Most moms will tell you that one of the most difficult things about breastfeeding (beyond the sore nipples and screaming, hungry babies) is the conflicting breastfeeding advice they get from family, friends, and yes, even doctors.
Take the issue of what medications are safe to take while breastfeeding, for instance. Moms often get such conflicting advice about that, they simply don’t know what to think.
I remember being told by a dentist that if I took the painkiller I was given after a tooth extraction that I would need to “pump and dump” until I was done taking it. But then when I called my son’s pediatrician, I was told that the medication I was prescribed was completely safe for breastfeeding, and I could continue without interruption.
What’s a breastfeeding mom supposed to believe when these sorts of situations come up?
A few years after the incident at the dentist, I became a lactation consultant and quickly learned that most medications actually are safe for breastfeeding (including the one I was prescribed by my dentist!) and that there are reliable, researched-based sources out there to help moms find trustworthy information on medications and breastfeeding. That’s some pretty great news, huh?
Here’s the lowdown on all this:
First, in a broad sense, the consensus in the medical world is that the vast majority of medications are compatible with breastfeeding, and breastfeeding moms generally shouldn’t have to wean or “pump in dump” in order to take most common medications.
Here’s why: Very little of the medications you take get it into your breast milk, and even if they do, they usually don’t pose a problem to a breastfeeding baby (and as your baby gets older, they pose even less of a danger).
Let’s take a look at what the Academy of American Pediatrics (AAP) had to say in an article about the topic, released in 2013.
“Many mothers are inappropriately advised to discontinue breastfeeding or avoid taking essential medications because of fears of adverse effects on their infants,” writes the AAP. “This cautious approach may be unnecessary in many cases because only a small proportion of medications are contraindicated in breastfeeding mothers or associated with adverse effects on their infants.”
Now, before you get your panties (or, ummm, bras) all twisted in a bunch, let me tell you that, of course, there are some medications out there that are downright dangerous for breastfeeding moms to take. The most well-known culprits are cancer medications (because of their radioactive elements), which unfortunately means that most moms facing cancer will need to wean their babies.
And as the AAP points out, there are obviously other medications out there that are problematic, including certain narcotics, some psychotropic drugs, and drugs used to help with smoking cessation. (To go through those medications one by one would be outside of the scope of this article and is really something you would need to discuss with your doctor.)
But as the AAP reports, there are actually some really incredible resources out there to help you sort this all out and to consult (again, in conjunction with your doctor, who can help interpret the data and make a game plan with you).
First, there’s LactMed, a database for physicians and breastfeeding moms sponsored by the National Institutes of Health (NIH) and updated monthly with new information as it comes in. You can look up any medication on LactMed and find out how much of the drug enters a baby’s body, the possible side effects it has on a baby, and other pertinent information.
Then there is the Infant Risk Center, an information center for pregnant and breastfeeding moms run by Dr. Thomas Hale, who compiles and conducts research on medications (including herbs and alternative treatments) and their affects on fetuses and newborns. He is well-respected in the breastfeeding and medical world, and has years of experience doing this research and making sense of it.
And the best part of it? The Infant Risk Center has a toll-free number (806-352-2519) that you can call Monday to Friday to speak to someone directly about your concerns about a particular medication and its effects on your breastfed baby. During the COVID-19 crisis, the Infant Risk Center has switched to live chatting on their website to answer any of your questions concerning medications and breastfeeding. This is particularly useful because getting a full picture of you and your baby (like how much your baby weighs, how often they nurse, etc.) are important puzzle pieces to put together when determining if a medication is safe.
Maybe the biggest roadblock in all of this is that, unfortunately, not all doctors have all the data on breastfeeding and medications. Doctors who don’t come in contact with breastfeeding mothers very frequently may just not have had a chance to keep up with new research. That’s why it’s often useful to call your pediatrician (who deals with babies daily) specifically to discuss your options — and to always seek a second opinion if something seems “off” with a doctor’s advice.
You may also want to keep the AAP article saved on your phone as well as links to LactMed and the Infant Risk Center. Some medical professionals don’t know about these, and you could really save the day (for yourself and for these doctor’s future patients) by referring your doctor to these resources.
All that being said, what if you really need to take a medication, and it turns out that it actually isn’t safe for breastfeeding? First, you may want to ask if there is an alternative drug that might serve a similar purpose, but that would be considered safe.
But if you exhaust all possibilities and find out that a medication you take requires you to stop breastfeeding for a short period or to wean altogether, please know that you and your baby will be fine. Sometimes moms have to make tough decisions, but it’s vital to remember that even more than breast milk (or anything else), a baby needs a healthy mama.
And finally, please remember always to speak to a medical professional before you start any kind of medication, herbal treatment, or alternative medical treatment while breastfeeding. Even though the basic idea is that most medications are perfectly fine, there are certainly exceptions, and it’s important that these risks are taken seriously.
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