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Propranolol and breastfeeding

I’m trying to build fact sheets on the drugs I am most frequently asked about. One that comes up frequently is propranolol to prevent migraines, to relieve anxiety and to remove symptoms of over active thyroid. Propranoolol can be used by breastfeeding mothers so long as they are not asthmatic.

propranolol and breastfeeding 

CBD Oil and breastfeeding

Lots of people seem to be interested in using CBD oil for chronic pain and/ or for anxiety. Sadly there is no research on the amount that passes through into breastmilk so I am unable to say whether it is safe for a breastfeeding mother to take or not at this time.

Change the conversation about medicines and breastfeeding

I spend on average 4 full hours across every day providing info to mums told they HAVE to stop breastfeeding to take medicines. Do more people know about the drugs in breastmilk service or are professionals less willing to take risks so stopping breastfeeding seen as best option? How can we change the conversation ?

Where does it make sense to tell mothers stop breastfeeding to take medicines when we have specialist support texts and services? Breastfeeding has HUGE advantages for mums, babies and the economy. We need to listen, support and provide evidence based info for all mums breastfeeding  and formula feeding not rely on manufacturers

There are economic savings for the health economy.  Renfrew (2012) provided a detailed cost analysis of potential savings, reductions in hospital admissions and GP appointments:

Assuming a moderate increase in breastfeeding rates, if 45% of women exclusively breastfed for four months, and if 75% of babies in neonatal units were breastfed at discharge, every year there could be an estimated:

  • 3,285 fewer gastrointestinal infection-related hospital admissions and 10,637 fewer GP consultations, with over £3.6 million saved in treatment costs annually
  • 5,916 fewer lower respiratory tract infection related hospital admissions and 22,248 fewer GP consultations, with around £6.7 million saved in treatment costs annually
  • 21,045 fewer acute otitis media (AOM) related GP consultations, with over £750,000 saved in treatment costs annually
  • 361 fewer cases of NEC, with over £6 million saved in treatment costs annually.

In total, over £17 million could be gained annually by avoiding the costs of treating four acute diseases in infants. Increasing breastfeeding prevalence further would result in even greater cost savings”

In addition, if half those mothers who currently do not breastfeed were to breastfeed for up to 18 months in their lifetime, for each annual cohort of around 313,000 first-time mothers there could be:

  • 865 fewer breast cancer cases with cost savings to the health service of over £21 million, 512 breast cancer-related quality adjusted life years (QALYs) would be gained, equating to a value of over £10 million.

This could result in an incremental benefit of more than £31 million, over the lifetime of each annual cohort of first-time mothers.

Treating babies with reflux and GORD

It seems form social media that many babies are now being diagnosed and treated for reflux (GORD). Before labelling a baby as having a medical condition it is often useful to seek input from a breastfeeding expert and consideration of the position the baby is in after a breastfeed. Not all babies who throw up need treatment!

reflux and breastfeeding

This fact sheet covers the medication used to treat reflux and GORD in babies and the preparation of PPI drugs for babies

treating babies with reflux or GORD

How to make an informed decision about drugs that you might be taking while planning a pregnancy

drugs in pregnancy 2 factsheet

Why Mothers Medication Matters, Wendy Jones

Pee and Poo Chart

During my presentation to LLL Ireland I was asked where was it possible to obtain a copy of the pee and poo chart I mentioned. This is from my book The importance of Dads and Grandmas to the Breastfeeding Mum. Hope it helps Mums, Dads and Grandparents keep track of adequate breastfeeds and output to ensure the baby is getting enough milk.

If there are not as many pees and poos you need to call for help from an expert in breastfeeding sooner rather than later to check the attachment is as good as it can be and baby is taking milk.

A diary of pees and poos taken from The importance of dads and grandmas to the breastfeeding mother

The Importance of Dads and Grandmas to the Breastfeeding Mother, Wendy Jones

Webinar on the importance of others to the breastfeeding mum live video

La Leche League of Ireland

Online version of the LLL of Ireland 2018 conference featuring Drs. Wendy Jones and Kathleen Kendall-Tackett.

Posted by Kathy Kendall-Tackett on Saturday, March 3, 2018

The History of Child Nutrition

THE HISTORY OF CHILD NUTRITION OVER THE PAST 200 YEARS

Not exactly a factsheet but explains how we reached the point in support of breastfeeding

Codeine ( or co-codamol) and Breastfeeding

It seems that more people ask about the use of codeine than any other drug. The changes in guidance following the MHRA report in 2013 and 2015 seem to cause much confusion. We need to be aware as mothers that if we take codeine and our babies become sleepy (sleep longer or more frequently) then this is a sign that we may have the metabolism that concentrates the drug in breastmilk and should stop taking the drug. It takes 15 hours to be clear from the system but unless the baby shows signs of breathing difficulties it isnt a reason to panic . If there are breathing difficulties medical help should be sought urgently.

The oral bio availability of dihydrocodeine is 20% due to substantial first pass metabolism. The half life is quoted as 3.5-5h (Martindale). 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. Bisson DL, Newell SD, Laxton C, on behalf of the Royal College of Obstetricians and Gynaecologists. Antenatal and Postnatal Analgesia. Scientific Impact Paper No. 59. BJOG 2019;126:e115–24.

Opioids should only be used if paracetamol plus ibuprofen/naproxen/diclofenac are providing insufficient pain relief or are contra indicated.

Dihydrocodeine has a cleaner metabolism and as such is preferred as the opiate painkiller (It is known as co-dydramol when combined with paracetamol) . This generally requires a prescription. In some areas codeine is still prescribed to breastfeeding mothers, in others it is totally forbidden. In this fact sheet I have tried to provide the full research history so that you can make an informed decision about what is right for you and your baby. We should also be alert to the fact that codeine is very addictive to us as adults so longterm use unless under medical supervision should be avoided

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