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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

breastfeeding and mental health

Recorded Facebook live for Perinatal Mental Health Partnership this week
www.facebook.com/PerinatalMHPartnershipUK/videos/826557897700531/

Evaluation of Drugs in Breastmilk Service

Most people know that I provide information to mothers and professionals on the use of drugs in breastmilk. The service was recently evaluated by Prof Amy Brown and team. I am staggered and humbled by the results. It seems that the small fishes that I rescue every day are becoming a huge tide of knowledge and empowerment

Please read the full report
https://breastfeedingnetwork.org.uk/wp-content/pdfs/BfN%20Final%20report%20.pdf?fbclid=IwAR2Ky4oAr_qYz9j2lqwPEULrOLoVOslxWIrQJkCwnnR4Slcl1_PMPNcd9Ww

Breastfeeding and Certolizumab pegol (Cimzia)

Certolizumab pegol is anti TNF alpha drug used to treat rheumatoid arthritis, Crohn’s disease, psoriatic arthritis, and ankylosing spondylitis. What makes it different is that it is the first drug I can remember which has been licensed for use in pregnancy and in breastfeeding. This means that the manufacturer in applying for marketing authority has accepted that it is safe. www.medicines.org.uk/emc/product/7387/smpc

Recently I have found myself suggesting it to mothers who are at the point of needing methotrexate to control their symptoms and therefore needing to stop breastfeeding.

I have to congratulate the manufacturer UCB Pharma on taking this very positive step and hope others follow suite. Please note I have no links financial or otherwise with them.

This is the study

CRADLE study

A very special day in my life

AOn Friday March 22nd I had one of the most wonderful, magical days of my life – I was presented with my MBE by Her Majesty the Queen at Windsor Castle. I was lucky enough to have all 3 of my amazing daughters and my wonderful husband there to share it with me as they have shared my journey.

Lots of people asked me in the week up to the Investiture if I knew which member of the Royal Family would be performing the ceremony. I didn’t know until about 5 minutes before I entered the Castle when one of the members of staff told me – tears immediately sprang to my eye (why did I use mascara!). This was beyond my wildest dreams as I am a Royalist and have been hoping that this would happen. I knew Prince Charles was abroad and that Prince William had presided over one earlier in the week but wasn’t quite sure. Only 2 Investitures a year are held in Windsor Castle so that in itself was a privilege. We were booked into a hotel literally opposite the Castle and it seemed unreal as I woke up on Friday that in a few hours I would be inside with all the magical pomp and ceremony that Great Britain does so well.

We drank champagne in our room that morning with our 3 wonderful daughters Kerensa, Beth and Tara who had travelled to be with us and with 2 sons in laws as well as Isaac and Elodie (and Tara’s bump!). The other 2 grandchildren were at school.

We joined the queue of people awarded honours and their families to enter the Castle at 9.45 and were directed up through the grounds which I had watched during the wedding of Meghan and Prince Harry. To see the history unravelling before us as we entered through this beautiful building and to see the wonderful art was quite spell binding.

I was directed into a room with other nominees to mingle and drink apple juice. All the staff were so supportive and kind, no doubt used to witnessing the nerves. I met several people from Hampshire and listened to their stories but what struck me was how “ordinary” everyone was, all of us still astonished to have been given the awards. Mine was for services to mothers and babies. We were given clear instructions on the ceremony and how to bow or curtsey as well as address Her Majesty, we filed nervously through rooms to the Waterloo Room where we were to receive our medals.

As I stood there, I tried to take it all in, that I had come to be here seemed truly amazing. I just follow my dreams and do what means the world to me which is help mums and babies continue their breastfeeding relationship when mum needs medication short or long term.

I managed my curtsy and approached the Queen who smiled encouragingly at me and asked about my role. She even laughed at my description of what I do and commented that it must be very interesting. She held out her hand to shake mine and I walked backwards to curtsy again and leave. My moment was over but will be etched in my memory for all time. I even got to say “breastfeeding” to the Queen!

We had professional photographs taken and took others outside which I will share with you

Thank you to everyone who supports what I do, those who signpost, mums who find their way here and professionals too who try so hard to provide information.  Mary Broadfoot and Phyll Buchanan who made this all possible initially and who encouraged me. BfN for continuing to support me. Last but very much not least my family who listen support, encourage me and take on my passion too, This has been an amazing journey for me, and I feel humble and proud to have been awarded this decoration. I won’t be stopping the work anytime soon. Wendy