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

 

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

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 !

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 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

www.ncbi.nlm.nih.gov/pubmed/26310088

cocaine and breastfeeding

Breastfeeding and bismuth subsalicylate (Pepto Bismol®)

pepto bismol

another of the frequently asked questions

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

Treating coughs, colds and sore throats in the breastfeeding mother

Lots of coughs and colds starting already so some information to pre-empt the questions which come every year

Posted by Breastfeeding and Medication on Thursday, September 13, 2018

post partum cardiomyopathy and breastfeeding

Great article from UKDILAS – www.cfrjournal.com/articles/postpartum-cardiomyopathy-and-considerations-breastfeeding

Abstract

Postpartum cardiomyopathy (PPCM) is a rare condition that develops near the end of pregnancy or in the months after giving birth, manifesting as heart failure secondary to left ventricular systolic dysfunction. Clinical progression varies considerably, with both end-stage heart failure occurring within days and spontaneous recovery seen. Treatment pathways for heart failure are well established, but the evidence about the safety of medicines passed to infants during breastfeeding is scarce and mainly poor; this often leads to an incorrect decision that a mother should not breastfeed. Given its benefits to both mother and infant, breastfeeding should not routinely be ruled out if the mother is taking heart failure medication but the consequences for the infant need to be considered. An informed risk assessment to minimise potential harm to the infant can be carried out using the evidence that is available along with a consideration of drug properties, adverse effects, paediatric use and pharmacokinetics. In most cases, risks can be managed and infants can be monitored for potential problems. Breastfeeding can be encouraged in women with cardiac dysfunction with PPCM although treatment for the mother takes priority with breastfeeding compatibility being the secondary consideration. International research is continuing to establish efficacy and safety of pharmacotherapy in PPCM.

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 [LactMed] 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 recognise that it may not be easy for the mother to stop breastfeeding abruptly – and that it is difficult to reverse.

post op analgesia

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