Breastfeeding and Medications
We know, most commonly consume drugs are safe for breastfeed babies. The amount of dose transferred trough breastmilk is relatively small and less than the known safe doses given to the neonates and infants immediately. There are several drugs contraindicated during breastfeeding such as anticancer drugs, lithium, oral retinoids, iodine and so on. A complete understanding of the principles underlying the transfer into breast milk is important. Later, the awareness of the potential adverse effects on the infant.
Several diseases can be cured without the need to take medication, only by improving nutrition and adequate rest. But there are also diseases that do require drugs, especially diseases caused by bacteria, serious diseases such as cancer and others.
Generally, the medicines taken by the mother will be absorbed in the milk, but at very low levels. Although some drugs can cause side effects for babies (even at very low levels), this is not a reason for mothers to stop breastfeeding. Only not mixed drugs with protein in the mother’s blood can be absorbed by breast milk. So, babies who drink breast milk from taking drugs mothers or during the treatment period will not be exposed or contaminated by the drugs consumed.
If indeed the pain experienced requires medication, breastfeeding mothers must be very careful about taking the drug. According to experts breastfeeding mothers may take drugs as long as the drug is safe for both the mother and the child. Because only about 1% of the medicines consumed by the mother will get to the baby through breast milk.
Even so, you should still consult with your doctor first to make sure whether the medicine to be consumed is safe. Some active drug substances can transfer breast milk and be consumed by babies. Here are some tips for taking medication for nursing mothers:
- Consult with a doctor or midwife, explain the condition of the breastfeeding mother. If the mother is nursing sick due to a viral infection, then the use of the drug can be overcome by rest and consume lots of vitamins in fruits.
- If you need to take the drug, ask for a low dose and consume it in the shortest period.
- If you are forced to buy over-the-counter drugs, choose a drug that includes safety information for pregnant and lactating women or consult a pharmacist
- Set the time to take medication, for example after breastfeeding, or when your child sleeps for a longer period. This is to minimize the risk of influencing the effects of drugs in breast milk.
- Pay attention to the appeared symptoms, like your child becomes fussy, a rash or red / bluish spots, pain, seizures, or changes in sleep and eating patterns arise. If one of the symptoms appears, check immediately to the medical workers.
- Try to milk and store breast milk so that it can be given at any time if the mother has to be forced to take medication close to the time for breastfeeding.
The doctor will give a local drug first. For example in the form of external drugs, such as creams, spray, and inhalation. If it is not possible, then a systemic drug, such as an oral drug, will be given. Some drugs should be avoided because it can reduce the production of breast milk such as metergin or hormonal contraception (contains the hormone estrogen). Drugs that have many side effects that expel urine (diuretics like furosemide) can also reduce breast milk. On the other hands, nausea drugs such as metoclopramide or cimetidine which are drugs for stomach pain can stimulate breast milk.
Besides consulting to a doctor, it is suggested to pay attention to the following things before taking any medicines:
1) Avoid consuming herbal medicines and herbs
2) Avoid consuming over medicines on the market without consulting a doctor. Although the dosage used is low, indiscriminate consumption of drugs without regard to the content and indications is not safe for the mother and baby.
3) Consider again whether it needs medication or not and how effective the drug is.
4) Giving local drugs rather than using antipyretic drugs, avoiding allergens rather than using antihistamine drugs. You can also eat foods that contain lots of fiber and drinking a lot rather than using laxative drugs.
5) If you have to take medication, choose an effective minimum dose. Choose how to inject or use local medicine. Take medication immediately after breastfeeding to reduce concentration in milk
6) Stop breast milk while if the medication consumed by a breastfeeding mother hurts the baby or breast milk before you take the drug.
The medicine will be safe if consumed:
- Fever-reducing drugs and analgesics (pain relievers), such as acetaminophen (paracetamol), ibuprofen, local anesthetics.
- Antibiotics, such as the penicillin group (Amoxicillin, ampicillin) and cephalosporin (Cefadroxil, ceftriaxone, cefotaxime).
- Asthma medications, such as Prednisolone, prednisone, salbutamol, fluticasone.
- Allergic rhinitis, Beclometasone, fluticasone.
- Medication for diabetes mellitus, such as Insulin, glipizide.
- Heart medications, such as Thiazide, propranolol, metoprolol, labetalol.
- Medication for epilepsy, phenytoin, carbamazepine.
- Anti-depressant, Sertraline.
- Thyroid medication, Propylthiouracil, Levothyroxine.
- Contraception: Progestin (mini-pill).
Drugs that are not safe for breastfeeding mothers include:
- Anticancer drugs and radioactive materials.
- Ergotamine (migraine medication)
- Lithium (antidepressant)
- Antibiotics: chloramphenicol
If the mother is sick with the flu, the mother should still breastfeed the baby. Mothers can do several things so that the virus that carries the disease does not spread to the baby. So that the baby does not catch the flu that is being suffered by the mother, the following steps can be done.
1) Do not sneeze over a baby. Use a mask during illness.
2) Wash hands with soap each time you are breastfeeding.
3) Cover the baby while holding it.
4) Do not share cutlery, such as cups, plates, and bowls.
5) Clean the breast with warm water and soap when you want to breastfeed.
Even though it is flu, the mother does not need to be afraid to breastfeed the child, because the baby will get antibodies to the disease from breast milk. Immediately consult a doctor to get safe flu medication for nursing mothers.