Drugs for two: caution when using medicines during breastfeeding

At a certain stage of lactation, most mothers need medication to treat a disease. In addition to the fact that you have to puzzle over how this medication will work on your own organism, you now have to take into account one more organism. Most of the medicines taken by the mother penetrate into her milk, but usually only about 1 percent of the dose taken is in milk. Here's how to take medication during breastfeeding without risk.

General Considerations

Before taking any medication during breastfeeding, consider the following:

• Will this drug cause harm to the baby?

• Will this facility reduce the production of milk?

• Is there a less harmful and equally effective alternative medicine?

• Is it possible to manipulate medication and breastfeeding in order to reduce the amount of medication that enters the child's body?

You should be aware that nursing mothers prescribe medications, based more on the law than on scientific data. A doctor who is not sure about the harmlessness of the drug can recommend that the mother does not breast-feed.

Pharmaceutical companies also legally protect themselves, not recommending breastfeeding while taking the drug( as indicated on the inserts and instructions in the "Therapist's Reference Guide").This cautious advice is usually cheaper than doing research to find out how much the drug is in the mother's milk and what is the effect on the baby. As a result of illiterate recommendations for completely harmless medicines, children are often prematurely, sharply and unnecessarily weaned.

How to juggle medications and feeding

If you need to take medicine, that's how to minimize the amount your child will receive.

Ask yourself if you really need this medicine. If you have a cold, can not you achieve the same result by hitting your legs, making inhalations, consuming more fluid and resorting to time management? Can not you get by with a medicine consisting of one ingredient, not several?

Find out if treatment can not be postponed. If you need a diagnostic procedure( for example, a radiographic study using radioactive material) or a planned operation, can you wait until the child is older by a few weeks or months? The drug can bring more harm to a newborn baby who receives exclusively breast milk than the more adult child who has alternative sources of nutrition and more mature body systems that are easier to cope with this drug.

Choose a medicine that does not penetrate into breast milk. Inform your doctor that breastfeeding is very important for you and your child and that you would not want to give it up without sufficient medical grounds. Your doctor may choose a medicine( for example, an antibiotic) that does not penetrate the milk well. In addition, your doctor may find another way to administer the medication so that he gets directly to the affected area and as little as possible enters your bloodstream. For example, in case of skin lesions, try to apply ointments instead of taking tablets, apply inhalation medications to asthma or bronchitis, and inject drugs from the rhinitis( anti-swelling) into the nose rather than taking it orally. Because short-term medications( taken three to four times a day) disappear faster from your milk, they are usually considered safer during breastfeeding than long-acting drugs( taken once or twice a day).

Alternate feeding and taking the drug. Find out from your doctor how long after taking the drug, its concentration is highest.(That is, when the drug reaches its highest level in your blood - usually at the same time it reaches the highest level in your milk.) Most drugs have the largest

concentration one to three hours after ingestion and practically disappears from the bloodstream after six hours. If there is any doubt about the safety of the drug, apply the following tactics:

1. As far as possible, before you start taking the drug, discard and store for storage so much milk that it is enough for several feedings.(See about expressing and storing milk in more detail in "Expressing milk.")

2. Feed the breast immediately before taking the medication.

3. Take the medication immediately before the longest period of a child's sleep, usually after the last feeding in the evening.

4. If the child requires breast before the expiration of three to six hours from the time of taking the drug, use "safe" milk from your stock or use artificial mixture.

5. Express and discard. Since most medicines leave breast milk as quickly as they enter it, some respected experts are convinced that waiting six hours before feeding is as effective as pumping and throwing out milk, but pumping can prevent milk stagnation. In addition, some fat-soluble drugs remain in the fat of breast milk, so you may need to express and pour out as much milk as the baby would have enough for a whole meal before the expiration of three to four hours after taking the medication.

This sequence of actions is only a general guideline, which can vary depending on the type of medication and the schedule of your baby's feeding.(Some radioactive substances, for example, take twenty-four hours to remove from your body.) Develop an optimal pattern of alternation with your doctor.

If the safety of the drug you are compelled to take is questionable, but for medical reasons your child simply needs your milk( for example, the child has an allergy to artificial mixture), in addition to observing the above alternate advice, contact your doctor to monitor the amounta drug that enters your milk or the bloodstream of a child.

Medications Mostly Fears of

The following recommendations will help you if you come across some of the most commonly used medications. Pain and antipyretic analgesia. Acetaminophen is the safest for the period of thoracic

feeding an analgesic: only 0.1-0.2% of the mother's intake of the dose goes to milk. Several doses of narcotic painkillers( demerol, codeine and morphine) after childbirth or surgery can cause the baby to have temporary drowsiness, but are not sufficient grounds for stopping breastfeeding. Long-term use during breastfeeding of narcotic analgesics may be unhealthy. Remedies for colds, coughs and allergies. These over-the-counter products are safe during breastfeeding, but observe the following precautions: try products consisting of one ingredient( either alone, decongestant, or antihistamine, for example) before applying the combination;funds with short-term effects are usually safer than those with a long-term effect. Before going to bed, cough syrup containing codeine is not dangerous;dextro-methorphan is preferred. It is better to take these medications after breastfeeding before bedtime and limit their intake to one to two days at a time. Watch whether your child will show increased irritability following the use of decongestants or excessive drowsiness after taking an antihistamine drug, and make the appropriate changes. Sprays for the nose( cromolin, steroid preparations, decongestants) during breastfeeding are safer than cold cures taken internally.

Antibiotics. Almost all antibiotics are safe for admission during breastfeeding, especially if you have an ordinary week or two-week course of treatment for the most common infectious diseases. Despite the fact that only a very small amount of the most widely used antibiotics( from the penicillin and cephalosporin group) enters the milk, the child may have an allergy to the antibiotic( skin rashes of an allergic nature), or he may have a thrush in his mouth, orDiarrhea can occur due to the prolonged exposure of the antibiotic to the intestine. In the newborn period with special care should be used antibiotic sulfamidnoy group. With prolonged use of any antibiotic such as tetracycline, your doctor may take precautions and prescribe the administration of large doses of the antibiotic intravenously, or he may prescribe special antibiotics such as Flagyl.

Caffeine and chocolate. No, you will not have to give up your favorite coffee, tea, soft drinks or chocolates for the time of breastfeeding to

.Studies show that only 0.5-1% of the mother's dose of caffeine or chocolate enters the milk. In rare cases, the child has irritability, which is caused by an increased sensitivity to caffeine or theobromine contained in chocolate.

Oral contraceptives. Most experts believe that tablets with a small dose of exclusively one pro-gestin( "mini-pill") during breastfeeding are safe. And for mothers, whose children are exclusively breastfed, mini-tablets provide the same effective protection as the older combination of progester-estrogen, which reduces the quality and quantity of milk and is also unsafe. Studies have shown that tablets containing only progestin do not affect the quality or quantity of milk and do not harm the growth and development of the child, and some studies prove that this type of tablets can even improve the production of milk. However, it sometimes happens that a nursing mother complains of a decrease in milk production even when taking minitablets. Although the eight-year follow-up of children of mothers who took pills with fifty micrograms of progestin during breastfeeding did not reveal

• breast pads( bra inserts);

• clothes specially designed for nursing mothers;

• Children's sling bag.