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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.

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 mcg/day and vitamin B6 above 20-50 mcg/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 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 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.

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/03/Breastfeeding-and-cannabis.pdf

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!

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/02/accidental-codeine.pdf

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.

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/epilepsy-and-breastfeeding-1.pdf

www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/epilepsy-and-breastfeeding-1.pdf

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.

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/tamiflu.pdf

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!

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/Moviprep-and-breastfeeding.pdf

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

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/colonoscopy-and-breastfeeding.pdf

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/dental-sedation-and-breastfeeding.pdf

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/endoscopy-and-breastfeeding.pdf

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

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/midazolam.pdf

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.

http://www.breastfeeding-and-medication.co.uk/wp-content/uploads/2019/01/accidental-aspirin-3.pdf


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