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Fact Sheets

  • 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 ...
  • Accidental dose of codeine when breastfeeding
    Interestingly I am getting more reports of mums who have taken codeine accidentally – having opened the wrong packet, or been given it by supportive partners or relatives and friends. They are terrified that they have to stop breastfeeding and ask for how long they need to pump and dump their milk (such a terrible risk of liquid gold!). Here is the answer! Accidental codeine / one dose and breastfeeding factsheet
  • Accidentally taking one dose of aspirin when breastfeeding
    It is surprising how often mums manage to take products containing aspirin by mistake – they are given by well meaning partners, friends at the office or just taken quickly for pain. Then the realisation that aspirin is contra indicated in breastfeeding. What to do? How long to express? The answer is actually simple with one single accidental exposure. The risk is low and I have been unable to find any references associating Reye’s syndrome with the amount of aspirin passing through breastmilk. Reye’s syndrome This is a rare syndrome, characterised by acute encephalopathy and fatty degeneration of the liver, usually after a viral illness or chickenpox. The incidence is falling but sporadic cases are still reported. It was often associated with the use of aspirin during the prodromal illness. Few cases occur in white children under 1 year although it is more common in black infants in this age group. Many children retrospectively examined show an underlying inborn error of metabolism. accidental/one off dose of aspirin factsheet Leave a comment Logged in as Wendy Jones. Log out? Comment Follow us
  • ADHD and Breastfeeding
    Currently there seem to be many questions about treatment of ADHD and breastfeeding. I’m sharing the chapter from my book Breastfeeding and Chronic Medical Conditions which I hope helps For more information : Breastfeeding and ADHD factsheet and maybe you would like to but the book available on Amazon
  • ADHD and Breastfeeding
    I have shared the chapter on ADHD from my book Breastfeeding and Chronic Medical Conditions multiple times this week. Many mothers seem to be diagnosed in later life and are concerned about breastfeeding. Hope this is a useful link. More information Breastfeeding and ADHD factsheet If this is useful maybe you need the book available on Amazon. I published on Kindle to try to make this more affordable and available to mothers and breastfeeding supporters as well as professionals
  • Agnus Castus and Breastfeeding
    I am not going to pretend that I am an expert on complimentary medicine but I am frequently asked about Agnus Castus for fertility and menstrual issues so am including this information based on the LactMed entry Agnus Castus and Breastfeeding Fact Sheet
  • 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 women 2020 Infographic guideline on anaesthesia and sedation in breastfeeding women
  • Anti epilepsy medication and breastfeeding
    A brief introduction to the information on the safety of anti epilepsy medication during breastfeeding. It does not include full information but you can find more in my book or by emailing me. There is no reason why women who have taken anti-epileptic medication throughout their pregnancy should not be encouraged to breastfeed their baby (Veiby 2013). However, women should be counselled on the signs of risk to be aware of, in particular excessive somnolence and poor weight gain. The risks increase with multiple drug regimens. Epilepsy and breastfeeding
  • Anti platelet drugs and breastfeeding
    Although it is rare for a young woman to experience a heart attack, transient ischaemic attack or stroke, it does happen. They are usually prescribed anti-platelet drugs and until recently we found difficulty in providing information. However, this is the most up to date information which I have sourced and hope it helps anyone in this most difficult position. Anti platelet drugs and breastfeeding factsheet
  • Antibiotics and Breastfeeding
    Although we now try very hard to avoid prescribing antibiotics unless essentail ( because of the risk that in the future we wont have antibiotics which are as affective against all infections), sometimes they are necessary. The use of antibiotics during breastfeeding often causes disquiet because most of them cause the baby to have loose bowel motions, sometimes tummy cramps, and sometimes vomiting. Is continuing to breastfeed actually causing harm and should feeding be interupted? Do we need pre biotics and probiotics to redress the balance in the baby’s gut? It is hard to watch a baby in distress but it is important to remember that when we breastfeed during an infection we are also passing antibodies to that infection in breastmilk to protect the baby. Breastmilk contains all the factors to redress the balance and return the baby’s gut to its normal state far better than any probiotics derived from other sources. But the ultimate choice is that of the breastfeeding mother. I hope that the information in this factsheet helps make that decision. Please email me if you want to discuss anything : wendy@breastfeeding-and-medication.co.uk Antibiotics and breastfeeding factsheet
  • Anxiety and breastfeeding – need to take a drug to relieve symptoms
    I was very proud to have co written a fact sheet for BfN on anxiety and breastfeeding which affects so many new mothers. Beth is a CBT therapist and approached the treatment with non pharmacological methods available via IAPT and IESO (although with a waiting list sadly for most). https://www.breastfeedingnetwork.org.uk/anxiety/ I looked at the relief of symptoms with long-term treatments such as SSRI drugs e.g. sertraline, citalopram, fluoxetine and paroxetine. Mothers may also be helped with propranolol to relieve palpitations and racing heart. Recently there have been more requests from mothers with anxiety or post traumatic stress to take benzodiazepine to reduce symptoms or to treat a panic attack. Occasional use might be acceptable with monitoring of the baby for drowsiness and effective feeding. However, regular use is not encouraged – particularly of diazepam – because of its long half life and potential to accumulate in breastmilk and the baby, but also because this family of drugs is addictive with as little as 28 days treatment. I have written this factsheet to provide as much information as possible on the use of anxiolytics diazepam, loprazolam and alparazolam during breastfeeding. anxiolytics and breastfeeding factsheet The information is taken from Breastfeeding and Medication which includes full references . Please consider buying the book if this information is useful
  • 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, MDSenior 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 ...
  • Azathioprine and breastfeeding
    I frequently get asked about the compatibility of azathioprine during breastfeeding . It is used for several auto-immune diseases including inflammatory bowel disease and sometimes rheumatoid arthritis. It is actually quite widely taken by breastfeeding mothers from the questions I receive. This information is taken from Breastfeeding and Medication “Azathioprine is an immunosuppressive anti-metabolite. It is converted to mercaptopurine in the body. It has a corticosteroid-sparing effect and is widely used to produce and maintain remission in IBD, as well as conditions such as lupus and rheumatoid arthritis. Traditionally, breastfeeding by mothers have been discouraged from continuing to breastfeed if taking azathioprine because of the theoretical risks of infant bone marrow suppression, susceptibility to infection, growth retardation and pancreatitis. According to recent research (Gardiner et al. 2007) breastfeeding need not be withheld in infants whose mothers are taking azathioprine. Gardiner et al. studied four mothers taking azathioprine. The metabolites 6-MP and 6-TGN were undetectable in neonatal blood and no clinical signs of immunosuppression were observed in the infants. Similarly Moretti et al. (2006) studied four babies and measured levels of 6-MP in breastmilk and neonatal blood for drug levels, white cell and platelet counts. Levels of metabolites were below the level of detection in the neonates and no clinical signs of immunosuppression were observed. Sau et al. (2007) studied ten women and similarly found no immunosuppression. Women taking azathioprine should therefore not be discouraged from breastfeeding. It is licensed to be given to children over the age of 2 years at a dose of 2 mg per day initially for severe UC and CD. Relative infant dose is quoted as 0.07% to 0.3% (Hale 2017 online access). The BNF states that it is present in milk in low concentrations, that there is no evidence of harm in small studies and the drug may be ...
  • Bacterial vaginosis and breastfeeding
    Many women are aware of the symptoms of bacterial vaginosis – an unusual vaginal discharge that has a strong fishy smell, particularly after sex. However, treatment can cause more confusion. I hope this factsheet clarifies the symptoms, self help and treatment during breastfeeding. Bacterial vaginosis and breastfeeding factsheet
  • Betahistine and Breastfeeding
    Betahistine (Serc ) is prescribed for dizzines and vestibular problems. There is little research available on it, because it isnt marketed in USA where most of the research studies are conducted. Anecdotally it is quite widely used without apparent problems. Observe the nursing baby for signs of drowsiness/ poor feeding in case This is the entry I made for Breastfeeding and Medication 2018 “Betahistine is prescribed for vertigo, tinnitus and hearing loss associated with Ménière’s disease. There is no data on the amount that passes into breastmilk . It is an analogue of histamine and is believed to work by improving the microcirculationn of the labarynth. Side effects are reported to include gastro-intestinal disturbances, headache,  pruritus and rashes. Prochlorperazine or cinnarazine would be the preferred to drug to treat dizziness. If betahistine use is perceived as essential the baby should be observed for drowsiness, GI disturbance and rash. There are no animal studies on use during lactation. Plasma levels of betahistine are very low. Plasma protein binding <5% (manufacturer SPC) Anecdotally it has been used without problems in breastfed babies “ The BNF entry (online access May 2020 is ” Use only if potential benefit outweighs risk—no information available”.
  • BfN drugs in breastmilk helpline
    Most people know of my involvement with BfN Drugline. This is a poster designed to be used publicly to spread awareness of the service
  • Bi polar disorder and breastfeeding
    This is one section of the new book that I am currently working on and should hopefully be available in kindle format shortly bipolar disorder and breastfeeding fact sheet
  • Bisoprolol and Breastfeeding
    Bisoprolol use seems to be increasing from the queries I receive. It is difficult to assess safety as published information relies on one study where the level in milk was undetectable BUT the baby was not given any of its mother’s milk. If other beta blockers are not suitable then the baby should be monitored closely for side effects and particularly hypo-glycaemia if newborn. BNF ” With systemic use in the mother, infants should be monitored as there is a risk of possible toxicity due to beta-blockade. However, the amount of most beta-blockers present in milk is too small to affect infants.” Bispropolol and breastfeeding factsheet
  • Blog Breastfeeding for Dads and Grandmas
    This is a blog which I wrote for the new Human milk page Tailor made for Tiny Humans http://human-milk.com/ Wendy Jones Blog – Breastfeeding for Dads and Grandmas I’ve just spent the Christmas holidays with my daughters, their partners and 3 grandchildren, two of whom are still being breastfed (21 months and 6 months). Having just had a new book published called Breastfeeding for Dads and Grandmas it made me think how different our holidays were in a very pro breastfeeding family than they might be in other families? The son in law who has yet to have children, is totally comfortable with sitting next to his sisters in law as they breastfeed (on occasion let it all hang out!) and has been immeasurably supportive to his own sister. She was going to “give breastfeeding a go” but is now as committed as our family and doesn’t understand why anyone would feed in any other way. However, the number of emails and Facebook messages from mothers suffering from anxiety since Christmas has reached unbelievable levels – on average 3 a day every day. Why might that be I wondered? I suspect that for many other mothers spending longer than usual in close proximity to the extended family can be stressful. The emotions seem to run at fever pitch in the Festive Season – everyone wants it to be perfect. Most of us spend too much, eat too much, drink too much, don’t exercise as much and generally suffer from “liverishness” as my Grandma used to term it (usually with an added “everyone could do with a good dose of syrup of figs!”). Nevertheless in this hot pot of emotion, parents try to manage their babies needs for quiet to feed or sleep, not to be cuddled by Great Aunt Ethel when they want Mum, don’t ...
  • 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. https://www.amazon.co.uk/Breastfeeding-Medication-Wendy-Jones/dp/1138298328/ref=sr_1_1?crid=1JCT5BRAX0OL0&dchild=1&keywords=breastfeeding+and+medication&qid=1594726503&sprefix=breastfeeding+and+me%2Caps%2C462&sr=8-1 http://tiny.cc/su9esz https://www.amazon.co.uk/Mothers-Medication-Matters-Pinter-Martin/dp/1780665857/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1594728158&sr=8-1 http://tiny.cc/2nxfsz https://www.amazon.co.uk/Importance-Dads-Grandmas-Breastfeeding-Mother/dp/1939807921/ref=sr_1_1?dchild=1&keywords=the+importance+of+dads+and+grandmas&qid=1594728263&sr=8-1 http://tiny.cc/jczfsz https://www.amazon.co.uk/Guide-Supporting-Breastfeeding-Medical-Profession/dp/0367206463/ref=sr_1_2?dchild=1&keywords=a+guide+to+breastfeeding&qid=1594728327&sr=8-2 http://tiny.cc/jczfsz
  • Born to be Breastfed radio interview
    Looking forward to talking with Marie Biencuzzo on Born to Breastfed about Breastfeeding for Dads and Grandmas http://borntobebreastfed.com/?author=1
  • 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.
  • Botox for medical purposes
    Botox injections are used for many medical purposes including migraine, anal fissures. The amount of botox getting into milk is low based on the research on 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. Hale also comments that when Botox is injected into the muscle, it produces a partial chemical denervation resulting in paralysis of the muscle. When injected properly, and directly into the muscle, the toxin does not enter the systemic circulation. Thus levels in maternal plasma, and milk are very unlikely. Waiting a few hours for dissipation of any toxin would all but eliminate any risk to the infant. Also, avoid use of generic or unknown sources of botulinum toxin, as some are known to produce significant plasma levels in humans. (Hale TW Medications and Mothers Milk online version accessed May 2020)
  • 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 http://www.b
  • Breastfeeding after CT and MRI scans
    Virtually every day I get messages from mothers and health visitors querying whether mothers can continue to breastfeed after CT and MRI scans. I was told that the national guidelines had been updated some years ago to align with RANZR guidelines . Sadly this doesnt seem to have been adopted by all radiology departments from my experience. I was lucky enough to work with Dr Gabrielle Cronin on this paper which was published recently in the Irish BMK https://rb.gy/opvtzx Most mothers are advised to stop breastfeeding for 24 hours but there is no evidence for this as most contrast media are not orally bio available and have half lives which do not justify this duration. More information https://www.breastfeedingnetwork.org.uk/ct/ https://www.breastfeedingnetwork.org.uk/mri/ RANZR guidelines
  • Breastfeeding after VQ scans
    One of the questions that frustrates me is “Can I continue to breastfeed immediately after a VQ scan, they think I may have a clot on my lungs? I’ve been told I have to stop feeding for 12 hours”. Most of these mothers have very young babies – often under 2 weeks so to dump that precious milk for 12 hours is really tough. There hasnt been enough time to build up expressed milk so necessitates the use of formula and a very premature end, against mum’s wishes usually, to exclusive breastfeeding. The evidence is really hard to find. One option is to request a CT scan after which breastfeeding can continue as normal. The #dontsaystoplookitup poster refers just to CT and MRI scans and not to VQ scans This information is from my book “Why Mother’s Medication Matters” Breastfeeding and VQ scan
  • Breastfeeding and anaesthetic
    On a daily basis mothers are being told that they have to stop breastfeeding if they have a general anaesthetic. No consideration seems to be given to the risks of not breastfeeding it feels, nor that women breastfeed as normal after a caesarian section (although I admit this is less common than under a spinal block). There is no evidence in any of the papers I have found that says anything other than that a lactating woman can resume feeding as soon as she is awake and alert following the operation. If she is drowsy she needs to consider the risks of co sleeping.   I have drawn up a table from the recommendations in the 2 expert sources Lactmed and Hale in the safety of the commonly used drugs for anaesthesia and post operative pain relief. I hope this helps mothers and professionals to work together to protect, promote and support breastfeeding as long as mother and baby wish. Hoping this helps some of the difficulties experienced by mothers who are already stressed at the idea of needing surgery. breastfeeding and anaesthesia 2
  • 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 bismuth subsalicylate (Pepto Bismol®)
    pepto bismol another of the frequently asked questions
  • Breastfeeding and Cannabis
    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
  • 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
  • Breastfeeding and Chronic medical conditions
    I’m very proud to announce the arrival of book 5 “Breastfeeding and Chronic Medical Conditions”. It is an accumulation of the knowledge which I have gained over the past 25 years in supporting breastfeeding mothers and answering their questions. It has been my “brain dump” so that hopefully I can move forward gradually to spending more time with my family than answering questions. The latter has rather taken over my life now. COVID has made me think about my priorities but lockdown gave me the opportunity to write this whilst I was shielding, I hope that it helps mothers and professionals make risk benefit decisions on how to help mums with chronic conditions manage their lives and breastfeeding. My book is available in paperback or kindle format on Amazon https://www.amazon.co.uk/Breastfeeding-Chronic-Medical-Conditions-Wendy-ebook/dp/B08HWZRVVT/ref=sr_1_1?dchild=1&keywords=breastfeeding+and+chronic+medical&qid=1600085418&sr=8-1
  • Breastfeeding and cocaine
    Using cocaine when breastfeeding is obviously not a good idea, apart from being illegal. But from messages I get almost every week it seems not uncommon. Everyone says that they are embarrassed and regretful and promise not to do again but need to know how to maintain milk supply and keep baby safe. In my quest to provide information to frequently asked questions this is detailed research on cocaine and the breastfeeding mother taken from an article I wrote for The Practising Midwife (Jones W Cocaine use and the breastfeeding mother. Pract Midwife. 2015 Jan;18(1):19-22.) as well as my book Breastfeeding and Medication Breastfeeding and Cocaine use Cocaine use and the Breastfeeding Mother (PubMed)
  • Breastfeeding and Codeine
    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. Codeine should only be used if paracetamol and 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 (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 ...
  • Breastfeeding and Crohns Disease or Ulcerative Colitis
    IBD and breastfeeding fact sheet
  • Breastfeeding and detox products
    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.
  • Breastfeeding and Gallstones
    The development of anaesthetic data was prompted at least in part by the questions from mothers are diagnosis, treatment and surgery for gallstones whilst pregnant. Women are more likely than men to have gallstones and they are more common after the birth of several children so unsurprisingly this frequently covers breastfeeding mothers. So here are my thoughts and a fact sheet on the topic gallstones and breastfeeding fact sheet
  • Breastfeeding and Inflammatory Bowel Disease
    Many people know that I have had Crohns disease since I was 22 years old  – that was when it was officially diagnosed but probably from 4 years before when I was 18 years old. It has had an immense effect on my life firstly medically – I have had 3 bowel resections and been on medications since the last one in 2002 which very nearly killed me. The only times when I was really fit in and well were when I was pregnant and breastfeeding which sparked my interest in becoming a breastfeeding counsellor 31 years ago. It meant I fed my second and third daughters for much longer (I became very ill soon after I weaned my first) and became passionate about supporting women to breastfeed. As a pharmacist that rolled into an interest and then passion about drugs in breastmilk. When I regularly had contact with mums with IBD asking about their medication I decided to set up the Facebook group as a mutual support group. Mums who understood the urgency of toilet visits when out shopping, understood how debilitating it was to be in constant pain, that we could discuss anything in a private forum with others in the same situation. Coincidentally it has become a place where people ask each other about drugs and look to me to provide evidence of safety in breastfeeding – that wasn’t the original intent but an excellent spin off.   I havent set up any other specialist interest groups – this is out of my personal interest. Unsurprisingly the diagnosis and treatment of inflammatory bowel disease has taken up a lot of space in my book Breastfeeding and Medication and I am keen that professionals understand that breastfeeding protects our babies but is also something which we value above many things. As of this ...
  • Breastfeeding and labarynthitis/vertigo
    I am frequently asked about taking prochlorperazine (Buccastem® or Stemetil ®) to treat nausea due to labarynthitis, vertigo or dizziness. It is a drug I would be happy to prescribe and have used it myself as have my two breastfeeding daughters. It seems a frequently asked question when the air pressure changes rapidly. Prochlorperaszine may also be used for nausea prochlorperazine and breastfeeding factsheet
  • Breastfeeding and lowering / stopping milk supply
    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
  • Breastfeeding and Medication 2 nd Edition
    Routledge offering a discount on the second edition of my book. Useful for healthcare professionals who care about supporting breastfeeding or peer supporters who get the questions or parents who want to be informed by the evidence
  • breastfeeding and mental health
    Recorded Facebook live for Perinatal Mental Health Partnership this week www.facebook.com/PerinatalMHPartnershipUK/videos/826557897700531/
  • Breastfeeding and multivitamin and mineral supplements
    Breastfeeding specific multi vitamin supplements are expensive and many mothers want to purchase standard multivitamin and mineral supplements. The standard products such as Sanatogen and Centrium are suitable for use. It is important not to take products which claim to be high dose and where the recommended daily amount is reported as in excess of 100% on the label. The only vitamins needed by breastfeeding mothers are vitamin d 10 mcg/day and folic acid 400mcg/day if no active contraception is being used. Normal diets should provide everything your body needs. Remember babies need vitamin d supplements too according to UK recommendations https://breastfeedingnetwork.org.uk/wp-content/dibm/vitamin%20D%20and%20breastfeeding.pdf However, we do know that as a new mum finding time to eat properly can be a challenge and a multivitamin is a safety net. AVOID dose of vitamin A above 700-800 mcg/day and vitamin B6 above 20-50 mg/day. Iodine can concentrate in breastmilk so do not take levels in excess of 100% RDA. Omega fatty acids are safe in breastfeeding
  • Breastfeeding and Neuropathic pain – gabapentin and pregabalin
    On my mission again today to write information on the frequently asked questions by mothers and professionals. Neuropathic pain affects many mothers with chronic conditions and the data is not easy to find. I hope this information, much taken from my book, is useful. If these fact sheets are proving helpful in your practice maybe you need a copy of Breastfeeding and Medication – available from Amazon and Routledge neuropathic pain and breastfeeding   https://www.amazon.co.uk/Breastfeeding-Medication-Wendy-Jones/dp/1138298328/ref=sr_1_1?ie=UTF8&qid=1537353455&sr=8-1&keywords=breastfeeding+and+medication
  • Breastfeeding and Oestrogen cream or pessary
    Oestrogen creams and pessaries seem to be prescribed with increasing frequency to breastfeeding women to help with healing of sutures, prolapses or for ongoing vaginal dryness. There is little research evidence to guide a discussion of compatibility with breastfeeding. Breastfeeding does seem to have an effect on natural vaginal lubrication for some and basics products such as KY Jelly®, Replens®, Sylk® and other products may help. But for others oestrogen creams may be prescribed by the GP or an obs and gynae consultant. It is known that vaginal absorption of oestrogen results in measurable amounts in milk (LactMed, Hale). In Nielson’s study 6 lactating mothers were given vaginal suppositories (pessaries) containing 50 or 100 mcg of oestradiol. Levels of oestradiol were measurable in milk whilst before application of the pessaries the levels was below that of detection. According to Nielson a ratio of transfer of estradiol from plasma to milk during physiologic conditions is calculated to be less than 100:10. Peak levels were found in milk between 3 and 11 hours after application but was inconsistent and irrelevant with ongoing use. Outcome data is not given in the data that I have been able to access. Nilsson S, Nygren KG, Johansson ED. Transfer of estradiol to human milk. Am J Obstet Gynecol. 1978;132:653-7. Hale says vaginal absorption is greater than oral and quotes Chollet who studied atrophic vaginitis in post menopausal women. It is unclear what relevance this has to brestfeeding Chollett J. A., G. Carter, et al. (2009). “Efficacy and safety of vaginal estriol and progesterone in postmenopausal women with atrophic vaginitis.” Menopause 16(5): 978-983. Levels of oestradiol in the 2 most commonly used products are: Ovestin – One applicator-dose contains 0.5 mg estriol. Vagifem contains 10 mcg estradiol per vaginal tablet neither product is licensed to be used in lactation. ...
  • Breastfeeding and Orlistat for Weight Loss
    orlistat and breastfeeding
  • Breastfeeding and pain relief after a c section
    This week I posted a link to a recently published paper which concluded that poor pain relief after a C section affected breastfeeding. https://consultqd.clevelandclinic.org/following-cesarean-delivery-postoperative-pain-affects-likelihood-of-in-hospital-breastfeeding/ I was saddened that we even had to think that pain would not be managed well for any mother, let alone when she was trying to initiate breastfeeding. It isn’t always easy to life a baby from a cot side crib when you have had surgery, let alone try to position a baby to achieve the perfect latch. copyright Juliet Klottrup What surprised and horrified me was the mother’s who replied that they hadnt been given good pain relief when in hospital. They mentioned: not being told that more than paracetamol was available being offered only paracetamol and ibuprofen even when they needed more being forgotten on medication rounds, being discharged without sufficient pain relief. This just isnt good enough and I would hope that everyone to whom this applies contacts the ward directly or through PALS that pain management plans are essential. Pain relief which should be given to a breastfeeding mum in my opinion: In theatre a non steroidal anti inflammatory eg diclofenac as a suppository On the ward there should be available oramorph (subject to extensive first pass metabolism so little in milk) Regular use of an NSAID – ibuprofen, diclofenac or naproxen (low levels in milk) plus paracetamol Codeine is no longer recommended but dihydrocodeine can be offered (https://breastfeeding-and-medication.co.uk/thoughts/dihydrocodeine-and-breastfeeding) Discharge packs should include the NSAID offered in hospital plus limited number of dihydrocodeine and if necessary oramorph. This may challenge the formulary in the hospital but can be overcome simply with care and thought for the patient. NO WOMAN SHOULD BE LEFT IN PAIN BECAUSE SHE IS BREASTFEEDING
  • Breastfeeding and pain relief for acute back injury
    So many mums seem to injure their backs – maybe we need antenatal classes on how to lift your baby (and equipment!) or more assessment of post-natal damage. When pain has not resolved with simple painkillers (paracetamol and ibuprofen (taken regularly and at full dose) sometimes further treatment is necessary from professionals. This may help the mother access physiotherapy or other mobility treatment. Information here on how to treat the pain of acute back injury and relieve the spasm. I hope that it aids mothers and professionals. Breastfeeding and pain relief for acute back injury
  • Breastfeeding and Podiatry
    Today’s question of interest is an area which frustrates me – mums needing ingrowing toe nail treatment involving the use of local anaesthetics and a few drops of phenol (or sodium hydroxide). Guidelines from podiatry seem to suggest this treatment cant be carried out until a mum stops breastfeeding. But that may leave her in pain for a long time. Why? It is unlikely phenol will get into milk but we have no published studies. My fabulous colleague produced this poster from data sent to us by mothers and presented it a conference in Oxford in June. One mum at a time challenging practice. Poster Breastfeeding and Podiatry factsheet
  • Breastfeeding and Thrush
    https://www.facebook.com/breastfeedingandmedication/videos/2342551639103500/?t=21 Medicalising Sore Nipples – thrush and breastfeeding July 2018
  • Breastfeeding with IBD – Colitis and Crohns Disease
    IBD and breastfeeding fact sheet
  • 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)
  • Carbimazole in women of childbearing age
    As for the valproate fact sheet this information on carbimazole taken for over active thyroid is included so that women who may become pregnant are aware of potential risks . https://www.gov.uk/drug-safety-update/carbimazole-increased-risk-of-congenital-malformations-strengthened-advice-on-contraception This factsheet gives further information carbimazole and pregnancy
  • 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 ...
  • Change to recommendation on the use of Teething gels containing lidocaine.
    We all know as parents how hard it is to comfort a baby who is teething and to witness their distress. As a pharmacist, mother and grandmother I know that the standard products often recommended in the past contained a local anaesthetic often lidocaine. In 2014 the FDA in USA first raised concerns stating that “Topical pain relievers and medications that are rubbed on the gums are not necessary or even useful because they wash out of the baby’s mouth within minutes, and they can be harmful”. Today the MHRA have announced that parents and caregivers are being advised that products containing lidocaine used for teething in babies and children will be sold only in pharmacies, under the supervision of a pharmacist from the beginning of 2019. The MHRA review concluded there is a lack of evidence of benefit to using products containing lidocaine for teething before non-medicinal options. Evidence of any risk associated with these products is very small given the wide usage of these medicines. A pharmacist or healthcare professional can provide appropriate guidance. Teething is a natural process and lidocaine containing teething products such as teething gels should only be used as a second line of treatment after discussion with and guidance of a healthcare professional. It is suggested that parents try non-medicine options such as rubbing or massaging the gums or a teething ring before considering teething gels after discussion with a pharmacist. Further information can be found : www.gov.uk/government/news/teething-gels-for-babies-and-children-to-be-sold-in-pharmacies-only And a patient information leaflet: https://assets.publishing.service.gov.uk/media/5c0fd7cbed915d0c736a1e64/Lidocaine-patient-sheet.pdf La Leche League GB have produced an excellent article on teething which can be accessed www.laleche.org.uk/breastfeeding-and-teething/#Pain. The NHS also has sound information: https://www.nhs.uk/conditions/pregnancy-and-baby/teething-tips/ Products include Dentinox gel ®, Calgel ®, Bonjela ®, Anbesol gel ®
  • Citalopram and breastfeeding
    Especially over the past year of the pandemic many mothers are asking about the compatibility of citalopram during breastfeeding. It has been a hard time for everyone with the incidence of anxiety and depression continuing to rise. As access to IAPT ( https://www.england.nhs.uk/mental-health/adults/iapt/) may be more difficult the prescription of medication is inevitable. Alternative CBT access may be available on line via and IESO (https://www.iesohealth.com/en-gb) Citalopram is widely used and we have a high level of experience with it over many years. It is the drug of choice if it has been used by the mother in the past. Unfortunately many doctors are, in my experience, still recommending that mothers should stop breastfeeding in order to take antidepressants. This may be that they think life would be easier if someone else could help with care of the baby or that the mother may get more sleep. Sadly, this doesnt always happen and the loss of oxytocin may also lower mood further. There is often an assumption that pressure to breastfeed can lead to depression but in my experience pressure to stop breastfeeding in order to take medication may increase depression and may also stop mothers accessing professional help to avoid having that discussion. This link to the RCGP perinatal mental health toolkit may be useful for professionals and parents RCGP perinatal mental health toolkit This factsheet contains information from my book Breastfeeding and Medication. Please message me for references used or with any questions. citalopram and breastfeeding factsheet Breastfeeding and chronic medical conditions contains chapters on anxiety and depression wendy@breastfeeding-and-medication.co.uk
  • Clinically extremely vulnerable, COVID 19 infection and breastfeeding
    Because I am immunocompromised myself, I am all too well aware of the information on protection from COVID 19 including the recommendations launched in December 2021 by the government on sotrovimab (Xevudy) and molnupiravir (Lagevrio) . This may affect some breastfeeding mothers e.g. those with IBD or on biologicals for other reasons . There are no simple answers but this is the information I have been able to find in one place. Clinically extremely vulnerable, Covid 19 infection and breastfeeding factsheet
  • Collagen and breastfeeding
    Collagen seems to be another frequent supplement I get asked about . Collagen is found in connective tissue and can be used during exercise routines but also in the prevention and treatment of wrinkles as well as to strengthen hair I believe. There are no studies on passage into breastmilk and it would therefore be unethical for me to comment. Sorry – another of the increasing number of natural products which seem to be attracting attention during lockdown and as we emerge.
  • Colonoscopy and Endoscopy in breastfeeding women
    I am so very tired of breastfeeding mothers who need colonoscopies and endoscopies being told that they need to interrupt breastfeeding. I am currently trying to engage with the national body to update national guidelines. Interestingly it is the same old story – we dont see breastfeeding women needing these examinations. So how come I do? This is the evidence that I have put together and am desperate to share with clinicians. colonoscopy and endoscopy in lactating women factsheet
  • 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/
  • Covid Vaccine and Breastfeeding
    I have been inundated with questions about the vaccine against Covid 19 and breastfeeding. Initially the recommendation was that it shouldnt be given until a mother had stopped breastfeeding (which caused consternation in the front line workers who needed it so badly to protect themselves and their families as well as patients ). This was revised by the MHRA and JCI once the first urgency of licensing the vaccines was past. The information is that either the Pfizer/BioNtech or Astra Zenica/Oxford vaccines can be administered to a breastfeeding mother. I wrote this update for BfN which contains links to all the other information including InfantRisk However, there are still queries from mothers who have been unsettled by poor information circulating on social media. I hope to allay these fears but ultimately the decision which you make is that which feels right for you. No there havent been any studies on the transfer through milk to babies but one is currently being undertaken by Imperial College using the milk of mothers before and after vaccination. It is not possible to interrupt breastfeeding for a period to minimise the transfer of milk. Vaccines do not have a half life like drugs. We have no reason to believe that the COVID-19 vaccine transfers into milk any more than any other vaccine which we use. What transfers are antibodies which the mother has made. We look forward to hearing whether these offer any protection to the baby. We know that antibodies after the mother has had COVID do transfer and protect. I hope that this helps to answer some of the frequently asked questions and that all those having the vaccine stay safe and well as they work so hard to protect and treat the rest of us. Thank you NHS https://www.breastfeedingnetwork.org.uk/coronavirus/ https://www.breastfeedingnetwork.org.uk/coronavirus/
  • Depression and breastfeeding
    The rise in the statistics on COVID seems to be exacerbating symptoms of depression for many, many people. I can totally identify with that because I am immunocompromised myself due to medication and have very much gone back into Shield mode. Many of the queries I have had in the last week relate to mothers who need to begin, increase or change their antidepressant medication but are being advised to stop breastfeeding to do so. There is evidence that stopping breastfeeding in itself lowers mood – you have a baby who wants to be breastfed and is fighting the change, you loose oxytocin, you become engorged – it isnt as easy as “stop now” might sound. This is the chapter on depression from my new book Breastfeeding and chronic medical conditions. I hope the chapter helps in itself but maybe you would like to buy it and learn more about how drugs get into milk. I will of course answer any queries you have wendy@breastfeeding-and-medication.co.uk More information: depression and breastfeeding factsheet
  • Diabetes and Breastfeeding
    Another information sheet for chronic conditions in breastfeeding mothers which will eventually become a book Diabetes and Breastfeeding factsheet If this is useful in your work maybe you should buy Breastfeeding and Medication or A guide to breastfeeding for the medical professional Email me at wendy@breastfeeding-and-medication.co.uk
  • 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
  • Donating breastmilk and taking medication
    I am very proud to support all the breastmilk banks in the UK who provide milk to mothers of neonates. I was intensely grateful just over a year ago when my youngest grand daughter was born early, weighing just 3 and a half pounds. My daughter had fed 2 other children and like me is passionate about exclusive breastfeeding. However, she was exhausted trying to pump and stimulate her supply for our little wee scrap to keep her blood sugars up. She was given the gift of a small volume of donated breastmilk which took the pressure off for a few hours to allow her to sleep. Of course this was all during the height of the pandemic and she was seperated from her husband and children. She described it this way: ” It was if the donor mums were holding both of us safe, they were feeding my baby for just a few hours whilst I regained my strength. I can never thank those mums enough for that relatively small amount of milk (24ml), which was worth so, so much to me. By the following morning I had enough milk to provide the supplements through the NG tube“ Milk from donating mothers has to be free of medication which might affect the health of the tiny, vulnerable pre-term. I have drawn up this list but it seems to change regularly . Thank you to every mum who makes the precious donation of breastmilk https://ukamb.org/medication-and-donating-breastmilk-2/ https://ukamb.org/medication-and-donating-breastmilk-2/
  • Ear drops and breastfeeding
    Continuing to work down the list of frequently asked questions and adding information from Breastfeeding and Medication 2018 If you are a professional or a volunteer frequently encountering questions from mothers or other members of the family maybe you would like to treat yourself to a copy! The ear drops I am asked about most frequently asked about are OTOMIZE and LOCORTEN VIOFORM but this fact sheet contains many others. Hope it puts everyone’s mind at rest. I remember a consultant many years ago telling a mother she couldn’t breastfeed for 2 weeks after using anti inflammatory ear drops. Unless she was going to drip excess out of the ear canal onto her nipples I could see no logic for this. I hope things have moved on but the patient information leaflet still causes concern.   ear drops and breastfeeding
  • Ectopic Pregnancy and Breastfeeding
    Sadly our family has recently experienced the tragedy of an ectopic pregnancy and the loss of a very brief dream. This has made me much more aware of the incidence and risk of this condition over and above the post I wrote in April. So some more facts – as my friend commented today I hate to waste any opportunity to educate! Ectopic pregnancy is a common, occasionally life-threatening condition, that affects 1 in 80 pregnancies. An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes. Symptoms usually develop between the 4th and 12th weeks of pregnancy. Women with an ectopic pregnancy may still be breastfeeding and wish to continue which can be supported. Symptoms Ongoing bleeding that is sometimes red or brown/black and watery (like “prune juice”) should be investigated. The bleeding may be heavier or lighter than usual, but pregnancy test is still positive One-sided pain in your tummy which may be persistent or intermittent or a generalised discomfort with bloating and a feeling of fullness (not associated with eating) when lying down. Shoulder tip pain which is often described as pain unlike any you have ever experienced before. (Ectopic Pregnancy Trust) Investigations Your GP will refer you urgently to the early pregnancy unit at your local hospital. You may have your Human Chorionic Gonadotropin (HCG levels) measured over a period of several days. If you are having a normal pregnancy these should double approximately every 48 hours. A smaller increase can indicate a risk of  of this being an ectopic pregnancy but this will be confirmed with ultrasound scans, initially across your tummy. It is likely that a transvaginal (internal) ultrasound scan will be required where a specialised probe is placed into the vagina to get a more detailed look at the reproductive ...
  • Ectopic Pregnancy and Breastfeeding
    Sadly recently I have heard from several mothers who have been diagnosed with an ectopic pregnancy. They have variously been told that they cant breastfeed again for 2 months and 3 months. One distraught mother planned to pump and dump her milk for 3 months with the hope that she could return to breastfeeding later. We should be using evidence based information sources as NICE PH11 recommended originally back in 2008. NICE Guidelines – prescribing So here is the information based on research. A mother administered methotrexate 50 mg/m2 IM for ectopic pregnancy can breastfeed as normal after 24 hours, In the meantime she should pump and dump to maintain her supply. She should not attempt to conceive for 3 months. Ectopic pregnancy and breastfeeding fact sheet  
  • Ehlers-Danlos Syndrome and Breastfeeding
    not a comon conditioon and easy to feel you are alone . Hope this helps. It’s a chapter from my book Breastfeeding and Chronic Medical Conditions Ehlers-Danlos Syndrome and breastfeeding factsheet
  • email contacts on the safety of drugs in breastmilk
    Today alone I have had email contacts from Peru, the Netherlands, USA and Italy. It shows how the problems around breastfeeding on medication are the same all round the world. It is sad that so often breastfeeding mums are told they have to stop breastfeeding in order to be treated for chronic or acute illness – usually unnecesarily and not using evidence based resources
  • 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
  • Evidence based information for GPs and breastfeeding and medication
    I’ve been searching back through my files and finally found a link to a training webinar I delivered for GPs in 2016. Hope maybe it is useful for education. Always happy to deliver a training session for expenses and a small fee https://vimeo.com/simonwade/review/171899989/679f7dcf07
  • Fibromyalgia and Breastfeeding
    Fibromyalgia is incredibly difficult to deal with when you have a baby. The most effective intervention is CBT. Please read this factsheet which is a chapter from my book Breastfeeding and chronic medical conditions available on amazon. Breastfeeding and Fibromyalgis factsheet
  • Flu and Breastfeeding
    Flu seems to be on the increase at the moment so I hope this information helps mums and professionals influenza and breastfeeding fact sheet
  • Fluoxetine and Breastfeeding
    In the final of the sheets on antidepressant / anti anxiety SSRIs is fluoxetine. It is often looked on as the least compatible with breastfeeding because of its long half life and greater passage into milk. However, it is often used in pregnancy because there are a significant number of studies https://www.medicinesinpregnancy.org/Medicine–pregnancy/Fluoxetine/. What is perhaps less well known is that if a mother has taken it throughout pregnancy the baby MAY be very drowsy in the first few days after delivery as it withdraws from the higher levels achieved through placental transfer. My recommendation for any mother taking fluoxetine during pregnancy and wishing to breastfeed is to learn hand expression in preparation https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfeeding-resources/hand-expression-video/ and to maybe discuss antenatal expression of colostrum with the midwife, just in case the baby is sleepy and taking time to latch effectively. Colostrum can raise blood sugars in very small amounts. (This is really helpful info for the red flags of low sugar and in my opinion explains everything well https://www.guysandstthomas.nhs.uk/resources/patient-information/maternity/protecting-your-baby-from-low-blood-glucose.pdf) So you can breastfeed after delivery if you have taken fluoxetine but you may need a little help and support. Seek this antenatally so you are well prepared. I would also add that if fluoxetine has been the SSRI that you have used and found effective in the past, then that would make it the first choice in breastfeeding. Some babies are colicky, some are drowsy, some vomit, some have loose diarrhoea – but we cant tell in advance. I remember the very first study I looked at on fluoxetine some 25 or more years ago that the mother and the baby’s paediatrician thought the baby hadnt changed behaviour when exposed to fluoxetine via his mother’s breastmilk. The baby’s father (also a paediatrician) perceived it as more irritable and on that anecdotal basis back then it was ...
  • Glucosamine and chondroitin supplements during breastfeeding
    Again I wonder if this is a consequence of the Lockdown but more breastfeeding mums seem to have taken up running again or for the first time. We have all needed to take exercise in this strange world the past few months. This is the information on glucosamine and chondroitin during breastfeeding – enjoy your running. Yes it is safe in breastfeeding : https://kellymom.com/bf/can-i-breastfeed/lifestyle/mom-exercise/ Glucosamine Glucosamine is either derived from shellfish or synthetically produced. The shellfish derived product should be avoided by anyone with a shellfish allergy. It is most commonly used to treat osteoarthritis and joint pain or to prevent joint damage. A glucosamine derivative, N-acetylglucosamine, is a normal component of human breastmilk. Glucosamine occasionally causes stomach discomfort in adults  but is generally well tolerated. There are no studies on levels in breastmilk but it is poorly absorbed and metabolised in the liver so levels absorbed by the breastfed baby are likely to be very low. Chondroitin Chondroitin is a  mixture of large glycosaminoglycans and disaccharide polymers, usually derived from shark or bovine cartilage. It is most commonly used to treat osteoarthritis because it acts as a flexible connecting material between the protein filaments in cartilage. Chondroitin is poorly absorbed orally with a bioavailability of about 10%. Its molecular weight averages 50,000 Daltons so is unlikely to be absorbed by breastfed babies at all.  It is well tolerated in mothers with occasional gastrointestinal upset reported. Although no studies exist on the use of chondroitin sulphate supplements during breastfeeding, small amounts occur naturally in breastmilk. Mothers of preterm infants excrete greater amounts of chondroitin into breastmilk than mothers of fullterm infants.The use of chondroitin by a nursing mother is unlikely to adversely affect the breastfed infant. References Coppa GV, Gabrielli O, Zampini L et al. Glycosaminoglycan content in term and preterm milk during the first month of lactation. Neonatology. 2011;101:74-76. ...
  • Hayfever and breastfeeding
    that glorious sunshine today and first signs of the yellow of oil seed rape fields heralds the onset of the hayfever season. You can breastfeed and take antihistamines, steroid nasal nasal sprays and eye drops   www.breastfeedingnetwork.org.uk/hayfever/
  • Hayfever and breastfeeeding
    This is the beginning of the hayfever season with the sun coming out so today I recorded the video about the compatibility of drugs to treat symptoms and breastfeeding I’ve also uploaded the powerpoint which I used to present this that you can share https://youtu.be/2bsCUFaeMMs hayfever and breastfeeding powerpoint http://s895428841.websitehome.co.uk/wp-content/uploads/2021/03/hayfever.jpg
  • High Dose Vitamin D Supplements and Breastfeeding
    The question as to the compatibility of high dose vitamin d supplements in the breastfeeding mother is a frequently asked question. We appear to monitor levels more frequently than we did in the past but research is difficult to source. I hope this information helps. High dose vitamin d supplement for breastfeeding mothers factsheet
  • How to advise women on the safe use of medicines while breastfeeding
    This article was published in the Pharmaceutical Journal June 2021 https://pharmaceutical-journal.com/article/ld/how-to-advise-women-on-the-safe-use-of-medicines-while-breastfeeding but I feel is too important not to be readily available for professionals. It should be part of the what mothers want professionals to know about breastfeeding series. So I have adapted it slightly to be in a pdf format so it can be used more easily How to advise women on the safe use of medicines while breastfeeding article If you use this information please do consider buying Breastfeeding and Medication
  • How to make an informed decision about drugs that you might be taking while planning a pregnancy
    drugs in pregnancy 2 factsheet    
  • Hypertension (raised blood pressure) and Breastfeeding
    Many mothers experience raised blood pressure it seems. Is this due to our busy lifestyles, more mums giving birth at an older age? Who knows but it causes a lot of confusion. The drug normally initiated if a mother has symptoms of pre-eclampsia is labetolol. It is usually continued after delivery until the BP has settled. Virtually none passes into breastmilk. However, some mothers with poor circulation may notice sore, white nipples where the supply to the tip is decreased . If this happens the drug may need to be changed. Prolonged high BP in pregnancy can lead to restricted growth of the baby who may be born sleepy. Rather than just monitoring blood glucose levels the baby should be helped to attach to the breast and feed regularly or be given colostrum by spoon or syringe. A drop of colostrum can work magic. Later blood pressure rises can be treated with enalapril, amlodipine and felodipine which are all compatible with breastfeeding according to expert sources. The NICE Guidelines NG 133 (2019) can also guide good practice. The data for this fact sheet is taken from my book Breastfeeding and Medication which provides more detail and references to studies. Please consider buying a copy for future reference. Hypertension and breastfeeding factsheet
  • 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
  • Inflammatory bowel disease and Breastfeeding
    I’ve made no secret of the fact that I developed Crohns disease identified back in 1976 when I was just 22 years of age. It has had a massive impact on my life – lots of hospital admissions, 3 bowel resections, lots of medication. It indirectly led to me developing peripheral vascualr disease so that at one time I could only walk 40 yards without pain. It also was responsible for a malignant melanoma which luckily was caught before it spread. It has also affected my liver and spleen so as you can understand it is a big part of my life. But on the positive side it was what caused my passion for breastfeeding as I was nevr fitter than when I was pregant or breastfeeding. I have attempted to pull all the information on diagnosis, treatment, live vaccines etc into one place into this rather large factsheet (almost a book) which I hope will help professionals support mums using evidence based information. I have already recorded a video presentation as a facebook live https://breastfeeding-and-medication.co.uk/live-video-2/inflammatory-bowel-disease-and-breastfeeding-facebook-live but am happy if you want me to present to a team – professionals, mothers with IBD. Just message me wendy@breastfeeding-and-medication.co.uk There is also a facebook page https://www.facebook.com/groups/BreastfeedingIBD with 1.4k members from all round the world. Hope this helps everyone to use the evidence from research to support breastfeeding mums with IBD. It is a disease I wouldnt wish on my worst enemy and it is hard to deal with when you have young children. Be kind and supportive! #dontsaystoplookitup Inflammatory bowel disease and breastfeeding – all you need to know?
  • Infliximab and breastfeeding
    Following on from the page on Azathioprine I thought it would be useful to add data on infliximab which is also widely used by breastfeeding mothers. Like most of the biologicals the molecules are too large to pass into milk. This information is taken from Breastfeeding and Medication In 2002, the NICE (NICE 2002) recommended that this drug be only used for the treatment of severe, active CD when treatment with immunosuppressant drugs and corticosteroids is not tolerated or has failed. It is now much more commonly prescribed to pregnant and breastfeeding women. Infliximab is a large molecular weight antibody and preliminary results suggest it is too large to pass into breastmilk and it is not orally bio-available. It is distributed primarily in the vascular compartment and has a terminal elimination half-life of 8 to 9.5 days. It is suggested that use by a mother should not preclude breastfeeding based on this data (Peltier 2001; Forger 2004; Mahadevan 2005; Basilisks 2006). The BNF states that the amount in breastmilk is too small to be harmful. Compatible with breastfeeding due to poor bio-availability and hence low-level absorption by the infant. Infliximab is usually either not detectable in breastmilk or detectable at very low levels. Absorption of the drug from milk by the infant is minimal. Follow-up of infants exposed in utero and breastfed during maternal infliximab therapy have found no adverse effects and normal development. The measurement of minute concentrations in the milk of some women raises the possibility of local immune suppression in the gastrointestinal tact, but levels were not high enough to be of concern for systemic immunosuppression (LactMed) References Forger F, Matthias T, Oppermann M Becker H, Helmke KInfliximab in breastmilk, Lupus, 2004;13:753. Abstract NICE Crohns Disease – infliximab 2002 Mahadevan U, Kane S, Intentional infliximab use during pregnancy for induction or maintenance of remission ...
  • Introduction to the pharmacokinetics of drugs in breastmilk for midwives
    I am all too aware of the gaps which many professionals find in their knowledge after training. That is why we all need to undertake CPD. I have written this brief introduction for midwives who see mothers during their pregnancy and after delivery. Midwives are often more accessible than medics, they may be seen as more approachable, they care about as well as for, women throughtout their career, they help to train junior doctors. So I hope this will help them to understand more about how drugs pass into breastmilk and where to seek more information if needed. Happy to provide training via Microsoft Teams if you wish and to answer any emails. Wendy@breastfeeding-and-medication.co.uk. Hope this is useful but please feedback if you need more, less, more details, any changes. And dont for get the books! Introduction to the pharmacokinetics of drugs in breastmilk for midwives
  • 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 breastfed babies
  • Leaving the Breastfeeding Network Drugs in Breastmilk Social Media Page
    In November 2015 we set up the BfN drugs in breastmilk facebook page with the help of a small group of admins to signpost to factsheets. The page has grown and grown in popularity and takes thousands of questions every year. I have been supported by Amanda a fellow pharmacist over the last 5 or maybe more years giving me one evening and then one day a week off and some much needed support. But last year I made the decision that I wanted to stop. I wanted my life back, evenings not checking my phone, a holiday without answering queries – something I havent had since 1998! I. I’ve been answering questions on the compatability of drugs in breastmilk since 1995. I’ve had 2 days totally off since then – my 65th birthday and the magical day at Windsor.It’s brought many joys, and some sadness but proudly for me an MBE for services to mothers and babies. So began a plan to recruit and train some more pharmacists to help and keep the support going. Eleven lovely young pharmacists volunteered and in May ten of them finished the training and are ready now to take over in a rota. This weekend I will be leaving the BfN facebook page although I will continue to answer emails whilst the team settle over the next few months. I’M NOT GOING AWAY THOUGH – I’m just pulling back to my own facebook page and this website. So will still be available to answer questions in either place https://www.facebook.com/breastfeedingandmedication/ or wendy@breastfeeding-and-medication.co.uk 1536319914 Dr Wendy Jones, MBE Picture date: Friday 22 March 2019. Copyright: PA Photos NOT FOR PUBLICATION WITHOUT WRITTEN CONSENT OF PA PHOTOS : 020 7963 7305.
  • Live vaccinations and Immunosuppressant medication taken by breastfeeding mothers
    To finish the posts on immunosuppresant medications the final most frequently asked question is about the administration of live vaccinations to the baby. This is particularly a problem with the rotavirus vaccine. The Torento consensus statement also suggested that live vaccinations are not recommended within the first 6 months of life in the offspring of women who were on anti-TNF therapy during pregnancy. The babies of mothers taking immunosupressant drugs eg azathioprine and infliximab have not been shown to be immunocompromised because of the limited passage of medication through breastmilk. However, if live vaccinations, particularly rotavirus are used then the mother with IBD should use precautions like wearing gloves when changing the baby’s nappy for 2 weeks after the vaccination to avoid picking up the particles of live virus shed in faeces. The Rotavirus Vaccination Programme Public Health England ” There is a potential for transmission of the live attenuated virus in Rotarix vaccine from the infant to severely immunocompromised contacts through faecal material for at least 14 days. However, vaccination of the infant will offer protection to household contacts from wild-type rotavirus disease and outweigh any risk from transmission of vaccine virus to any immunocompromised close contacts. Those in close contact with recently immunised infants should, as always, observe good personal hygiene which should include handwashing after changing the infant’s nappy” ” Rotavirus vaccine should not be given to infants of mothers that used immunosuppressive biological therapy during their pregnancy because of the potential that these will have a postnatal influence on the infants’ immune status. It is recommended that immunisation with live vaccines should be delayed for 6 months in children born to mothers who were on immunosuppressive biological therapy (TNFα antagonists and other biological medicines such as Infliximab) during pregnancy. As Rotarix vaccine is contraindicated in infants presenting ...
  • Low dose aspirin and breastfeeding
    It is not uncommon for breastfeeding mothers to need to take low dose aspirin, sometimes for reasons in pregnancy or after cardiac events. Whilst it isnt recommended regularly as a painkiller at a dose of 600mg four times a day it is compatible with breastfeeding in low dose of 75-150mg daily. low dose aspirin and breastfeeding If accidentally taken at an analgesic dose see https://breastfeeding-and-medication.co.uk/fact-sheet/accidentally-taking-one-dose-of-aspirin-when-breastfeeding
  • Lupus, hydroxychloroquine and breastfeeding
    It seems that many more women with chronic illnesses are having babies and breastfeeding. I have included a chapter in the second edition of Breastfeeding and Medication on this. This fact sheet on lupus and hydroxychloroquine whilst breastfeeding is taken from the book, due to be published May 2018 Lupus and hydroxychloroquine and bf
  • Maternal Mental Health Awareness Week
    BfN blog may 2018 This is my blog written for the Breastfeeding Network for maternal mental health awareness week. Perinatal mental health and its impact on breastfeeding and vice versa is becoming a specific passion of mine. So sad that women are repeatedly told you cant have medication UNLESS you stop breastfeeding. Incorrect and unhelpful
  • MBRRACE-UK report concern over the safety of drugs in breastmilk in one case
    MBRRACE–UK released their 5th report ‘Saving Lives, Improving Mothers’ Care’. It describes the lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity from 2014-2016. Here’s The Breastfeeding Network’s response. The Breastfeeding Network (BfN) welcomes the report. While the research has found that the number of women dying as a consequence of complications during or after pregnancy remains low in the UK – with fewer than 10 out of every 100,000 pregnant women dying in pregnancy or around childbirth, the report highlights the unacceptable disparity in care for black and ethnic minority women. Shereen Fisher, Chief Executive for the Breastfeeding Network said, ‘The almost five-fold higher mortality rate amongst black women compared with white women requires urgent explanation and action. BfN welcome further exploration into this unacceptable disparity to ensure there is real change for black and ethnic minority women’. A key concern, is the tragic case of a mother dying several weeks after her baby was born (Commencing treatment, dose and compliance page 39). There were delays in prescribing thromboprophylaxis because of concerns over breastfeeding. Dr Wendy Jones, lead pharmacist for the BfN Drugs in Breastmilk Information service, said ‘I have long feared such a scenario. Physicians need to be aware how to check that a drug treatment is compatible with breastfeeding quickly, using evidence-based sources. The drugs in this case are widely used in the immediate postnatal period yet emergency medicine teams are often unable to access readily available evidence-based information on medication and breastfeeding as quickly as they need. The information should have been readily available in guidelines or a reference source including specialist information. The wording of the BNF: “Due to the relatively high molecular weight and inactivation in the gastro-intestinal tract, passage into breast-milk and absorption by the nursing infant ...
  • Medication taken during pregnancy loss
    Sadly dreams dont always come true and babies are lost during pregnancy. If that happens and you are still breastfeeding a toddler do you have to stop? Lots of information here I wrote for www.essentialparent.com. Extracts taken from Why Mothers Medication Matters Medication during pregnancy loss 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. Those 9 hours make a massive difference to a breastfeeding dyad which seems to be ignored by the professional 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
  • Migraine prophylaxis and breastfeeding
    So many people now seem to have regular migraines which are debilitating and make life with babies and children a nightmare. Preventive treatment may be appropriate if the mother suffers at least two attacks a month, an increasing frequency of headaches, suffers significant disability despite suitable treatment for migraine attacks or cannot take suitable treatment for migraine attacks. Beta-blockers e.g., propranolol are effective. Tricyclic antidepressants e.g., amitriptyline  Topiramate Pizotifen Botox Riboflavin all of which are safe in breastfeeding. More information in the factsheet Migraine prophylaxis and breastfeeding factsheet References are available by emailing me wendy@breastfeeding-and-medication.co.uk or can be found in Breastfeeding and Medication
  • Migraine treatment and Breastfeeding
    Another chapter from my book Breastfeeding and Chronic Medical Conditions today on the treatment of migraines which affect so many people. Migraines are miserable, when you have to continue to deal with a baby or toddler or older child and cant go and sleep in darkened room they can break the best. This factsheet goes through some of the treatments for breastfeeding including sumatriptan. Hope it helps. Maybe time to buy the very reasonably priced book available from Amazon ? https://www.amazon.co.uk/Breastfeeding-Chronic-Medical-Conditions-Wendy/dp/B08HTG6LBK/ref=sr_1_1?dchild=1&keywords=breastfeeding+and+chronic+medical&qid=1622820951&sr=8-1 Treatment of migraines and breastfeeding factsheet
  • Mirtazapine and Breastfeeding
    With the developing COVID situation more mothers are struggling to sleep and being prescribed mirtazapine for anxiety and depression associated with poor sleep. This is the information I used in Breastfeeding and Medication. For more information Mirtazapine and Breastfeeding Factsheet or maybe buy the book
  • Mirtazapine and breastfeeding
    Another medication used during breastfeeding for anxiety and depression is mirtazapine. It may be used where other SSRIs have not been effective or tolerated. Mirtazapine may be also be seen as an option where insomnia is a symptom of  anxiety or depression. The baby should be observed for signs of drowsiness and ineffective feeding. Care should be taken with co sleeping because it is likely to cause drowsiness in the lactating mother. Falling asleep in chairs or on sofas should be regarded as an even greater risk https://www.basisonline.org.uk/ LactMed summarises that “Limited information indicates that maternal doses of up to 120 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months.” In practice the normal dose is 15mg taken at night. Professionals may find the RCGP Perinatal mental health toolkit a useful resource https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/perinatal-mental-health-toolkit.aspx The information in this factsheet is taken from my book Breastfeeding and Medication. Please message me with queries or the references used. wendy@breastfeeding-and-medication.co.uk Mirtazapine and breastfeeding factsheet
  • Mirtazapine and breastfeeding
    One of the newer ways of treating depression is Mirtazapine. It is structurally dissimilar to SSRIs and tricyclic antidepressants. It produces fewer symptoms of sexual dysfunction that have been reported in SSRIs and is particularly useful if insomnia is present as part of the depression picture. We all know of those long nights as you struggle to sleep but your brain wont stop. The literature on breastfeeding is poor with only 11 breastfeeding mothers in total studied but the poor oral bio-availability together with the studies is reassuring that little passes into milk but as with all centrally acting drugs we should be observing the baby for signs of increased drowsiness or poor feeding Mirtazapine and breastfeeding factsheet If you found this useful you might like to consider buying the book from which the information was taken. Please email me with any questions wendy@breastfeeding-and-medication.co.uk
  • Miscarriage and Breastfeeding
    I’ve realised that the information I wrote long ago now, on loss of a pregnancy and breastfeeding is not very detailed so today I have written a more detailed factsheet. My heart goes out to everyone who has to go through the loss of a baby through miscarriage. We dont talk about it openly often enough considering how common it is . Sending hopeful rainbows for the future miscarriage and breastfeeding factsheet
  • MRI, gadolineum and breastfeeding
    There are ongoing queries about the use of gadolineum as a contrast agent for MRI procedures. This is the research I have accessed which suggests there is no need to interrupt breastfeeding at all MRI and breastfeeding MRI and breastfeeding
  • Multiple Sclerosis and Breastfeeding
    This is one of the chapters of the new book I am just finishing and about breastfeeding with a chronic condition. So many people told not to breastfeed or to stop for medication. Hope this changes some of those concepts. Any queries please feel free to email wendy@breastfeeding-and-medication.co.uk multiple sclerosis and breastfeeding
  • My Story
    this is the background to why I am so passionate about breastfeeding and drugs in breastmilk https://breastfeeding-and-medication.co.uk/my-story
  • Naproxen and Breastfeeding
    Naproxen is frequently used as an anti inflammatory and to add pain relief for instance after surgery. However, there seems to be concern about prescribing it for the breastfeeding mother. I hope this information helps. Naproxen and Breastfeeding factsheet If it was useful maybe you need to buy the book?
  • Nausea and Breastfeeding
    One of the more frequently asked questions recently relates to nausea and even vomiting when breastfeeding. It may be due to norovirus, pregnancy (see https://breastfeeding-and-medication.co.uk/thoughts/suffering-from-morning-sickness-and-still-breastfeeding ) or to stop nausea from medication e.g morphine. I hope this factsheet provides some options. The information is taken from my book Breastfeeding and Medication which provides more details and references. Maybe you need to buy a copy? Nausea and Breastfeeding
  • New book Breastfeeding for Dads and Grandmas
    https://www.amazon.co.uk/Importance-Dads-Grandmas-Breastfeeding-Mother/dp/1939807921/ref=sr_1_1?ie=UTF8&qid=1485609461&sr=8-1&keywords=breastfeeding+for+dads+and+grandmas Delighted to see the second of my babies published – UK and US versions and Kindle edition
  • Noethisterone and breastfeeding
    Many mothers take norethisterone to delay periods before holidays or even their wedding. Others use it to stop heavy bleeding and wish to continue to breastfeed norethisterone and breastfeeding factsheet  
  • Norethisterone and Breastfeeding
    http://s895428841.websitehome.co.uk/wp-content/uploads/2019/09/norethisterone-and-bf.pdf
  • Opiates and the breastfeeding mother
    I’m not sure how many ways I can provide this information. Multiple times EVERY day I hear of breastfeeding mothers being sent away with prescriptions and told to stop breastfeeding or are told they cant have strong pain killers if they are breastfeeding – so it is their choice! NHS why cant you understand that there are opiate options for breastfeeding mothers. Opiates should not be used as freely as they are or put onto repeats prescriptions without fully informing the patient that they are addictive. But sometimes we all do need help short term. Opiates and the breastfeeding mother If you are finding these fact sheets useful maybe you would find buying my book a valuable investment! £30.73 on Amazon today ! https://www.amazon.co.uk/Breastfeeding-Medication-Wendy-Jones/dp/1138298328/ref=sr_1_1?ie=UTF8&qid=1537258447&sr=8-1&keywords=breastfeeding+and+medication
  • Oral Terbinafine and breastfeeding
    Some mothers develop fungal nail infections in pregnancy and delay treatment. When breastfeeding, topical treatments are preferable. I am asked at least once a week about oral terbinafine – hard to answer with little research. Hope this information helps with shared decision making. Oral terbinafine and breastfeeding factsheet email wendy@breastfeeding-and-medication.co.uk
  • Oseltamivir for flu and breastfeeding
    Just this week the number of queries about the use of oseltamivir (Tamiflu) has increased dramatically so I have written this fact sheet. Hope the incidence of flu doesn’t increase dramatically this year. The best prevention is hand washing and that those with symptoms stay in isolation. Tamiflu and breastfeeding factsheet
  • Osteoporosis and breastfeeding
    Following on from the data on the menopause and braestfeeding, I know many women are advised to limit the duration of breastfeeding in order to protect their own bone density. This sadly often shows a mis understanding of breastfeeding and its importance to the ongoing health of mother and child. I hope this information taken from Breastfeeding and Chronic Medical Conditions helps Osteoporosis and breastfeeding fact sheet please email me wendy@breastfeedi9ng-and-medication.co.uk if you need more information
  • Pain relief after birth and breastfeeding
    I was recently asked for input in a guideline on pain relief for new mothers after birth. I was surprised to see it almost seemed to penalise breastfeeding mothers suggesting that if you are breastfeeding you cant have effective pain relief for more than 3 days even if you have had a c section. With a new grandchild due in June I decided to put together this information. It includes pain relief, laxatives, haemorrhoidal treatment and iron supplements Pain relief after birth Codeine and breastfeeding
  • 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. https://jamanetwork.com/journals/jama/article-abstract/2661581?redirect=true www.breastfeedingnetwork.org.uk/analgesics/
  • 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
  • Perinatal Mental Health in pregnancy and breastfeeding
    I saved this presentation to share during UK Maternal Mental Health Awareness Week which is this week. It is a presentation which I have on my last study day on my birthday this year. I hope it covers many of the things I have tried to pass on over the years. I also post it today in honour of my daughter who is a CBT therapist and has helped me learn so much along my own journey into understanding mental health. She gave birth to a gorgeous, if tiny, little girl this morning – my sixth grandchild who I cannot see in person during this crazy, demanding time in our lives. I think the COVID-19 pandemic has played with the minds of many of us. I hope this presentation helps with CPD and I am happy to answer any questions via email wendy@breastfeeding-and-medication.co uk. Mental health in pregnancy and breastfeeding powerpoint If it is useful there are 2 books you might find valuable.
  • Pivmecillinam and breastfeeding
    pivmecillinam-and-breastfeedingDownload
  • Post operative analgesia for the breastfeeding mother
    Having had to support a mum with a fracture this week told that she could have adequate analgesia or breastfeed but not both I have decided to cut this out if the anaesthesia document so that it stands alone. I continue to be frustrated by the lack of understanding of professionals about normal breastfeeding let alone term or extended breastfeeding even where this is below the 2 years recommended by WHO. I’m going to keep on supporting mothers to challenge poor information using the hashtag #usetheevidence. In 2008 NICE issued a recommendation about using specialist sources on the safety of drugs in breastmilk and not relying on the licensing of drugs whereby virtually no medicine can be prescribed to a lactating mother. Buy a specialist text Breastfeeding and Medication! Prescribing  https://goo.gl/VvMxqT Recommendation 15 Who is the target population? Hospital doctors, GPs, obstetricians, pharmacists, specialist nurses, dentists and PCT medicine management teams.post op analgesia Who should take action? NHS trusts responsible for maternity care and GP surgeries, community health centres, pharmacies and drug and alcohol services. What action should they take? Ensure health professionals and pharmacists who prescribe or dispense drugs to a breastfeeding mother consult supplementary sources (for example, the Drugs and Lactation Database  or seek guidance from the Specialist Pharmacy Service. Health professionals should discuss the benefits and risks associated with the prescribed medication and encourage the mother to continue breastfeeding, if reasonable to do so. In most cases, it should be possible to identify a suitable medication which is safe to take during breastfeeding by analysing pharmokinetic and study data. Appendix 5 of the ‘British national formulary’ should only be used as a guide as it does not contain quantitative data on which to base individual decisions. Health professionals should recognise that there may be adverse health consequences for both mother and baby if the mother does not breastfeed. They should also ...
  • poster that dads are important to breastfeeding mums
  • press release Why Mothers Medication Matters
    Why mothers medication matters will be launched at Effraspace London on 1st June and will be on sale from 8 June. So proud of my third baby
  • 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
  • Progesterone Pessaries and Breastfeeding
    A question which is coming up very frequently just now is the use of cyclogest pessaries in pregnacy for mums who are still,breastfeeding. So to save me keep typing ( and to help you, of course) here is the information. Progesterone pessaries and breastfeeding factsheet
  • 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 bf
  • Protein Shakes and Breastfeeding
    During the “lockdown” I have had more questions than usual about using protein shakes as part of a return to fitness/ exercise programme. Great to see so many people getting fit but sadly I cant help on the use of protein shakes as there is no research that I have found to prove safety. I’m not happy to comment without evidence to back what I say which I am sure you understand.
  • Publicity for Why mothers’ medication matters
    Excited to see this publicity for Why Mothers Medication matters on Hellomagazine.com today https://goo.gl/39gWBC  
  • Raised cholesterol and breastfeeding
    When I was working as an independent pharmacist prescriber my main role was to look at primary prevention of cardio vascular disease – identifying factors which raised the risk of people to have a heart attack or stroke in the next 10 years. I used an online calculator using various data like BMI, smoking status, blood pressure and cholesterol ( https://qrisk.org/three/). I didnt see many breastfeeding patients and we concentrated on the over 50s. But in the process I learned a lot about managing weight and encouraging a healthy diet and portion size, smoking cessation and control of cholesterol. In many cases we managed to reduce the risk with lifetyle changes. It seems that mothers may now have their cholesterol measure and advised that it is too high. I had 20 -30 minute appoitments to encourage lifestyle change. This isnt possible for GPs with pressures on appointments so often the mothers are offered medication to reduce cholesterol. Until recently the only drug compatible with breastfeeding was cholestryamine. This is fine if there isnt a history of familial hypercholesterolaemia and a much higher risk of a cardio vascular event. A colleague pointed me to some data on elactancia which had a very different list of references and information on cholesterol in standard artificial formula. Thus began a journey to this factsheet over the past couple of months. It isnt a recommendation, as there are currently no studies on the use of statins during breastfeeding nor the effect on the baby . However, it looks at an evidence base which can prompt discussion with clinicians. I hope it helps. My thanks to Sam Morris and Amanda Da Costa for their knowledge and support as pharmacists and breastfeeding helpers on the BfN Drugs in Breastmilk Information Service Raised cholesterol and breastfeeding factsheet
  • Raynaud’s and Breastfeeding
    Raynaud’s phenomenon affects up to 10% of otherwise healthy women aged 21-50 years of age. It is 9 times more common in women than men. Yet many doctors are unaware that Raynaud’s can affect breastfeeding. It produces deep pain after feeds with a mother often automatically covering her nipples or massaging them to restore the blood flow. Symptoms are often mis-diagnosed as thrush when in fact the use of fluconazole can make the symptoms worse by causing further vasoconstriction. Most mothers who experience problems with Raynaud’s during breastfeeding, have a history of cold hands and feet or a close relative who has. It may be that in a family it is routine to wear thick socks and gloves, maybe a vest without realising that they may be “unusual” in their response to the cold. Babies of mothers with Raynaud’s may be born early and / or smaller because of restriction of blood flow to the placenta. It is not uncommon for there to be a maternal (or close family) history of migraines. Symptoms which differentiate Raynaud’s phenomenon with other causes of breast pain are: Pain in both breasts after feeds Pain which may be precipitated by being cold or for example going down the freezer aisle in a supermarket Rapid 3 colour change in the nipples after feeds Pain that is resolved by warmth or gentle massage A history or close family history of poor circulation   Raynauds and breastfeeding Treatment of Raynaud’s during breastfeeding Don’t ignore the fact that pain after breastfeeds may be due to less than perfect attachment of the baby at the breast. A white tip to the nipple after feeds is not the same as the tri colour change typical of Raynaud’s Nifedipine 30mg a day (either as 10mg three times a day or long acting 30mg once daily. The amount in breastmilk is too small to affect babies ...
  • Retinoid beauty creams and breastfeeding
    With the launch of a new beauty cream containing retinol advertised as reducing wrinkles, the questions about beauty products similar to it have increased. Or maybe we all just need something to cheer us up during Lockdown. There is no research on the use of topical retinols and the best information I have sourced is “Because it is poorly absorbed after topical application, it is considered a low risk to the nursing infant” (Lactmed accessed June 2020 studies referenced below.) Hale (Medications and Mother’s Milk accessed June 2020 states “Tretinoin is a retinoid derivative similar to Vitamin A. It is primarily used topically for acne and wrinkling and sometimes psoriasis. Used topically, tretinoin stimulates epithelial turnover and reduces cell cohesiveness. Blood concentrations measured 2-48 hours following application are essentially zero. I have been unable to access the full papers and so would recommend caution They Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006;24:167-97. Zip C. Common sense dermatological drug suggestions for women who are breast-feeding. Skin Therapy Lett. 2002;7:5-7. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II Lactation. J Am Acad Dermatol. 2014;70:417.e1-417.e10. . Zbinden G. Investigation on the toxicity of tretinoin administered systemically to animals. Acta Derm Verereol Suppl(Stockh) 1975; 74:36-40. Lucek RW, Colburn WA. Clinical pharmacokinetics of the retinoids. Clin Pharmacokinet 1985; 10(1):38-62
  • review of the importance of Dads and Grandmas to the breastfeeding mum
    delighted to read this review on twitter, Than you Karen @sprogcast https://motherworldly.com/blog/book-reviews/book-review-the-importance-of-dads-and-grandmas-to-the-breastfeeding-mother-by-wendy-jones/
  • Rheumatoid Arthritis and Breastfeeding
    I’m really saddened that so many mothers are recommended to stop breastfeeding in order to be treated with medication. There is some evidence that breastfeeding in itself protects the mother https://www.unicef.org.uk/babyfriendly/news-and-research/baby-friendly-research/maternal-health-research/maternal-health-research-rheumatoid-arthritis/ I hope that this factsheet provides some alternatives. The information is taken from Breastfeeding and Chronic Medical Conditions – price reduced so worth buying a copy on Amazon RA and Breastfeeding Factsheet
  • Rosacea and breastfeeding
    It is funny how questions come in groups. At the moment many mothers are contacting me with questions about Rosacea particularly wanting to use Soolantra (Ivermectin cream). This is the chapter from my book Breastfeeding and Chronic Medical Conditions which I hope helps. The information on ivermectin cream is limited but Hale suggests a relative infant dose of 1.3 even after oral medication, so topical absorption is unlikely to affect a breastfed infant. I have today (5th March 2021) reduced the price of the paperback and kindle version of Breastfeeding and Chronic Medical Conditions. Please email me with any questions wendy@breastfeeding-and-medication.co.uk Rosacea and breastfeeding factsheet
  • Royal Pharmaceutical Society
    really proud to be mentioned by the Royal Pharmaceutical Society today #wearepharmacy
  • Sertraline and breastfeeding
    Especially over the past year of the pandemic many mothers are asking about the compatibility of sertraline during breastfeeding. It has been a hard time for everyone with the incidence of anxiety and depression continuing to rise. As access to IAPT and IESO is more difficult the prescription of medication is inevitable. Sertraline is the first choice medication for breastfeeding mothers as virtually none gets into milk and that we have a high level of experience with it over many years. Unfortunately many doctors are, in my experience, still recommending that mothers should stop breastfeeding in order to take it. This may be that they think life would be easier if someone else could help with care of the baby or that the mother may get more sleep. Sadly, this doesnt always happen and the loss of oxytocin may also lower mood further. There is often an assumption that pressure to breastfeed can lead to depression but in my experience pressure to stop breastfeeding in order to take medication may increase depression and may also stop mothers accessing professional help to avoid having that discussion. This link to the RCGP perinatal mental health toolkit may be useful for professionals and parents RCGP perinatal mental health toolkit This factsheet contains information from my book Breastfeeding and Medication. Please message me for references used or with any questions. Setraline and breastfeeding factsheet Breastfeeding and chronic medical conditions contains chapters on anxiety and depression wendy@breastfeeding-and-medication.co.uk
  • Skin allergy tests and breastfeeding
    Mothers have been reporting that they have been advised to interrupt breastfeeding or even stop altogether in order to have skin and patch allergy testing. This doesn’t seem based on evidence but possibly without national guidelines. The allergens do not pass into the blood stream let alone breastmilk so there is no reason to interrupt breastfeeding. Medication Should you react severely to an allergen test and require administration of an antihistamine, an adrenaline injection (e.g. EpiPen)  or a steroid that does not stop you breastfeeding as normal Adrenaline/epinephrine injection e/g/ EpiPen ™. Ingredient present in milk but unlikely to be harmful as poor oral bioavailability . Half life 2 minutes so all gone from the body in 10 minutes. Antihistamine – https://www.breastfeedingnetwork.org.uk/antihistamines/ Prednisolone – https://www.breastfeedingnetwork.org.uk/prednisolone/ Skin allergy tests and breastfeeding
  • Sleep problems when breastfeeding
    One of the hardest questions I have to answer. I want to help but I need to keep the breastfed baby safe too Sleeping tablets Avoid if possible. Use for as short a time as possible. Observe baby for drowsiness. Avoid falling asleep with the baby in bed, on a chair or sofa Committee on Safety of Medicines advice 1 Benzodiazepines are indicated for the short-term relief (two to four weeks only) of anxiety that is severe, disabling or subjects the individual to unacceptable distress, occurring alone or in association with insomnia or short-term psychosomatic, organic or psychotic illness. 2 The use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate and unsuitable. 3 Benzodiazepines should be used to treat insomnia only when it is severe, disabling, or the individual is caused extreme distress. Sleeping tablets and breastfeeding factsheet
  • St John’s Wort and Breastfeeding
    Sadly the incidence of post natal depression and anxiety has increased and even doubled during the pandemic http://New mothers twice as likely to have post-natal depression in lockdown and we know that many find it hard to go to see their doctor or fear that they will be told to stop breastfeeding to take medication. Some prefer a more natural, herbal remedy and will purchase St John’s Wort. This is the information on the compatibility of hypericum with breastfeeding. If you want to discuss your medication and suitability please email me on wendy@breastfeeding-and-medication.co.uk . St John’s Wort and breastfeeding factsheet
  • Stillbirth and Milk Supply
    Following on from the information on miscarriage I decided I needed to carry on talking about the hardest topics for mothers and think about the unthinkable – stillbirth, a baby born sleeping, and how to deal with the subsequent milk supply. I could fervently wish this never needed to be read but I hope that it provides information for mothers, families and professionals in this awful situation. stillbirth and milk supply factsheet
  • Suffering from morning sickness and still breastfeeding?

    Recently lots of mums have been asking about medication to help with severe morning sickness/hyperemesis when still breastfeeding an older child. You can take medication and no you dont have to stop to “protect” the unborn baby. Eat good nutritious snacks – promise I wont mention ginger!

  • 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! £30.73 on Amazon today and worth every penny terminations and breastfeeding
  • Thank you Alison Thewliss MP
    I’m feeling over awed by the fact that the amazing MP Alison Thewliss put down an early day motion about my Points of Light award https://www.parliament.uk/edm/2017-19/1307 … I’m emotional and inspired Thank you @alisonthewliss from the bottom of my heart
  • The History of Child Nutrition
    THE HISTORY OF CHILD NUTRITION OVER THE PAST 200 YEARS
  • The menopause and breastfeeding
    I’m seeing increasing numbers of questions form mums in the perimenopause who are still breastfeeding. Maybe they delivered later or maybe they have been feeding to term or maybe lots of other reasons. I remember asking for blood tests to check my hormone levels because I just couldnt think clearly anymore and my memory was poor which wasnt ideal as I was just becoming an independent pharmacist prescriber! My levels had indeed dropped and I went on to HRT. This may not be everyone’s choice or be suitable for them I have spent many hours this year looking for guideance on HRT and breastfeeding and failed to find any studies or conclusive data. Everything is anecdotal at the moment but I hope this information helps. As usual please message me on wendy@breastfeeding-and-medication.co.uk if you have a question The menopause and breastfeeding factsheet
  • the role of formula manufacturers
    http://www.babymilkaction.org/archives/10476 Every day I hear stories where mothers have been advised to stop breastfeeding in order to take medication, without considering the risk to mum and baby of interrupting breastfeeding even temporarily. Formula milk is not the same as breastmilk and never will be. Not all babies will drink from bottles. Not all mothers can express. Not all babies will go back to the breast. Not all mothers can maintain their supply. Medication should not be a reason to stop breastfeeding without looking at evidence based sources on safety, taking professional responsibility and last but not least involving the mother in making an informed decision
  • Three books published soon
  • Timing of breastfeeds if taking medication
    I’ve recently had several emails/ Facebook messages that mothers have been advised to pump and dump their breastmilk for a period of time after taking medication in order to minimise / prevent exposure of the baby to the drug. This has often been undertaken when the drug is compatible with breastfeeding and resulted in the unnecessary exposure of the baby to formula milk. For most drugs taken for more than 3 days the amount in milk is constant across 24 hours. So timing feeds with respect to breastfeeding or dumping of the breastmilk is pointless. The half life of a drug is very important but just one of the factors in determining the compatability with normal breastfeeding. If you want to know more please consider buying “Breastfeeding and Medication” Timing of medication and breastfeeds
  • Tranexamic acid to treat heavy periods experienced by breastfeeding mothers
    One of the advantages of breastfeeding is that for many it may be months or even years before menstrual bleeding returns regularly. However, some mothers do experience heavy flow which needs to be treated. Tranexamic acid is usually the drug of choice at a dose of 1 g 3 times a day for up to 4 days, to be initiated when menstruation has started; maximum 4 g per day (BNF 2018). Mothers can continue to breastfeed as normal. There is one reported case of restless in the baby in a study of 21 mothers but in general it seems anecdotally, to cause few problems. tranexamic acid and breastfeeding factsheet
  • 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
  • Treating coughs. colds and sore throat in the breastfeeding mum
        Every year there are many questions on coughs, colds and sore throat so thought I would pre-empt them this year by recording a live video as well as the links and fact sheets Hope everyone has a healthy winter ! Treating coughs colds and sore throats in the breastfeeding mother   cough and cold remedies and breastfeeding 2018 sore throat and breastfeeding 2108 https://www.facebook.com/breastfeedingandmedication/videos/251606965539626/
  • Turmeric supplements and breastfeeding
    Turmeric is a supplement recommended for the relief of inflammation in many chronic conditions. It is, of course, a spice used in curries. When taken as a supplement levels are significantly higher than those used for culinary purposes. This is the information on compatibility with breastfeeding that I found in LactMed https://www.ncbi.nlm.nih.gov/books/NBK501846/ (the emphasis is my own) : Summary of Use during Lactation Turmeric (Curcuma longa) rhizome contains curcuminoids such as curcumin. No data exist on the excretion of any components of turmeric into breastmilk or on the safety and efficacy of turmeric in nursing mothers or infants. Turmeric is “generally recognized as safe” (GRAS) as a food ingredient by the U.S. Food and Drug Administration. Turmeric is generally well tolerated even in high doses, but gastrointestinal side effects such as nausea and diarrhea, and rare allergic reactions have been reported, and it may increase the risk of bleeding in patients taking warfarin and antiplatelet drugs. Because of a lack of data, turmeric in amounts higher than those found in foods as a flavoring should probably be avoided during breastfeeding. Turmeric has been used as a galactogogue in India; References from LactMed https://www.ncbi.nlm.nih.gov/books/NBK501846/ 1.Sayed NZ, Deo R, Mukundan U. Herbal remedies used by Warlis of Dahanu to induce lactation in nursing mothers. Indian J Tradit Knowl. 2007;6:602-5.2.Chaudhuri RN, Ghosh BN, Chatterjee BN. ...
  • Valproate and pregnancy
    I know that this page is about breastfeeding and medication but I think that is important to share this too. I started writing it for another organisation a year ago but it hasnt gone anywhere so now it is here. Anyone who is on sodium valproate (Epilim) should be taking adequate contraceptive protection https://www.fsrh.org/news/mhra-contraception-drugs-birth-defects-fsrh-guidance/ . It could be for epilepsy or it could be as a mood stabiliser but it is essential that you do not become pregnant. This factsheet explains why valproate in pregnancy
  • webinar on the importance of others to the breastfeeding mum
    https://www.facebook.com/Kathy.KendallTackett/videos/1602042849909631/
  • What do women want healthcare professional to know about the needs of the perinatal mum with mental health challenges?
    I have tried to get this paper published but have failed because I am not associated with a university, have any means of applying for ethics approval or can pay – so sharing it freely in the hope that the voice of the mothers are widely heard. What do women want healthcare professional to know about the needs of the perinatal mum with mental health challenges?Download
  • 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. https://breastfeeding-and-medication.co.uk/my-story
  • Why Mothers Medication Matters
    new Facebook page to celebrate the birth of my new book https://www.facebook.com/whymothersmedmatters/ Book launch tomorrow June 1 
  • Why Mothers Medication Matters publication 23 Feb 2017
    http://www.pinterandmartin.com/why-mothers-medication-matters.html  
  • World Prematurity Day
    17 November 2021 World Prematurity Day. Sharing the chapter on premature birth and breastfeeding from Breastfeeding and Chronic Medical Conditions. I know there is so much more to add still and I will be writing more over the next few months Premature Birth and Breastfeeding factsheet