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breastfeeders - to tamiflu or not to tamiflu?

(17 Posts)
treedelivery Fri 17-Jul-09 19:55:24

DD2 is 6 months.

I don't feel too bad tbh, so do take the meds, feel way better, and let her have the tiny dose through my milk.....
or just not bother and let her have any immunity I can give her, and shake it off in my own time. Its very bearable.

If she gets though, and I didn't take the meds I'll be mortified! But then this is a newish drug with no safety info.........

Argh!

JudyBlume1019 Fri 17-Jul-09 22:13:49

I think I will tamiflu in the event. Would also be reassured that a bit was filtering through to the baby to cover him??
Will copy and post some stuff sil sent me:

Breastfeeding and swine flu

Women who are breastfeeding should continue while receiving antiviral treatment or prophylaxis as they are not contraindicated in breastfeeding.

In particular mothers should feed on demand. Where possible additional formula should not be used so that the infant receives as much of the maternal antibodies as possible.

If a mother is ill, she should continue breastfeeding and increase feeding frequency. If she becomes too ill to feed then expressing milk may still be possible.

It the baby becomes too ill to breastfeed then expressed milk should be used.

The risk for swine influenza transmission through breast milk is unknown. However, reports of viraemia with seasonal influenza infection are rare.


Antiviral treatment

Antiviral drugs are not a cure, but can aid recovery if taken within 48 hours of symptoms developing. There are two possibilities: Oseltamivir (Tamiflu) and Zanamivir (Relenza)

Oseltamivir and its active metabolite, oseltamivir carboxylate, are excreted into human breast milk in very small amounts. Limited data suggest that clinical sequelae from maternal treatment would not be expected in a breastfed infant.

There are no data on zanamivir use during lactation but based on limited bioavailability the systemic exposure of a breast fed infant from maternal treatment is expected to be insignificant.

The overall consensus is that treatment with either drug is not a reason to discontinue, or put limitations on, breast feeding full-term or pre-term infants. Due to the very small amounts transferred into breast milk, and the limited oral bioavailability of either drug, the benefits of breast feeding are considered to outweigh any, albeit unidentified, risks.

Data on oseltamivir are limited. The recommendation for zanamivir is based on pharmacokinetic principles only.


Reducing the risk of transmission from mother to baby

As with general precautions, mothers should take steps to reduce the risk to their infant by washing their hands frequently with soap and hot water or a sanitiser gel and by using clean tissues to cover their mouth and nose when coughing or sneezing. Tissues should be binned after use.

Mothers and infants should stay as close together as possible and encouraged to have early and frequent skin-to-skin contact with their infants.

Babies hands should be washed if they have been in their mouth.

Limit sharing of toys and other items that have been in infants' mouths. Wash thoroughly with soap and water any items that have been in infants' mouths.

Keep dummies (including the dummy ring/handle) and other items out of adults' or other infants' mouths prior to giving to the infant.

The available scientific evidence shows that the basic face masks do not protect people from becoming infected and that the best way of reducing the risk of transmission is by hand washing and using and disposing of tissues.


General treatments of symptoms for breastfeeding women include drinking plenty of fluids and relief of symptoms with paracetamol or ibuprofen to control any fever.

Paracetamol is well tolerated and is licensed for women during pregnancy and for small children. It is also widely used for neonates, particularly in hospital and specialist care, although not specifically licensed for this group.

Over-the-counter influenza treatments containing decongestants and/or sedatives in addition to paracetamol and are not recommended. They are only marginally effective and there is also a risk that safe paracetamol dosage could be exceeded if over-the-counter remedies are used while paracetamol is also being taken. Instead nasal decongestant sprays, steam inhalations and a simple cough linctus can be used alongside paracetamol.

There are also suitable antibiotics, should these become necessary for the treatment of complications, such as bacterial respiratory infections

artichokes Fri 17-Jul-09 22:21:31

I was told Relenza is OK for BFing. Tamiflu less certain.

whomovedmychocolate Fri 17-Jul-09 22:49:24

GP told me today not to take Tamiflu and no Relenza left here! shock. Mind you I declined the drugs for the urchins too, they feel shitty enough without a spate of vomming!

Musukebba Fri 17-Jul-09 22:53:07

Only a fraction of the mum's oseltamivir is likely to get through into the breast milk so it's vitally important that women taking Tamiflu keep feeding their babies. Benefit far outweighs the risks.

In the mum oseltamivir will reduce the viral shedding and make it less likely that baby catches it.

No studies on Relenza (zanamivir) but is expected to be none in the milk.

Musukebba Fri 17-Jul-09 22:55:04

WMMC: Tamiflu better than nothing in pregnancy... is the DoH advice.

whomovedmychocolate Fri 17-Jul-09 22:57:11

I'm not pregnant (am I shock) - I do feel pretty bad, perhaps I am shock.

No, I'm not. Definitely, DH swears he hasn't been anywhere near me because I've been looking 'peaky' for weeks hmm

wink

LackaDAISYcal Fri 17-Jul-09 22:59:32

info from the BfN

Personally I wouldn't bother as it only lessens the impact or reduces the length days of the illness, it doesn't stop you from getting ill.

If your symptoms aren't too bad I would be inclined to not bother. It's also only effective if taken within 48 hours of symptoms starting. If you are out with that time frame, it won't help.

I hope you feel better soon sad

Musukebba Fri 17-Jul-09 23:04:51

Ah sorry WMMV I thought GP had said no Tamiflu cos of PG.

Been absent for a while and not kept up with the news... ;)

whomovedmychocolate Fri 17-Jul-09 23:09:22

Thank god for that - thought you knew something I didn't - no she definitely said 'no tamiflu if you are breastfeeding' and then went on to berate the lack of availability of Relenza. Mind, she is a bit barking. But very funny!

Musukebba Fri 17-Jul-09 23:20:10

LOL some GPs are hilarious. I had to ring one up the other day because the locum had asked the office manager to tell a 16/40 woman by phone that it was Tamiflu or nothing; they had Relenza in stock but was being reserved for the asthmatics. hmm

whomovedmychocolate Fri 17-Jul-09 23:25:55

I think she was a bit peed off actually, apparently the phone lines to the surgery were down with over-demand and patients decided it would be a good idea to turn up with their diseases instead! I'd emailed the surgery instead so I got through. Poor dear. Personally I'd hose people with Raid or Dettol if they just decided to 'pop in' with obvious signs of flu!

treedelivery Fri 17-Jul-09 23:46:45

Thank you people.

Still utterly undecided what to do...........

If it's only going to buy me a few hours of healing time then reall, I guess there isn't a lot of point is there?

But then maybe dd2 would benefit from a tiny dose in the milk and OH Lord I DUNNO!!

I'm ill. I can't do choice. Sniff. Oink.

Feel like I have an elephant sat on my chest. Or perhaps a large pig. Urgh.

whomovedmychocolate Sat 18-Jul-09 22:31:26

Mine feels like a large lump - oh wait, that's the cat. <kicks cat off>.

Treedelivery - sounds like you are taking a sensible approach. Hope you feel better soon.

treedelivery Sun 19-Jul-09 13:59:46

Feeling better. Yay. No mn this morning as the site wouldn't load, so I had to get better. hmm

Still in bed holding the lap top captive though grin

Childen all ok, and I'm still suffering with elephant on chest feeling. Maybe its the weight of the baby attached to my boob all the time. Also cough and sore throat.

<<whine whine>>

whomovedmychocolate Sun 19-Jul-09 21:35:28

Sympathies, I'm tandem feeding and have had both on the 'milk, milk, milk' train all sodding day! hmm

Glad you are feeling better though!

LUCIA22 Sun 19-Jul-09 21:47:29

I have undiagnosed possible swine flu and have been breastfeeding my ds 4months old. I had first symptoms on Thurs so too late for tamiflu now anyway but dont really feel that ill. Only felt bad for the first 8 to 10 hours. I was told that if I did have it then he would get some immunity from me through my milk which has made me less worried about him catching it. I understood that tamiflu wasnt licensed for under 1's and that it wasnt a complete cure anyway. I would have thought it would be better to avoid taking it if you dont really need it.

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