Apple Cider Vinegar and Breastfeeding

Apple cider vinegar seems the “in” thing for weight loss at the moment, sipped in water and sometimes sweetened with honey. As the pandemic loosens it’s hold it seems that more breastfeeding mothers than usual are looking for an answer to weight loss.

There is no research data on whether it is safe in breastfeeding. It certainly isn’t something I would advocate: not least because there is no evidence, that I found, that it’s effective for weight loss although culinary use is unlikely to be an issue. Back to less in, more out – healthy eating and exercise – sigh!

I would NOT advocate this for any breastfeeding mother – or anyone else for that matter

I found this link interesting https://www.health.harvard.edu/blog/apple-cider-vinegar-diet-does-it-really-work-2018042513703?fbclid=IwAR037-joCZ_XbvfuIv48c3cGekHN6e35U1kP618RLh5tnJ5A-42Q_A5ZL7c from Robert H. Shmerling, MD
Senior Faculty Editor, Harvard Health Publishing. His words not mine:

What is the apple cider vinegar diet?

Apple cider vinegar comes from apples that have been crushed, distilled, and then fermented. It can be consumed in small quantities or taken as a supplement. Its high levels of acetic acid, or perhaps other compounds, may be responsible for its supposed health benefits. Although recommendations for “dosing” vary, most are on the order of 1 to 2 teaspoons before or with meals.

What can the apple cider vinegar diet do for you?

For thousands of years, compounds containing vinegar have been used for their presumed healing properties. It was used to improve strength, for “detoxification,” as an antibiotic, and even as a treatment for scurvy. While no one is using apple cider vinegar as an antibiotic anymore (at least, no one should be), it has been touted more recently for weight loss. What’s the evidence?

Studies in obese rats and mice suggest that acetic acid can prevent fat deposition and improve their metabolism. The most widely quoted study of humans is a 2009 trial of 175 people who consumed a drink containing 0, 1, or 2 tablespoons of vinegar each day. After three months, those who consumed vinegar had modest weight loss (2 to 4 pounds) and lower triglyceride levels than those who drank no vinegar. Another small study found that vinegar consumption promoted feeling fuller after eating, but that it did so by causing nausea. Neither of these studies (and none I could find in a medical literature search) specifically studied apple cider vinegar.  A more recent study randomly assigned 39 study subjects to follow a restricted calorie diet with apple cider vinegar or a restricted calorie diet without apple cider vinegar for 12 weeks.  While both groups lost weight, the apple cider vinegar group lost more.  As with many prior studies, this one was quite small and short-term.

In all, the scientific evidence that vinegar consumption (whether of the apple cider variety or not) is a reliable, long-term means of losing excess weight is not compelling. (On the other hand, a number of studies suggest that vinegar might prevent spikes in blood sugar in people with prediabetes and type 2 diabetes by blocking starch absorption — perhaps that’s a topic for another day.)

Is there a downside to the apple cider vinegar diet?

For many natural remedies, there seems to be little risk, so a common approach is “why not try it?” However, for diets with high vinegar content, a few warnings are in order:

  • Vinegar should be diluted. Its high acidity can damage tooth enamel when sipped “straight” — consuming it as a component of vinaigrette salad dressing is a better way.
  • It has been reported to cause or worsen low potassium levels. That’s particularly important for people taking medications that can lower potassium (such as common diuretics taken to treat high blood pressure).
  • Vinegar can alter insulin levels. People with diabetes should be particularly cautious about a high vinegar diet.

So what?

If you are trying to lose weight, adding apple cider vinegar to your diet probably won’t do the trick. Of course, you’d never suspect that was the case by the way it’s been trending on Google health searches. But the popularity of diets frequently has little to do with actual evidence. If you read about a new diet (or other remedy) that sounds too good to be true, a healthy dose of skepticism is usually in order.

Products to support hair growth/ thickness

It is normal during lactation to notice that your hair becomes thinner or may even appear to drop out in significant levels. In pregnancy we grow more hair and the apparent loss is usually just a return to normal.

It may however, be a sign of thyroid deficiency so always worth checking with your doctor and requesting a blood test to check levels, just in case.

Most of the commercially available products which claim to thicken, strengthen, promote growth of hair contain biotin in addition to the normal vitamins and minerals.

Symptoms of biotin deficiency include thinning hair, skin rash, and depression. The recommended daily dose of biotin for a lactating woman is 35 µg/day. Levels of biotin in human milk range from 5 to 9 µg/L, indicating that there is active transport of biotin into milk. No adverse effects have been found. (Hale Medications and Mother’s Milk)

Biotin (vitamin B7) is needed in very small amounts to help the body break down fat. The bacteria that live naturally in the bowel synthesise biotin, so it’s  unclear whether supplements are necessary if a varied and balanced diet is eaten.. Biotin is also found in a wide range of foods, but only at very low levels. There’s not enough evidence to know what the effects might be of taking high daily doses of biotin supplements. Taking 0.9mg or less a day of biotin in supplements is unlikely to cause any harm. ( NHS Vitamin B https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/)

Vitamin and Mineral content compatible with breastfeeding https://breastfeeding-and-medication.co.uk/fact-sheet/breastfeeding-and-multivitamin-and-mineral-supplements

Dihydrocodeine and breastfeeding

I keep being asked about strong analgesics in breastfeeding. Lots of people seem unaware that codeine and dihydrocodeine sound similar but do not have the same risk in breastfeeding. Although many babies dont exhibit drowsiness when exposed to codeine during breastfeeding, dihydrocodeine is preferred.

This explains why:

The analgesic effect of dihydrocodeine appears to be mainly due to the parent compound. The oral bio availability of dihydrocodeine is 20% due to substantial first pass metabolism. The half life is quoted as 3.5-5h . It is metabolised in the liver by CYP2D6 to dihydromorphine, which has potent analgesic activity. However, the CYP2D6 pathway only represents a minor route of metabolism, with other metabolic pathways being involved.

The metabolism of dihydrocodeine is not affected by individual metabolic capacity as the analgesic effect is produced by the parent drug compared to codeine which is a pro drug.

Dihydrocodeine may be the preferred weak opioid for postoperative use in the breastfeeding woman, because of its cleaner metabolism compared with codeine and wide experience of use after caesarean section

Caffeine and Breastfeeding

Several questions have come up recently about caffeine intake and breastfeeding. With spending more time indoors we are probably all drinking more caffeinated beverages.

Most of us drink caffeine in one form or another. Women who drink a significant amount of caffeinated drinks who notice that their babies are jittery and restless, may find reduction in caffeine consumption leads to resolution of symptoms. This does not mean that all breastfeeding women need to restrict their consumption of tea and coffee A baby who appears restless may benefit from lowered caffeine intake by the mother but for the average consumption there is little evidence to support restricting intake. From research maternal consumption below 300 milligrammes a day should not cause issues for breastfed babies.

Extract reproduced from Breastfeeding and Medication 2018 by Jones W (Routledge, London)

Congratulations Crohns and Colitis UK

Congratulations @CrohnsColitisUK for @PPAScotland award for cover of the year 2019. Normalising breastfeeding despite chronic condition requiring medication. I’ve had this horrible condition since 1976 but stayed well compared to many mums. www.facebook.com/groups/BreastfeedingIBD/

Royal Pharmaceutical Society

really proud to be mentioned by the Royal Pharmaceutical Society today

#wearepharmacy

Breastfeeding and anesthetics study

This is the e poster presentation I spoke about at the iHV conference in Manchester yesterday. Why do we treat women who are breastfeeding but need surgery differently to the ones undergoing a c section? Interrupt breastfeeding, no support with pumping, difficulties storing expressed breastmilk, negative comments. If you are infant feeding advisor do you know what happens on the surgical wards at your hospital? Can you do some training?

Hoping to turn this into a paper and publish