Labetalol, pre eclampsia and breast feeding(11 Posts)
Would anyone know what the deal is with Labetalol please?
I'm 36+wks pg (DC3) and been diagnosed with pre eclampsia, they are hoping I get to 37 weeks before they induce me etc etc.
Am on 200mg of labetalol twice a day - but the leaflet specifically says I cannot breastfeed whilst taking this drug.
Let's just say - I SHALL be breastfeeding, regardless, even if I stop taking the drug - but I would rather work out what to do here and whether it's a) the usual careful bumpf they put in most drug leaflets b) really that harmful to the baby and therefore I need to change drug or c) something that I can work through with the doctors....
Talk to your gp.
I went on atenolol after birth with pre eclampsia, and went to my gp with concerns that the leaflet said not to use when breast feeding. He dismissed my worries with no information or explanation, and insisted on a lengthy weaning programme. When I went to see the consultant for the 6 week post natal check, he said just stop taking it, which I did and I was fine, although there was no blood pressure monitoring at all at this point,
I later changed my gp after another prescription which was supposedly not suitable for breast feeding mothers.
I recommend testing your gp attitude towards breast feeding sooner rather than later.
Chances are you won't need to take it once the baby's born.
I have known some women continue to take it in the initial p/n period while breastfeeding.
I know women who have taken blood pressure meds for the rest of their lives after pre eclampsia, too.
Well pre eclampsia resolves once the placentas delivered. So if they continue to have bp problems after that then they've probably had hypertension that has just been picked up in pregnancy.
I was given labetalol on the postnatal ward when DD2 was born 7 weeks ago, even tho I was breastfeeding and she has got a tiny hole in her heart, doctor did not seem bothered and he did have some figures to answer my questions with, about how much of the dose is typically present in breast milk etc. Something like 0.04% but don't quote me on that, brain not terribly reliable at the mo.
Anyway the labetalol didn't do a lot for me and my gp was keen to get me off it as soon as it was safe. He told me there were better alternatives if we needed longer term bP control.
I had done a bit of googling myself and labetalol did seem to be the overall least risky option immediately after birth. I felt it made my baby sleepy though, not surprising as I could hardly keep my eyes open a couple of hours after taking each dose. I was on 200mg 3 times a day, when time to stop I reduced it over the course of a week.
I had pregnancy induced hypertension and took labetolol for last 5 weeks of pregnancy and about 10 weeks after, tapering down gradually and bf the whole time.
As a side note: don't listen to any midwife who tells you to stop taking it immediately you've given birth as you won't need it any more. I did. She said she'd double check with doctor but evidently forgot. By the time I'd gone without it for 18 hours my BP was through the roof and they refused to discharge me from pn ward for another 36 hours as it came back down
I'd also agree with what leafmould has posted above, some women do need to take bp medication for a long time after. More than one of the doctors I saw in hospital described pregnancy as a window to the future, whereby problems we may encounter in later life can first appear in pregnancy (think gestational diabetes, women who have this are at increased risk of type 2 when they are older?).
Call the Breastfeeding Network drug helpline and speak to the ladies there - they'll tell you the answer ;-)
I had severe PE and had an emergency section at 32 weeks. DD was in special care and too teeny to breast feed but inwas expressing for her as soon as I was well enough - I came straight off the Labetelol after giving birth and went onto Nefiderpene (not sure if I've got the spelling right). I was on that for three / four weeks until my BP had stabilised. I think mine was a fairly severe case - I ended up in intensive care etc etc but there was definitely a discussion with regard to drugs compatible with breast feeding / expressing.
PE has a tendency to carry on for a few days after birth - even getting worse for a short time. The high BP can last a while too depending on the severity of the PE - or at least this was how my case was explained to me by my consultant.
DD is 15 months and my BP is 120/70 so no lasting effects at all
Pretty much every drug says it shouldn't be taken by pregnant women, or while breastfeeding. It's because it would be unethical to test drugs on these groups so they can't say it is definitely safe IYSWIM.
Most doctors have very little knowledge about breastfeeding as they have little or no training on it. Many will say that drugs aren't safe when they are. The best source of information is the BfN Drug in Breastmilk helpline, or a reference book called Medications and Mothers Milk by Hale (my doctors have a copy in each consulting room - they are fab!)
I took Labetalol while pregnant and then while breastfeeding and had no problems. My blood pressure returned to normal afterwards, though I weaned off the Labetalol slowly as per my consultants instructions and over about 4 weeks.
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