To expect not to be told to stop breastfeeding in order to take a drug that has been classified as SAFE for breastfeeding(216 Posts)
I have a rheum appt coming up and am psyching myself up for it. I have psoriatic arthritis and need to start DMARDs asap, however consultant refuses to prescribe them while I am breastfeeding. The paperwork I was given by the hospital says sulfasalazine is safe for BF, directly contradicting the consultant!
DS2 is 15m and on one feed a day now. I'm half tempted to say I've stopped, I won't as I don't tell lies to HCPs, but IABU to think the consultant is BU? I went in last time saying "but it says its safe" and was told I was wrong
And, what do I do? If it were a GP, I could get a second opinion easily, yes? How do I do that with an NHS specialist?
Can you take the information in with you for him to look at?
Maybe print off the details for that drug from LactMed and have the Breastfeeding Network drugs helpline number to hand for him to call and check there and then?
Here's the LactMed page with references - not sure what argument he could have against this?
Can you contact the pharmacist at the Breastfeeding Network and ask for help getting evidence showing it is safe? www.breastfeedingnetwork.org.uk/drugs-in-breastmilk.html
The Drugs in Breastmilk helpline generally isn't picked up during the day, you tend to leave a message and she comes back to you, so I wouldn't leave it till the appointment to talk to her.
Jesus you'd risk a child who is perfectly old enough to be weaned for what reason exactly?
What risk MrButtercat? You sound confused.
mrButtercat the drug is safe.
Perhaps the consultant isn't used to dealing with breastfeeding patients and is wary of prescribing a medication.
However tell him to look in the BFN book
May be a risk,may not.
I personally never even took a paracetamol,a heavy duty drug that may or may not be safe depending on who you're listening to not a chance.
I had similar, my consultant checked the drug and agreed to prescribe
Check out the LactMed link above for some evidence of risk MrButtercat. This particular drug is classified as safe and isn't a reason to stop breastfeeding.
<pins on medal>
My pharmacist checked for me as they have up to date info and faxed a copy to my consultant .
Congratulations to you, did you miss the bit where I am fucking disabled though and in chronic pain?
I will print out the info and take with me, prepared to be told my random internet info is wrong though...
Ahh, pharmacist faxing over info is a very good idea!
If it was a newborn I'd understand however 15 months.Why would you want any exposure that you don't have to give? You don't need to bf at 15 months.
No-one has mentioned risking a child?
You don't need to breast feed at all MrButtercat.
If it was me I would tend to follow the advice of the consultant especially in view of the age of your child. Medicine isn't an exact science (so I've been told) and opinions differ. What is the point of risking this drug being passed on to your child. None as far as I can see.
Unfortunately LIMITS YABU to expect to get sense out of a lot of healthcare professionals, relatives, friends, work colleagues, and The Daily Mail when it comes to BF.
And when it comes to lying to HCP, does that include HVs?
Ok exposing a toddler to a drug that it doesn't need to be exposed to then.
The evidence is that its safe, this particular baby is only bfeeding once a day so the op will be able to time tge meds to make sure there is less chance any is present in milk (tho evidence shows it doesnt really go into the milk).
bfeeding is not just about nutrition but it does have nutritional benefits as well as being good for immune system eyc but its about comfort and security. Weighing up minute/minimal risk against immesurable benefits for the child.
How marvellous some people can afford to be so precious as to not even take paracetamol when feeding, others have health conditions that require medications so they can function etc, the risks and benefits have to be weighed up. And given i bfed for over nine years i couldnt avoid medication for that entire time, so i looked at the evidence, spoke to specialists and made an informed choice with the backing of my hcp each time.
Op print out the relevant info and maybe get them to speak to the relevant peoole at bfeeding drug helpline, my consultant did this
Oh for goodness sake Buttercat, BFing a toddler has far more benefits (health and otherwise) than taking a safe drug (which may not even pass into the milk) has drawbacks.
As I said with a newborn I understand the dilemma to some degree,with a toddler not at all.
Mrbuttercup this is symptomatic of a lack of awareness around use of medication in lactating women among health professionals. Breast feeding benefits toddlers hugely and they temd to be healthier than their non breast fed peers so it is a risk benefit exercise.
Posted to soon Op can you ask for a second opinion
Science changes all the time.Exposing babies and toddlers to any drug when you don't have to is foolish.
Vivienne, if there's no evidence of risk, it is officially considered safe and even the hospital is saying it's safe, why would you listen to the opinion of one man over all that?
What if the consultant told you paracetamol wasn't safe in pregnancy/breastfeeding, despite all evidence to the contrary - would you listen only to his opinion then too?
No drug is without side effects. And nobody can guarantee any drug 100% of the time for 100% of people. But I agree with making an informed choice and weighing up the pro's and cons. I wonder why this particular consultant is so against you b/f with this particular drug. Maybe he is frightened of being sued in future. That is a serious statement.
Evidence for now,drug advice can change any time.
Errr why not just give him cows milk?
Yes and the solution of hcp is often formula because that carries no risk.
MrButtercat, every drug is tested and it only once it been approved then it can be prescribed. Part of the way drugs are approved is to work out who can and can't take the drugs.
it must be approved by National Institute for Clinical Excellence. if they have deemed a drug to be safe for breastfeeding they know alot better than a consultant.
There are absolutely no immunological benefits in cows milk for human toddlers not like breast milk it is not just food
McNew but science can change things at any time,you don't need to take that risk at 15 months.
They don't need immune benefits at 15 months.1 feed a day would give vey little benefit.
I had to stop breast feeding to take anti depressants and then found out theat I didn't need to
was very sad
MrButtercup I assume you have DCs? Do you ever take them in a car, cross roads with them, go swimming, allow them to go on a climbing frame or play sports? I do all of those things with my DDs because (although there are risks involved) they are all have huge benefits.
Bfing a toddler is also beneficial. The OP has done her research and it seems that the risks (if there are any) are tiny compared to the benefits.
OP in your situation I would try presenting the facts to the doctor concerned, and if that didn't work I would probably lie.
Cow's milk isn't as good for toddler as human milk.
Human milk, even when the mother takes a drug that is safe for breastfeeding and has minimal if any impact on the infant, is still better than cow's milk.
There is no exposure.
The drug is safe to use whilst bfing.
How do you think they decide this? Just pump a load into mum, whack the babe on the boob, then if said babe doesn't grow another head go 'oh yeah, that'll do'? It's been properly tested and it doesn't affect the bm therefore it's safe.
I'd print off as much official information as possible then go in armed, and if he still refuses ask for a second opinion. And also ask for his source of information stating it isn't safe, helps to know who you are up against. Hope it goes well for you.
But sorry I know risks of climbing frames(practically zero with my 3), nobody can foresee the future re drugs and future research.
I would mail Wendy at the breast feeding network. She's wonderful and will give you loads of evidence based information on any drug you are interested in.
Mrbuttercat, a child's immune system isn't developed until they are 2. That's one reason to keep feeding but there are many more. You seem woefully ignorant of breastfeeding past the newborn stage
Maj a they don't even need cows milk in liquid form at that age if they eat cheese and yog which most toddlers do.
Sulphasalazine can take a couple of months to kick in properly, are you sure he isn't giving you something else to deal with the pain in the meantime and that might be the problem?
I think apt of HCPs are very prone to erring on the side of caution when prescribing medication for breastfeeding women. I suspect it is a symptom of increasing litigation. However, where there is evidence that a drug is safe to use, sticking their heads in the sand and saying 'no,no,no' is a failure to treat their patient appropriately. You can request a second opinion if you want to OP - PALS will be able to support you with this.
This isn't about breast feeding toddlers, it's about adaquate information on drugs prescribed being utilised rather taking the easy option.
Don't understand your point MrButtercat. Toddlers don't need to eat vegetables either, but they are healthier if they do.
Nope not ignorant just not prone to sticking my head in the sand.Would never expose my dc to anything I wouldn't choose to pour on their cereal whatever the immune benefits at 15 months.15 months is a world way from 6 months or even a year.
Sorry, I dont understand what you mean runner?
MrButtercat, to use your own argument, we don't know what future science will tell us, it may say that BFing to 2 is always best, irregardless of drugs in BM? If I had a crystal ball, I'd make a decision based on future research, but I don't, so have to work with what I have.
Maj a 1 feed a day aint going to make any child vastly healthier and certainly isn't worth the risk of future adverse drug research.
One piece of broccoli a day won't make a vast difference either, maybe I shouldn't bother with vegetables at all? Anyway, in the future science may find broccoli causes cancer
Beyond I doubt it as the maj haven't been exclusively bf or even bf until 2 for years and years.
Very few babies are exposed to dugs through bm given the range,the numbers that don't bf and the numbers that would avoid exposure.
Maj a to be honest unless you're getting 10 portions a day into them it probably is neither here nor there sadly.
(can't believe I actually just used the word "irregardless")
It's still possible to research the effects of breastfeeding, even if the majority aren't breastfed!
MrButtercat. You seem to be making the assumption that cattle never receive any medication that may or may not make its way into the food chain.
No drug is 100% safe. None. They all have side effects. And they're not really side effects, they're effects. Taking any drug involves a risk benefit analysis. Often research into the use of medication in pregnant and breastfeeding women is limited because it is ethically difficult to run clinical trials on these groups of patients. If I were you, I'd seek the advice of the lactation helplines, pharmacists etc and talk these through with the consultant. But no-one can guarantee the safety of any particular medication for a specific patient-it's not possible.
MrButtercat I would imagine that cows are being pumped with drugs that require significantly less safety testing than those certified as safe for pregnant/bfing women, yet you would happily give your children cows milk? Everytime you give your children anything you have to trust the current information.
Try to speak to the senior pharmacist at the hospital. Contact PALS to arrange this. They will almost certainly be able to have a more rational discussion about risks/benefits with you than the consultant, who is likely erring (too much) on the side of caution.
I was about to make the same point re cows milk, they are pumped full of antibiotics and allsorts. Unless you buy organic then most food products will have residual levels of pesticides etc.
You will be exposed to more chemicals etc in day to day life than the tiny amount that may get into bresst milk, howevet breast milk is the only nutritional source perfectly tailored for your individual child and with antibodies etc as well.
Unless you live in a bubble you cannot irradicate risk, its about making an assesment and looking to see if benefit outweighs risk. The benefits of bmilk outweigh the negligable risks in this case.
But non organic cows milk is widely used in liquid form and in solid form aroud the world across a whole lfetime,has been for years.Must be one of the most scrutinised foods ever.Not so a variety of drug tainted breast milks.
Cow's milk is much more drug tainted than breastmilk, but you still give it to your child as you believe it's safe MrButtercat. Don't you care about the risks that might be discovered in the future?
Funnily enough, breastmilk is also widely used around the world and has been for years, and was significantly more "tainted" in the past
I'm sure that's exactly what people thought about beef pre-BSE MrButtercat
Mr Buttercat your argument makes no sense. We cannot make decisions on the basis of purely hypothetical future risk. Future research may find that exposure to sulfasalazine in breastmilk is dangerous even for toddlers on 1 feed a day although the risk seems low because the drug has been licensed for 60 years so we'd prob know by now. Future research may also find that excessive cows milk consumption in early life is unhealthy and children would be far safer drinking breastmilk for longer - worldwide this one seems marginally more probable since this is a majority behaviour and Britain which bucks the trend has high rates of childhood obesity and childhood allergies. Please note I am definitely not saying obesity and allergies are caused by cows milk exposure feeding, just that it is at least as plausible a hypothetical risk as Buttercat's imaginary research into adverse effects of drugs.
So the only information Limits can use to make her decision is what is available to her now. That should be the best available currently so she should definitely consult the Breastfeeding Network. But it is not necessarily the case that her rheumatologist's information on the risks of this drug when breastfeeding an older child will be the best available currently - and the information available will probably be scant.
Nothing you eat is the equivalent of pouring onto your child's cereal anyway. Drugs vary hugely in terms of their later serum concentration in breastmilk - only a tiny minority are present in significant amounts in breastmilk. Those of us who have the misfortune to take those drugs are in the unenviable position of having to breastfeed our children to protect them from withdrawal effects so they are generally pretty well-studied. So forgoing paracetamol whilst breastfeeding was a pretty pointless gesture tbh. No medal.
And what Fay said,few women are going to volunteer research whilst pregnant which would give the most reliable picture and you'd need to look at effects over a lifetime after so really research aint that reliable.
If you don't need to put a child at risk why would you?
Obesity is due to people eating pies and not doing enough exercise.
Why do you give your children cow's milk then MrButtercat, why are you putting them at risk?
MrButtercat is being a contrarian.
Someone who would think paracetamol is unsafe to risk while bf is at the far end of the spectrum - and that's ok, as long as it doesn't mean judging people for not sharing the same spot on the spectrum.
And I hear a lot of judging here
sorry I know risks of climbing frames(practically zero with my 3)
I am sorry but how do you know this. A fall from a climbing frame can be serious, my brother had to be put asleep to have his arm reset.
Mine had cows milk because scientifically at 1 as it's safer than lesser known drugs.I have had a lifetime to little effect, not so the huge catalogue of drugs one could take when bfing.
Op does not need to expose her toddler.
Very sorry to hear about your psoriatic arthritis OP, I had a different condition many years ago which caused chronic pain for a long time (years), it can be so draining and dispiriting. I do hope you get your medication soon.
Have you considered asking PALS for help navigating the etiquette of the system? I BF DD until quite a bit older than 15m and I think the benefits after 12m or so were more emotional than physical. You are not BU to try to understand and weigh up relative risks and scientific evidence.
No one could possibly want to protect your DS more than you xx
But it might be proven unsafe in the future - isn't that your argument about scientifically safe medication?
We used to think beef burgers were scientifically safe, then there was mad cow disease. Mad milk disease might be just around the corner for all you know.
On a different note re health benefits of breastfeeding. I recently saw a mother drink 2 cans of tango, then breastfeed her 18 month old at lunchtime, followed by going him a pack of quavers for desert. I was confused....
I know all kids vary, but how do you know
I think "future science" might tell us that buttercup is trolling to make trouble.
Science doesn't change all the time, and the human body has wonderful ways to protect itself, like highly evolved breastmilk filters. A large number of drugs are perfectly safe while feeding.
I've just sent a very longwinded email to Wendy bfn
Isabeller, my plan of action is
- get ridiculous amounts of info ready to take with me (have emailed clever drugs lady wendy to ask her help too)
- read up on studies so I know what I'm talking about
- convince consultant
- ask for second opinion if no joy
- PALs if no joy there
This seems to be a common problem among consultants. I wouldn't get the breastfeeding network to give you information because despite it being from a respected pharmacist it tends to be dismissed because it is from a breastfeeding charity. I would ask (demand) the consultant commissions a report from the hospital pharmacist for his area. It will say exactly what the breastfeeding network report will say. Then armed with that he cannot possibly have an objection to the drug. If he does then demand a second opinion which is your entitlement.
FWIW I have never found a second opinion is needed, they always prescribe.
just i understand the health benefits of breastfeeding. But i imagine they were pretty much cancelled out by the tango and the quavers. I wonder if sometimes you have to weigh it up.. ie. surely better little toddler didn't have tango laced breast milk, drank water instead and had maybe some fruit for desert? where is the cut off point on what is healthy?
Oh fgs her breast milk won't have been tango laced as you put it, it doesn't work that way.
Er... the milk doesn't get "laced" with tango Breastmilk isn't made from whatever you happen to have eaten 5 minutes before - the content is pretty much the same regardless.
As for quavers, surely quavers and milk is healthier than quavers and water?
"tango laced breastmilk" oh ffs!
makes me think of DS1 who is convinced that when he poos it is the last thing he ate! Got home from a party and he shouted "mammy, party food poo!"
I'm sure most people know that crisps aren't the healthiest snack ever, but you don't think "well they've had quavers now - might as well forget about a healthy diet and just feed them liquidised mars bars from now on".
i guessed if she was breast-feeding him at lunchtime, that he would also get a feed later that day. Hence tango would definitely be in the system by then. But if the reason one choses extended breastfeeding is for the health benefits, why give quavers at all???? the vitamin content of quavers is limited. I just found it odd that's all, and i think it is odd.
Beautiful - breast milk isn't made from the food you eat. It's made from your blood.
Beautifulbabyboy - what are you talking about?
Under what bodily mechanism does the tango get piped into the breastmilk?
Do please explain that instead of the tango being metabolised by the mother's digestive system, it bypasses this and gets sent to the breasts where it 'laces' the milk?
Quavers for an 18 mth old are ok - I mean not great, but ok. They're not very high in sodium, and I doubt a baby of this age would manage anything like a whole packet, so as an occasional item, I would not lose any sleep over them. They certainly don't 'cancel out' the breastmilk - again, how would that work???
Good plan OP, right behind you
The tango won't affect the milk, even mothers who are malnourished can make milk for their babies. Drinking tango does not mean she will then produce tango breast milk. I suggest you do some research on this issue.
Here you go beautifulboy this may enlighten you
Why does anyone give quavers ever? You have some odd ideas!
Most children's diets are a mix of healthy stuff and treats. Just because you choose a healthy milk doesn't mean you never let anything but carrot sticks and lentils cross their lips.
Honestly, breasts don't just suck up anything from the stomach and churn out milk. Milk is made from blood, it contains mostly water, fats, protein, vitamins, minerals etc. Regardless of diet (unless the mother is severely malnourished and vitamin deficient) milk content will be pretty much the same.
I once ate a Greggs steak slice with one hand whilst feeding baby in the other
<<calls social services>>
I once had a margarita in one hand, a cheeseburger in the other, and fed a baby while consuming both.
Social services and a medal please.
Jesus some people are so bloody uneducated when it comes to breastfeeding... And that's fine, until you start sprouting your ignorance as gospel.
OP - I'm disabled and suffer from chronic pain too. Often doctors are too concerned about covering up their backsides, frankly. There are safe options for most medications out there; as others have mentioned the BFN Drugsline is a great place to start. Would also see a different doctor is possible. There is a book called "Medications and Mothers Milk" which is well worth having a look at if you can get hold of a copy.
And FWIW I breastfed DS until he self weaned just before turning three. During this time I was on various medications. The minute risk at the percentage that would be passing through vs the long term benefits he continued to gain from breastfeeding was an almost non argument, frankly.
Love the sound of breastmilk laced with Tango. I'd drink that! Is it fizzy?
Maj a errr bm is effected by diet- my DS couldn't tolerate oranges,onions and as for caffeine.
beautifulboy given that she had given him quavers for lunch isn't it even better that she gave him nutritious breast milk along side.
Ps there are many varied reasons why people might breastfeed a toddler. It's not just about health reasons. It should require no more discussion or rationalisation than giving a cup of cows milk.
I just took two paracetamol for a headache, and I'm bfing a toddler who's over two AND I'm pg...Where do I send my 'good mummy' stripes back to?
If that is true, seriously not being rude or obtuse, my friend had a baby who was allergic to soya, she had to cut all soya out of her diet to carry on bf. I was in awe of her ability to do this, and what was sad is that if she forgot or ate something which had soya in it the baby would subsequently have a bad reaction. Hence my looking and thinking hmmm tango / quavers / bf. I woukdn't smoke and then run a 10k - I would think why am I doing all this good stuff and then pollute my body with a cig.
I really thought other people would find it odd too. Will go back to my little cave.
Strong flavours and tastes, and large amounts of certain things, will pass into your breast milk. But your body makes creating milk the priority, so even if you were eating terribly, or hardly at all, your milk would still be 'good quality'.
Boobs. I was awaiting your presence you child drugger, you
There has been research re warning against eating junk food and dieting.
Re Quavers and bm sorry but a toddler eating a diet full of shite like Quavers and Tango is likely to become obese regardless of how much bm he drinks.Bm sadly isn't the elixir of life(although some may wish it was).
Some proteins (like cow's milk and soya proteins) can pass into the breastmilk, as can alcohol and some drugs. There isn't really anything in tango to cross over though.
Thanks to everyone who's helped by the way, you've been brilliant
<<sneakily hi fives KobayashiMaru>>
The toddler didn't drink the tango... And the odd packet of quavers won't make a child obese.
No. The elixir of life is Gin.
Oh, and as for 'give them cows milk'... Do you honestly think THAT is a better alternative? It's full of chemicals, horribly produced, and has very poor nutritional value by the end of the production line. It's pushed for calcium intake etc, but children can get that in much better ways, as can adults. If you're going to drink cows milk, then you are better off getting raw organic milk. But I guess you don't do that, do you?
I used to drink
wine coffee a lot when breastfeeding. Minimal amount passes through, and again, the benefits of natural term breastfeeding still outweighs any minor risk to exposure to caffeine, or anything else.
I'm guessing you don't feed your dc cheese,yog,ice cream,butter........then.
Sir my dc couldn't tolerate caffeine in bm.
He doesn't have milk to drink, never has. He does have yogurts and cheese sometimes. My objection however was your suggestion of 'just give them cows milk' as an equal exchange for breast milk. Which it simply isn't.
I think I suggested other sources as clearly the op doesn't need to bf.
It's really difficult to stop a toddler bfing before they're ready to. Not something I'd want to go through without good reason.
"Clearly the op doesn't need to breastfeed"? Seriously?
The WHO minimum breastfeeding recommendation is two years old. The benefits for both mum and baby do not stop.
talking bollocks not as educated on this matter as you seem to think. Would suggest doing some reading before you continue posting thins like that.
1 bf a day would be practically buggar all benefit.
There is little evidence of health benefits beyond the age of 1.
Again, what makes you think that?
It's been pretty wildly reported so 1 bf a day in an 18 month old is not worth the risk of exposure.
Oh dear buttercat, I carried on BFing DD2 while taking antifungkes, that are definitely not recommended for BFing.
Have you actually tried weaning a child who don't want to be and doesn't drink cows' milk or formula milk.
I'm afraid I concluded that she was quite big enough that the tiny bit of carry over in breastmilk for a short course of medication would have to be risked.
There is a huge difference in size, weight and therefore any possible risk between a tiny baby surviving only on BMilk and a toddler just having one feed at night.
In anycase most drugs not shown as safe for BFing are probably prescribed 'off licence' to children anyway.
Actually the evidence is quite the opposite.
Star an 18 month old does't need to drink formula or cows milk they could um eat cheese and yog.
Why should they? If mum and child are happy to continue breastfeeding, why should they make do with cheese and yogurt? Which has no relation and compares in no way whatsoever to breastfeeding?
Mrbuttercat you obviously have your ideas
issues about breastfeeding, and that's fine, you are entitled to them. However please don't keep blurting these inaccurate facts on a public forum. Granted the op seems to know her stuff and won't be influenced by it all, by some other mums without previous knowledge may be misinformed. At least state they are only your opinions if you are not willing to find out the facts.
I have a 10 month old. If I stopped breastfeeding now I would have a nightmare. As others have said it's not just about nutrition. She depends on it for comfort too.
If lac med says its safe than it, s fine.
Today I needed antiobiotics for a uruine infection. The gp checked her book and was able to prescribe a particular drug. Yet on the patient leaflet it doesn't advice it.
It's alll about manufacturers and medics protecting their backs even when drugs are reported to be safe.
Mrs issues err how so?
Really don't appreciate the ishooooos baloney to belittle posters out of having an opinion.
And sorry I've seen no opinions on here that will make me change my opinion.
MrButtercat you are talking out of your arse all of the credible bf evidence contradicts everything you have posted.
OP you sound like you have a good workable plan there. Best of luck with it. I was told by my GP that you couldn't treat a breastfeeding woman for thrush when my little man was 5 days old. Showed him the publication provided for health professional by our version of the NHS and he still said he wouldn't be comfortable with that - the useless bastard. Easy to change gp here but joyfully I had to pay the useless beggar 50 for that 'sound' advice. My next gp did not hesitate because he was up to date.
But you're not stating it as your opinion, you're stating it as fact. When actually, factually, you are completely wrong.
And a PP is correct; that is unfair of you. The OP seems to know her stuff, but there may be other new mums reading this who are not so aware, and will be influenced by the crap you are sprouting.
You keep making these odd statements MrButtercat, but don't seem to be able to back them up at all?
Who recommends breastfeeding till 2 I believe. Also there is really good article listing all the benefits week by week. This doesn't stop at 12 months but 2 years.
But, all the rest of this nonsense aside, they can easily know if the drug passes into bm by, err, checking.....
But as someone else said, if your bar for dangerous when BF is Paracetamol (which you'd directly give to a child if they needed it) then you set the bar rather low, and I'm surprised you let your children leave a little padded room to be honest!
* MrButtercat* you say "It's been pretty wildly reported...."...typo or the truth? 'Wild" reports might well indicate no benefits to breastmilk after 1 - but it doesnt make sense!
What happens to breastmilk at a year? Does it turn to dirty dishwater ?
Or does it remain as breastmilk, with the same nourishing constitutents as ever?
And moreover, it's delivered in a way that mothers and babies/toddlers enjoy and which enhances their relationship.
What's not to like??
And while for some individual babies, traces of flavourings and proteins which get into the breastmilk may cause problems, this does not affect the quality of the breastmilk. There's no evidence that oranges are a problem - and no plausible biological reason why they would be. However, rarely, I suppose the occasional baby might seem to have a reaction.
You are spouting opinion about breastmilk, food and drugs as if it was fact and in a judgemental way. It doesn't say a great deal in your favour.
I read that it is very hard to get a big enough study to properly be sure that there are no side effect of most drugs in breast milk. For things like paracetamol studies have been done over a fairly long time period but lots of drugs are less common or newer and so less likely to have had in depth research. That said, they must analyse the quantities in breast milk and have done some research to say that it is probably safe. Most likely it would be fine but maybe your doctor thinks that there is some risk that doesn't need to be taken. I do feel for you as must be horrid being in pain / being forced to consider giving up bf before you want.
There are plenty of nutrionally good reasons to start breast feeding.
There are no nutritional reasons to stop breast feeding.
The op has made it clear her and her child wish to continue.
There is medical evidence from the hospital to ptove the drug is not harmful to even tiny baby's whilst breast feeding.
So why exactly should she not challenge this? Why should she stop breast feeding?
The problem is not with the size of the study, the problem is you cannot ethically give a bunch of bf women a drug they don't need to see what the effect is on the baby....however, you can take samples of breastmilk from women who are using the drug and see what trace if any of the drug is in the milk. You can also see how long the 'half life' of the drug is ie how long it stays active in the body before being reduced to nothing. A short half life means the body deals with the drug quickly and it disappears. A long half life means it hangs around.
You can also see how the drug behaves in blood, how well it can mix with a fatty substance (like breastmilk - some meds don't mix at all), and you can do this in the lab, without it coming near the baby.
You can then draw a scientific conclusion, and adjust advice accordingly.
Vijac that is why so few drugs are approved as safe for breastfeeding. It has no impact on the validity of safety claims of the drugs that are approved - the burden of proof being as high for any other relevant sub-group of patients.
It's not like they say, "well this is difficult to study so fuck it lets just say it's safe".
It was the alpha parent timeline of a breastfed baby. Makes interesting reading.
This thread has made me giggle
btw no my children don't eat cheese, yogurts (or beef actually) nor do they drink cows milk). I'm only bf the younger toddler though so I wonder what harm the older one is going to come to.
My youngest also broke his leg when he was 1 from that risky climbing malarkey.
<steals medals pins to other people and puts them on myself>
Doctors don't always know. I had an extremely painful condition after DS2 was born, and consultant said the medication (in this case cream) wasnt safe when breastfeeding. I was in a very difficult situation (ie I wanted to keep on feeding BUT I was in so much pain)... but when I called the BF Network they said it was fine so I could kept on feeding. Same thing at 15 months as 3 months - why can't baby have benefit of breastmilk due to a non existance or minor risk.
Cream, being a topical preparation, can't really get into the breastmilk. It's really only systemic meds that cause a problem, and even then most are just fine.
good luck for meeting
Tiktok, I'm interested in what you said about half-lives of drugs/substances in the body. I've been wondering about this for ages - if I drink a big glass of wine in the evening after DC's last feed, and don't feed again until the morning, does the alcohol in the milk remain at the same level overnight (unless I express and discard, obviously) or does it gradually decrease just like the alcohol in my bloodstream?
Sorry to hijack!
JacqueslePeacock firstly there is no need to 'pump and dump'. Your final point is correct, the levels decrease gradually overnight. Also the levels of alcohol that pass into your milk are tiny, so if you did have to feed overnight, it wouldn't be a drama, though obviously best avoided with very young babies. The level of alcohol peaks in your milk at around 1-1.5hrs after ingesting (obviously depending on several factors).
Thanks for the answer - I'm just curious really. DS is nearly 2 now so definitely no pumping & dumping for me anymore, and thankfully night feeds are very rare (finally!). I was just puzzling over the biology of it.
wow there is some bullshit being perpetrated on here today.
Some things are transferred in small or even large quantities to breast milk. Other things are not transferred at all.
Some things have a lower safe limit below which they have no physiological effect, others don't.
All of this is found and out and measured before a drug is declared safe for BF. So...if it says it is, then it is.
I have exciting news for buttercat, there are DRUGS in COWS MILK. ARGHHHHH nooooooo.
There is also a small but identified risk of serious allergic reactions to cows milk. So I personally would not be bandying cows milk around as the 'safe' alternative to Bfing while taking a demonstrably safe drug.
In this case the BF+drug is almost certainly safer than cows milk.
MrButtercup, what would you do with my DS who can't have cows milk or soya (yuk) in any form and I needed to take medication?
Actual science showing that consumption of dairy can increase the risk of some cancers, especially breast and prostate. Really not that great to replace breast milk, eh.
I am a GP and I find it astounding how many HCPs are not well informed about drugs in breast milk. I had a patient in tears because she wanted antidepressants for her disabling PND but also wanted to continue breastfeeding and was convinced she couldn't do both after speaking to the psychiatrists, when there are several antidepressants that are absolutely fine to breastfeed with.
There are many drugs that are safe in breastfeeding if you look at the evidence ( Buttercat that may be a novel concept for you so sorry if this is all a bit over your head) and it is misinformation and lack of knowledge about breastfeeding that can lead HCPs to suggest women 'just stop' breastfeeding. I am on a one-woman misison to change things within our practice, and then our locality....
Buttercat you are coming across as one of those slightly hysterical Daily Mail types who are scared of 'chemicals' and who think that breastfeeding is actually a bit icky.
OK there is a general acceptance (in the USA) that this particular drug CAN and DOES appear in breast milk, and metabolised derivative thereof, which frankly are more likely to be of issue here.
And I quote "This drug passes into breast milk and could have undesirable effects on a nursing infant. Consult your doctor before breast-feeding." from here http://www.webmd.com/drugs/drug-6260-sulfasalazine+oral.aspx?drugid=6260&drugname=sulfasalazine+oral
It is also backed up here in the UK http://www.nhs.uk/Conditions/Arthritis/Pages/MedicineOverview.aspx?condition=Rheumatoid%20arthritis&medicine=Sulfasalazine
http://www.infantrisk.com/forum/showthread.php?569-Breastfeeding-on-Sulfasalazine explains the point well I am about to make below.
Bearing in mind the undesirable side effects of this drug are gastro-intestinal related let's face it exploding nappies and associated drama are fairly unpleasant to deal with
CLEARLY this is a case of INFORMED CONSENT - you the patient needs to know this is a side effect (to your child) and if you are happy to deal with this and accept the risk. I suspect some people would rather not risk such episodes with a small child, but also the consultant needs to explain to you why they think such a thing, for all we know there could have been some advice given to change the stance on this that has not filtered into the general populus now.
Take your information but don't treat this as a battle, you are still on a fact finding mission here, you may discover information you are not aware of now that may alter your thinking. Be open to information not just I am right.
Good luck and I hope you can come to a fully informed decision about your treatment that helps you and your DC
seriouswispahabit I wish you were my gp any chance you want to move to Ireland we would welcome your bf advice with open arms.
No Serious not scared of chemicals however I would avoid exposing a newborn or toddler to drugs if I could ( the op can)as none of us can write the future.
Well aware of antibiotics in non organic cows milk.Strange some posters seem to have a fear of anything cow related however would happily expose young babies and toddlers to drugs far less widely scrutinised(or used).
Health professionals do not take prescribing of DMARDs lightly. While most are safe for most people, they are a large number of people who have unwanted side effects - some noticeable like a twitch/tic,weight gain/loss, hirsutism and alpeocia amongst others. But they are equally as many that can cause hidden symptoms that can take a toll on the body as a whole - have effects on kidney and liver function, the body's ability to process certain other chemicals, occasionally rise in other hormones. (Look at Roaccutane as an example)
When an individual is started on a DMARD they are very closely monitored for the first 6 months and then are normally reduced to 3-6 monthly reviews, dependent on the drug and general health (this would then increase again if they become pregnant, or are commenced on other meds).
Personally I would not like to start a patient on a DMARD while they are pregnant or breast feeding without very careful consideration as their body is not in its natural state ie it already has elevated levels of hormones, proteins and enzymes which while are safe may mask the true effect of what the drug is doing. It is entirely different if they have been on it for some time prior to being pregnant/breast feeding as we already know what their resting state is.
I think that sometimes the public are very judgemental about HCPs and their opinions on breastfeeding, and while I will agree that some are archaic and lacking in knowledge. The vast majority actually do know what they are talking about. (I will probably be flamed for this comment).
I tend to find that breastfeeding is such an emotive issue for some that if I suggest that a Mother were to stop breast feeding for reasons pertaining to her own health. They immediately stop listening at the point when i make the suggestion and dont actually listen to the explanation.
Just for those who might say that I dont know what I am talking - I breast fed until my daughter was 9 months and stopped due to being so grossly anaemic, vitamin deficient that i had to have specialised high dose therapy along with other drugs (including an anti-depressent) in an attempt to normalise by levels. I also take a drug similar to a DMARD once weekly to maintain these levels and am expecting my second child in Jan 2014.
it's not just antibiotics butter there are tons of chemicals and drugs in cows milk organic or not. And as several people on here have or know DC that went into anaphylactic shock on introduction of cows milk, you will no doubt understand why we find advising people to introduce cows milk a somewhat risky activity.
sorry didnt realise that that was so long
Anyhow op you chose to post on aibu,I answered.If you don't like answers different to what you want to hear don't post or bother with consultant appointments.
butter nobody likes answers that differ from the truth though...whether or not they support your point of view. Your answers fail the evidence/truth test not the popularity of opinion test.
Icb the vast maj of kids don't have dairy allergies.This thread isn't a dairy allergy thread.
I have nephews with a cows milk allergy,they had goats milk formula on prescription.There are alternatives.
Your posts are so ridiculous MrButtercat.
What a shame everyone on the thread can see that and you can't.
MrButtercat I have no problem with cows milk. I drink it. My 17 month old drinks it since I stopped bfing. I just thought that your logic that the op should not expose her child to any risk, and switching to cows milk being the way to achieve that, was nonsensical. Everything carries a risk.
No not any risk,the risk of a drug with side effects as described further down.Op doesn't need to take the risk.She asked for an opinion and she got it.
Being sacred of cows is sensible. I once spent half an hour up a tree to avoid cow related death.
Redastra, thank you for posting exactly what the consultant should have said to me if that was the problem! I accept that as a reason, makes perfect sense to me. No idea why the consultant thought it would be best to tell me it was a definite no way, not ever though?! Because that is not the same thing by far!
MrButtercat - "Anyhow op you chose to post on aibu,I answered.If you don't like answers different to what you want to hear don't post or bother with consultant appointments." Are you confusing me with someone else? I'm quite sure I havent told you or anyone else not to post?
It may not be a dairy allergy thread, but I did need medication and my son can't have dairy nor goats milk, nor soya. So what was I to do? Not take the medication or leave my son without any milk as he won't take the amino acid based formula.
As opposed to goat's milk formula Mr Buttercup that poses no risk. You do realise that the benefits of breastfeeding are a thinly veiled disguise for the risks associated with formula don't you? Do you inflict those risks on your children?
Apologies for derailing even further but Tenacious - all proteins (including milks) are amino acid based. It's the definition of a protein.
Sorry Neu your post makes no sense.
Op glad you got the info you needed,did you not ask why when you went in?
Soooo all those posts saying ignore him were worthwhile then,glad the op stuck around and didn't sail off into the sunset.
I know but thats what the HCP that prescribed the formula called it. I call it fake milk or that disgusting stuff but I'm not sure either of those would go down well.
Well Mr Buttercup if we follow good science and use the biological norm as breastfeeding and then rewrite the so called 'benefits' of breastfeeeding we soon find ourselves seeing the risks of formula.
Formula does not contains antibodies which help protect babies against infections such as coughs, colds, chest infections and tummy upsets.
Formula increases the risk of childhood obesity.
This list is clearly not exhaustive and doesn't include the formula risks for the mother such as an increase in certain forms of cancer in women who do not breastfeed.
My question was are you consistent and did you not expose your children to those risks?
The research on childhood obesity has been debunked.Research re formula says one thing one minute and something else the next.Formula is one of the most scrutinised foods there is.It isn't a drug.
The fact is if you lead a healthy lifestyle a few months of formula aren't going to have much of an impact ie any risk is utterly minute as the years of formula fed babies(which the maj of adults are in this country)attest to.
Obesity is caused by too many pies and not enough exercise.
Vinegar - amino acid based formula like Neocate or Nutrimagen are prescribed to babies who can't tolerate milk or soya formulas.
I understood the implication maja - just pointing out that all milks including BM contain amino acids.
The research on childhood obesity has been debunked.
MrButtercat, I am really interested to hear that. Would you give me a link so I can read the research or more info?
Golly gosh, no, I didnt think to ask
I thought I'd just assume I knew better than a qualified specialist just because I'm a mum, BFC and a biology student!
On the other hand, you could read my posts and see that I did query it, and was told I was wrong, it was never safe for ANY bf mum (not what Redastra said), regardless of the fact that the literature he gave me contradicted this.
I'm trying very hard not to rise to it, but you seem determined to word all of your posts to sound like a ill-informed twat who is being argumentative for the sake of it.
I hope my post has made things a bit clearer, it is not the hard and fast answer as to why some things are not prescribed but it is one possible reason.
The other people to contact for advice is the Arthritis UK charities
www.arthritisresearchuk.org and www.arthritiscare.org.uk
You are also perfectly entitled to ask your GP to organise a second opinion for you if you feel you would like to discuss everything with someone else. (Can I ask whereabouts you are?)
I also suggest to patients to stick a sheet of paper to the work top in the kitchen with a pen and everytime you or your partner think of a question right it down, read over them the night before going to the appointment and take it with you so that if you get flustered or tongue-tied (I do when it is about me) then you have something to keep you focused.
I also feel really bad for you that your thread has been hijacked by a discussion about breastfeeding/formulas/general nitpickishness (is that even a word?!?!)about individuals personal choices and beliefs!!
Nah Www.Google.Com plenty of debunking and debunking "research" changes aaaaaalll the time.IQ one minute,not the next.
Couldn't give a stuff I bf(but how long is a piece of string). Also used formula later as using ones common sense it's a far healthier and safer food than the vast maj of foods fed to toddlers.
I used the same common sense to avoid my babies consuming drugs which haven't been as scrutinised or as widely used.<shrugs>
Thread hijack was very expected in AIBU, its not a problem
I'm in Newport
Op I am glad you got the info,I am surprised as every consultant I've ever asked answers my questions re anything.I do do the pen and paper thing though.
One to thing to keep in mind OP is that, at 15 months, your baby is relying on breast milk for a lower percentage of her calories than a newborn, who is completely dependent on it. Also, she has a much more mature liver now, so will be better able to metabolise any drug metabolites which may enter milk.
The decision to take a DMARD should never be made lightly, but assuming your DD is a healthy toddler then the benefits of breastfeeding far outweigh any risk of small levels of drug metabolite potentially being present in the small amount of milk she is drinking.
MrButtercat I really didn't need a GIYF response. I wanted to know if you actually had evidence that the obesity link with FF had been definitely debunked.
You've answered me by omission, however, so I know that you have no actual, concrete evidence and it was just goading. Thank you.
MrButter, you say "The research on childhood obesity has been debunked.Research re formula says one thing one minute and something else the next.Formula is one of the most scrutinised foods there is."
All of that is utter rubbish - please don't send people to Google for their answers when you are challenged.
Formula is indeed 'scrutinised' though in that it has to meet nutritional minimums and be produced under hygienic conditions. But scrutiny and knowledge also shows that it is not the same as breastmilk and in particular does not have human antibodies which play an important role in supporting health and well-being. No amount of 'scrutiny' will make these suddenly appear in formula....
buttercat , you are not being helpful. do you work for a producer of artifical milk for infants?
OP is not asking for advice on stopping. she wants support on how to get a perscription she believes she needs and is safe.
Here is what a doctor friend told ME when faced with a similar situation. It worked.
write to the consultant and the practice manager to ask what their policy is on supporting breastfeeding mothers .
make sure you ask what this policy means in pracice
also ask how they are adhering to the WHO guidelines on suporting breastfeeding mothers (at all stages not just at newborn stage) AND which recommends complementary breastfeeding for two years and beyond.
duh . i meant
ask what their policy means in in practice
Ffs , amino acids in artificial milk! , suggest you dont go down this path - it is a bit of a marketting ploy. All proteins , including those in milk, have amino acids, just like walls have bricks. the consultant is likely to not take you seriously if this comes up.
the consultant's practice manager should come around though, if you hand him the Lac Med advice stating the drug is BF compatible, coupled with the WHO advice on the importance of supporting BF mothers , and ask how they are going to reconcile the two documents in the face of the consultant's ostensibly less informed position.
You have a right, it's not a privillige, to continue to both seek appropaitate pain relief while doing long term breastfeeding as recommended by the worlds premier health care advisory organisation.
Plus the WHO is not a bunch of witch doctors or a front for infant milk companies (unlike what you might get from google or from some goady , negstive, thread hijackery types on mumsnet).
The info from the manufacturer is to use with caution as it is present in small amounts in breastmilk.
Probably fine to use, but there are no definite answers. Your consultant should be able to justify his decision though.
kelpeed, amino acid based formula is for babies who are allergic to cow's milk/soya milk. The OP isn't giving her baby hypoallergenic milk.
Sorry, maybe this has already been said (I can't read all the shit stirring nonsense from the no life brigade) but just to say
You are entitled to a second opinion in the NHS
Buttercat, do you work for Nestle?
oops my intent about this stuff was not clear (sorry)!.
but this is the problem with referring to it as "amino acid based formula " yes ? it is just not a good description for this product - everyone gets confused and starts linking amino acid withvarious source ingridents as if it was some sort of superior product because it has amino acids in it but without making theother point that all proteins are comprised of amino acids anyway.
anyway, i meant it as an aside comment to indicate that this thread has been well and truly hijacked.
I find this sad and distressing because OP (and likely loads of lurkers) is asking for advice which is very important to her and her baby relationship in the longer term. if Bcat wants to not feed over a few months or whatever that is his (!) perogative but i really wonder if he is in aposition to actual give out sdvice.
Mrbuttercats tone of his comments appear to be for pointscoring and distorting scientific advice, not providing. support. my point about his motive also remains. MrButtercat is spraying all sorts of guff about the perils of breastfeeding in mothers who need to take medicines to encourage fear and unnecessary anxiety and prpogate distress.
throwing in pseudo scientifc and misleading names for formals is part of this deliberate confusion, to bring it on equal terms to actual human milk.
Mrbuttercat - why are you so invested indismissing OP longer Bf goals when you have never been in such a situation yourself ? Doiyou work for an infant formula producer or an ancillary company?
I don't think "amino-acid" based suggests a superior product - it suggests something artificially created, or stripped down to the bare essentials. Most people would baulk at having to feed their baby an amino-acid based milk rather than a cow's milk (or even soya) based milk.
But cow's milk and BM are "amino acid based". That's what both me and kelpeed were pointing out. More accurate to stick to calling them hypoallergenic imho.
Anyway it has diddly squat to do with the OP's issue so I am bowing out now.
He's entitled to not want to take the risk with your toddlers health, it may later turn out to be dangerous and it will be on his conscience if it does. Not to mention the potential lawsuits if a drug he prescribes to a woman harms her child to never needed to be exposed to it in the first place.
'who' never needed to be exposed to it.
Please give an example of any case where a mother has sued her doctor for prescribing a safe drug to use when breastfeeding when the mother has been fully aware and able to choose, and chooses to continue, zatya.
This just does not happen.
Ahh but it might....not...as it would be informed consent and so no reasonable grounds to sue on...
Seriously the misinformation surrounding bfeeding is astounding at times
MrButtercat "Also used formula later as using ones common sense it's a far healthier and safer food than the vast maj of foods fed to toddlers."
Nearly spat my coffee out laughing at this! Clearly things like apples, bananas and chickpeas just don't make the grade.
Just thought I would paraphrase the buttercat U-turn in case people missed it.
buttercat Don't take the drug even though it is listed as safe for BF because what if its wrong and there is a small risk...what if in the future someone finds a new risk?!?! You don't need to keep BFing you can switch to formula or cows milk.
Us: But there are actual known proven risks to giving formula and cows milk contains many drugs with at least as little or less certainty about safety as the drug in question, and it is also possible to be seriously allergic to cows milk.
<here is comes...brace yourself U-TURN>
buttercat yeah but the risk of anaphylaxis is tiny....only very few kids are that allergic to cows milk. Yeah there are risks to formula but its been really well scrutinised....oh and anyway I don't believe the research coz it doesn't suit me.
So in conclusion, there is no level of risk associated with BFing that buttercat finds acceptable (even in the case of fictional risks), but essentially any risk associated with formula or cows milk is fine...because it is small....
What is the cause of this blatant double think? Well it's obvious innit. buttercat feels that formula/cows milk is the default nutrition for a toddler and BM is some deviant variation...hence you just have to put up with risks inherent in cows milk, and should avoid incurring the 'unecessary' risks of BM.
Meanwhile back in reality cows milk is the deviation, BM is the default nutrition for a toddler and switching to cows milk is the risky alternative....
Buttercat seems to have disappeared....maybe to do some thinking and reading
Maybe. But probably not.
Back from the hospital and need to say another, even bigger THANK YOU to everyone who helped!!
Between you guys, the local lactation consultant, and Wendy the pharmacist, we won! Woop woop!!
Delighted to read that and I believe that even getting the specialist onto thepharmacist and Wendy will help him in the future with other b f patients.
Hurrah That;s brilliant news. Hope the medication helps, and well done for standing your ground
hurray. really glad it worked out. and keeps on working out. Lactation consultants are worth weight in gold.
(no smiley thingy for boobs though, so how about these intead?
Just caught up with this, OP. Glad it worked out for you.
So delighted! Really hope you start feeling better soon xx Is
Well done. Great news.
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