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A very special day in my life – awarded an MBE and presented with it by Her Majesty The Queen

On 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

Botox and Fillers and Breastfeeding

From my aged viewpoint having botox and fillers whilst breastfeeding feels odd. It would never have occurred to me but I’m trying not to sound old fashioned!

There is no published research that I have been able to find and trust on the passage of fillers into milk so I cant say that they are safe or unsafe. I just do not know.

There is some information from one mother who caught botulism from eating fermented salmon eggs. She continued to breastfeed. No botulinum toxin or botulism was found in the breastmilk or the baby. The doses that are used medically are far lower than that which would have caused the mother’s botulism so the amount in breastmilk is assumed to be too low to produce adverse effects.

Both these cosmetic procedures have to be undertaken with this limited information in mind. It is your choice and I am not making any recommendations.

References
1. Lee KC, Korgavkar K, Dufresne RGJ et al. Safety of cosmetic dermatologic procedures during pregnancy. Dermatol Surg. 2013;39:1573-86.
2. Middaugh J. Botulism and breast milk. N Engl J Med. 1978;298:343.

Detox products and Breastfeeding

I am often asked about products, usually herbal, to detox and about breastfeeding afterwards. In general these products contain a combination of herbal laxatives and at least one diuretic . Basically the result is to make you pass more urine and develop diarrhoea to “cleanse” the system and usually to lose weight. There is a large risk that in doing so your milk supply will diminish too.

The data on the safety of the herbs in breastfeeding is often poor. I cannot provide data that these products are either safe to use and feed as normal or that they are unsafe – there is just is not enough data that I would be confident in using. Therefore I cannot help with information. The decision has to be your own or on the recommendation of a qualified herbalist who is willing to take professional responsibility.

Cannabis and Breastfeeding

Cannabis use on a regular basis by breastfeeding mothers concerns me. Cannabis has a long half life (25-57 hours) and it takes 5 times this to be removed from milk. THC crosses the blood brain barrier and it is known to accumulate in body fats. Although it is highly protein bound and subject to first pass metabolism, the milk plasma ratio is 8. We do not know enough about the impact on the developing brain to be sure that the amount passing through breastmilk is safe. Regular use is not recommended in the breastfeeding mother or other members of the family who may expose the baby through passive inhalation.

Breastfeeding and Cannabis factsheet

Bowel cleansing before colonoscopy and breastfeeding

Just recently I have been contacted by several mothers who were told that they cant breastfeeding during the 24 hour period of bowel prep prior to a colonoscopy or for 24 hours following the procedure under sedation. This is not supported by research and understanding of the pharmacokinetics of the drugs used. It is also a potential risk in that the mother may develop blocked ducts or mastitis necessitating antibiotics if she is unable to express her milk, or in many cases hasn’t been advised to! Not all babies will drink from a bottle so may become dehydrated. Some babies are allergic to cow’s milk protein and may be compromised by 3 days of artificial formula. Hence this fact sheet on the bowel preparations generally used.

It is acceptable to breastfeed as normal during bowel prep. The mother should drink freely of the allowed clear fluids. Someone may be needed to look after the baby during rapid need to evacuate bowels – unless you have taken these products you cant begin to understand the urgency!

Bowel prep and breastfeeding factsheet

Midazolam as a sedative for procedures in breastfeeding mothers

The reason I write these factsheets is in response to the questions which are posed to me on social media. I have included the use of midazolam in fact sheets on colonoscopy, endoscopy and dental sedation on information on the Breastfeeding Network but still mothers are told that they need to delay procedures, are only allowed gas and air during the procedure or must stop breastfeeding for 24 hours. The latter is recommended by the manufacturers but since the half life is 3 hours it is all gone from the mother’s body and therefore her milk within 15 hours. However, looking at the pharmacokinetics of midazolam use as a single dose sedative is not a contra indication to normal breastfeeding as confirmed

Guideline on anaesthesia and sedation in breastfeeding: https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.15179

“Midazolam: extensive first-pass metabolism results in low systemic bioavailability after oral doses, so blood levels in the infant after breastfeeding can be expected to be low [20]. Breastfeeding can be resumed after a single dose of midazolam as soon as the woman has recovered from the procedure.”

Midazolam and colonoscopy

Midazolam and dental sedation

Midazolam and endoscopy factsheet

This factsheet contains information taken from my book Breastfeeding and Medication 2018. I hope it helps breastfeeding mums and professionals

Midazolam factsheet

Orlistat for Weight Loss and Breastfeeding

orlistat and breastfeeding

Lowering / stopping milk supply and Breastfeeding

Sometimes mothers want to reduce their breastmilk supply. I’ve provided some information and links on herbs and medications – some things have evidence of effectiveness, many do not.

lowering or stopping breastmilk supply

Terminations of pregnancy and Breastfeeding

I have had 6 mothers contact me in the past 72 hours asking about continuing to breastfeed an older child after a termination. It is hard enough to have to make the decision to terminate without having to lose the current breastfeeding experience. So here, without judgement, is the information that mothers, their family and professionals may need to protect that relationship.

This is data taken from my book. Why not buy a copy! Worth every penny

terminations and breastfeeding

Bismuth subsalicylate (Pepto Bismol®) and Breastfeeding

 

Another of the frequently asked questions is the use of Pepto Bismol™ for indigestion or nausea

Pepto Bismol™ is marketed to relieve symptoms of upset stomach and diarrhoea. It’s active ingredient is bismuth subsalicylate, so it is related to aspirin which we avoid during breastfeeding at painkilling doses.

We are unsure if bismuth subsalicylate passes into a mother’s breast milk. Although bismuth salts are poorly absorbed from the maternal GI tract, significant levels of salicylate could be absorbed in theory. There are currently no reports of Reye’s syndrome in babies exposed to bismuth subsalicylate and it is normally only used very short term for stomach upset.

Breastfeeding mothers would be well advised to use alternative products to treat acute diarrhoea E.g. loperamine (Imodium®) if possible. However, In my experience of queries Pepto Bismol may be the only product available late at night and at weekends. The risk of short term use is probably low although this cannot be proved. The decision remains with the mother as to whether she wants to take it. Continuing to breastfeed during a stomach upset transfers antibodies to the baby to offer protection from the bacterial or viral condition.

It is also advertised to treat heartburn and indigestion for which there are many alternative remedies which are safe in breastfeeding, containing aluminium, calcium and magnesium carbonate.