How to check what medicines are safe to use while breastfeeding
How many of us suffered through colds and hayfever while pregnant with only feeble hot lemon and honey drinks for relief? Oh, how I longed for decongestants and antihistamines! If you were to read Patient Information Leaflets (“PILs”, aka the little bits of white paper inside medicine boxes), you’d be forgiven for thinking the situation with taking medicines while breastfeeding isn’t much better. However, the wonderful people over at the Breastfeeding Network have compiled a number of fact sheets summarising the available safety information on a whole range of different types of prescription and over-the-counter drugs so that breastfeeding mums can make informed choices about what they take. They also run a Facebook page and email information service in case a drug you wish to take isn’t covered in their factsheets, or if you just need a bit more advice.
The science bit
So why do drug manufacturers recommend against the use of so many medicines while breastfeeding? The answer is simply lack of conclusive evidence. Virtually all clinical trials exclude pregnant or breastfeeding women because of the ethical and legal implications if something were to go wrong. If you asked a pharmacist or GP if a medicine was ok to take while breastfeeding, they’d probably recommend against many of them because the textbook they refer to (the British National Formulary or BNF) usually provides little guidance. However, there is often additional information available from pharmacokinetic and pharmacodynamic studies, which can tell us how much of a drug passes through to the mother’s milk, for example. Small trials and case reports of breastfeeding women who’ve taken medicines sometimes also add to the body of evidence.
So how do I know which drugs are safe?
Your GP should always be your first port of call for any prescription medicines. However, if they are recommending against you taking something that you feel you really need, it’s worth checking the Breastfeeding Network’s information sheets. Print one off and take it to the GP with you if necessary. They cover everything from antidepressants to migraine medication.
For over-the-counter medicines, it is definitely worth checking the factsheets before completely discounting taking something. For example, I am currently suffering with hayfever (and also breastfeeding), but all the available over-the-counter medicines are not recommended by the manufacturer. However, when I checked the relevant information sheet from the Breastfeeding Network I can see that certain types of hayfever tablets reach low levels in milk and therefore should be ok for me to take. This is, of course, my decision based on what I have read, and what I feel are the relative risks of taking the medicine versus the benefits of me getting some relief!
Needing to take medication should never be a barrier to you continuing your breastfeeding journey. So arm yourself with knowledge and make the decision that’s right for you. Good luck mamas!