Breastfeeding mothers get sick and breastfeeding does not prevent them from becoming ill as the rest of the population.
There is a great fear of medication during breastfeeding because there is a belief that the drugs the mother takes go directly into her breast milk and reach the baby in their entirety. This has two clear negative effects: mothers either do not take the medication they need or they stop breastfeeding, partially or totally, to take their medication.
The lack of knowledge of some professionals on the subject also leads them to recommend weaning when the mother has to be medicated, and causes curious situations like the following: a mother of a three-month-old baby that needs to be prescribed an anti-inflammatory for pain and is recommended to stop breastfeeding, when in fact this same medication had been prescribed to the mother just after delivery (with a newborn baby) to relieve the pain produced by an episiotomy or a C-section.
What should a breastfeeding mother consider when she needs medication?
First of all, you should be aware that drug package inserts often do not provide reliable information on compatibility with breastfeeding. Surprisingly enough, pharmaceutical companies are not willing to take even the slightest risk in the face of possible future demand. Thus, in most medicines there is a common section called “Pregnancy and Breastfeeding” (as if both situations were the same) where it is specified that the medicine passes into the milk. Obviously, this does not help at all. Nursing mothers can take medication and it is not necessary to go through the whole breastfeeding process without a painkiller because of the fear that it could imply some risk for the baby.
But do drugs pass into the milk?
The passage from medication to milk depends on many factors and therefore they do not behave in the same way, some do not even reach the milk. Each medication must be evaluated individually. Some will be totally compatible, others will have some risk for breastfeeding or according to the baby’s age, and others will be completely incompatible and it will be necessary to stop breastfeeding. From this last assumption we find very specific medications that are not administered for common diseases.
Why do some medicines pass into the milk and others do not?
The greater or lesser passage of a substance into the milk depends on many variables such as molecular weight, protein binding, milk/plasma index… etc, so it is always necessary to assess the compatibility of every medication. Also the baby’s age is something to consider, since a newborn baby that depends exclusively on its mother’s milk is not the same case as a toddler.
Where can I find reliable information?
As we have already said, drug leaflets are not a good source of information and, in the same way, the vademecums used by health professionals do not provide better information regarding breastfeeding.
But mothers who breastfeed should know that they do have good and reliable sources of information that can help them check the safety of the medicines they need to take.
This information can be found mainly at two sites:
www.e-lactancia.org (An English version is available)
Both are databases produced by breastfeeding doctors and have specific studies that support the information they provide and that allow us to know with absolute certainty whether or not a medicine is safe during breastfeeding.
Remember that the classification by risk levels in the e-lactation database is intended for babies from 0 to 1 month, as they grow, the risk is lower.
*At LactApp you will also find a list of the most common diagnostic procedures, so that you can check their compatibility with breastfeeding at any moment.