Medication safety and breastfeeding
What meds are are during breastfeeding- Asking you doctor isn’t always going to get you the correct answer. In my hospital days I’ve heard anesthesiologists tel a patient to “pump and dump” for 4 hours because of Benadryl- a med MANY c/s moms routinely get for itchiness after surgery. This is an L2 (more on that in a minute) and most likely safe. And in the wake of a 20% PPMD (Post-part I’m mood disorder- not just depression but also anxiety) rate in the US, I’ve heard countless OB’s, Pedi’s and even Psychologists tell a patient to “pump and dump” for simple SSRI’!!!
Let’s talk real about med safety when breastfeeding. There are some studies, not as many as there are on non-pregnant or non-breastfeeding med safety but still some. There is an amazing resource- “Hale’s Medications and Mother’s Milk” by dr Thomas W. Hale, R.Ph., Ph.D and it covers EVERYTHING. Why your OB or Pedi doesn’t have one in their office, or at least on their phone, I don’t know. But I do. This book is big and heavy but I carry it everywhere. I have one at my office and one for home visits. Being able to get the correct, study based answer is essential.
How this works is by class- there is L1-5. L1 is compatible- think of prenatal. Lots of studies with good reliable and reproducible results showing no harm at all. Few drugs make it into this category due to the high need for studies alone. L2 is probably compatible- limited number of studies but good outcomes and no cause for worry. L3 is probably compatible but either no controlled studies or risk is possible. This is a cost vs benefit area, it depends on the case. L4 is potentially hazardous but may be used if deemed medically necessary for life for the mother. L5 is Hazardous- think oncology drugs. Definite harm to baby if used during breastfeeding.
Most of the drugs you may have taken while pregnant or breastfeeding areL2 or L3, but it’s always good to know. Sometime one antidepressant might be an L3 and another L2 so knowing that might help you choose what to try. And that allergy med saving your life during hay fever or around your cat, some are L2 and others L3- it’s always good to know. Some oral contraceptives (when you finally feel good enough to think about sex again, but definitely NOT good enough to consider having kids 11 months apart!) are safe L2 and others will dry up your milk! most common pain meds for after a painful vaginal delivery or c/s are L3 but Codiene is L4 and potentially hazardous.
These are just a few examples of the common meds during pregnancy and breastfeeding. Don’t let a cold med or birth control dry up your milk. Don’t let a worried Pedi tell you to stop breastfeeding now that you need meds for PPMD (and thank God you are reaching out for help!). Find out what is true and what is unnecessary worry (you have enough of that).
Email or call for an appointment today or reach out to an IBCLC you know that is educated on medication safety while pregnant or breastfeeding. Don’t let any doctor tell you a medication is unsafe or you should stop breastfeeidng without being sure!