To think that medication should state clearly on the outside of the packet whether or not it is suitable for breastfeeding mums?

[Tubegirl]

This has come up a few times now since I have been pregnant/breastfeeding. I am aware that not all medicines are suitable in either situation. I am quite happy to read the leaflets that come with medication BUT, surely it would be better to have it on the outside of the packet nice and clear?

Two situations happened recently - the first happened when DD1 came back from contact with worms so we had to treat the whole family. DP gave me the tablet which I took without thinking - then suddenly had a panic and read the leaflet which of course stated in very small writing that I shouldn't have. I spoke to Dr on the phone who said IHO that it would be ok and mostly they write that because there is no specific research saying unequivocally it is ok (rather than that there is research that it definitely isn't ok). Anyway, there were no ill effects on DS and from then on I've been very careful about any medication.

This week I have major viral infection and feeling dreadful. I asked my dm to pick me up something to soothe my throat what was suitable for BF mother. She went to chemist and asked specifically and was told I could have strepsils. I took one and out of habit opened the leaflet and scanned through to find - sure enough - not recommended for breastfeeding mothers or women who are pregnant.

Surely this is a serious enough issue that pharmaceutical companies ought to do some specific research and ought to label the outside of the packet clearly. I mean - breastfeeding mothers are by their very nature sleep deprived and time poor, wouldn't this be so much better or am I being unreasonable?

I'm a bit on the fence with this.
on one hand most medicines are safe for breastfeeding mums and many are even ok for pregnant women.

I spoke to Dr on the phone who said IHO that it would be ok and mostly they write that because there is no specific research saying unequivocally it is ok (rather than that there is research that it definitely isn't ok).

your dr is right in this regards. studies would be highly unethical but for many medicines (worming tablets and strepsils included) there are many reports of exposure and it can be concluded that they are fairly safe.

They simply aren't allowed to write that on the box OP. They can't make false claims and unless studies have been conducted (which your GP rightly says would be unethical). The regulations are extremely tight around medicines, especially after the thalidomide tragedy and rightly so.

The problem is they can't test on pregnant mums/breastfeeding babies, so would have to rely on any studies that have been done, which may not have clear outcomes.

GPs have access to a book that lists whether medication is advised in breastfeeding- but I suppose they have to use their medical knowledge to assess whether the benefits of the drug are worth the risks. This couldn't really be translated to a black and white yes/no.

if in doubt you can contact the breastfeeding network, they have a hotline you could call

Agree with all the posters above, how do you think that pharmaceutical firms would be able to advise you whether or not a drug is suitable to have when pregnant/ bf, only through trails on pregnant or bf mothers, do you fancy volunteering for one?

I have an ongoing condition that requires treatment from time to time, when I was TTC or when pregnant I would discuss it with the doctor and each time it came down to using a treatment that had been around for ages.

Whilst I sympathise that there is very little you can take, dreaded getting a cold / flu whilst pregnant YABU.

Yes I see what you are both saying regards research - and of course noone in their right mind is going to volunteer to be a guineapig here. Perhaps I should simply ask that someone somewhere compiles a list of things that are very definitely safe and keeps it up to date which is displayed in chemists for reference. Probably wouldn't feel anywhere near as frustrated if I had had some sleep the past three nights tbh. Having this kind of illness without being able to rely on decongestants is horrible!

Oops that should read trials, although a nice walk might help.

They can't really do that either. No one has tested broccoli on BFing Mums so they can't even say that is safe. Always ask a HCP then make a judgement call.

I have to admit you have all pointed out a very obvious angle to me which I hadn't really considered. Thanks in particular Mousymouse, that's a good idea.

Steam and olbas oil on your pillow for congestion OP. I realise that's not what this thread is about, but they are both fine for you. And if you are sneezing, don't try to stifle it, sneeze through your nose, its natures way of clearing your sinuses. Make a huge difference.

And the BFN are brilliant at telling you what is safe through historical use. I even took their list to the GP when ds and I both had thrush and he was refusing to prescribe fluconazole (that isn't right but I can't remember exactly what it was)

Oh and do you know why decongestants aren't recommended? The breast is actually a sinus, so the can dry up too! I was fascinated reading up on all this stuff. Our bodies are quite amazing!

This is like the peanuts thing.

All packets of food say either:

a) Nothing about peanuts
b) does contain peanuts
c) traces may be present
d) made in a peanut free factory

soooo
Medicines could say:

a) risks unknown for taking while BFing
b) Not to be taken while BFing
c) Known to be low risk to take while BFing.

Given that every medicine could be categorized this way, I can't see why it can't be done clearly on the packet.
YANBU

ICBINEG, how scientifically would you identify the risks whilst pregnant / BF? Enough to have the medicine authorised by the regulatory authorities and to counter any legal claims if you are wrong?

I agree with the OP on this. I got some topical ointment to tackle a fungal nail infection, brought it home, having read the box etc. In small print on the leaflet inside the box - not suitable for breastfeeding mothers.

If you're going to put this information in infinitessimally small print on the blasted information leaflet, you can also put it somewhere useful on the outside of the box so we can make an informed decision whether to buy it.

I find pharmacists really helpful, ask before you buy any medicine if you are concerned, or get the leaflet out and read it before you buy.

I see your point and absolutely it would help to have it on the outside so it is clear. Unfortunately though it counts for a lot of situations and it would end up being a long list of unsuitable fors or do not use if?on the outside. My brother has epilepsy and half the time we end up needing to double check with the pharmacist as the information isn't given at all in the small print.

I was always very worried about this with my first and then with my second child found myself mainlining great quantities of morphine every 3 minutes whilst bf so on reflection I was just being a bit PFBish.

FireOverBabylon - yes I suppose that is sort of half of my point - I wouldn't purchase medication that isn't suitable. But as others point out I have the option of asking a pharmacist. But then again, I am busy, tired (and on this occasion ill) and might not have time so would it be very unreasonable to have 'not suitable' on the outside of the box - I note here that they do that for other categories - e.g. the strepsils say on the outside of the box not suitable for children under 6 so why not BF mothers as that is contained in the leaflet. But as regards the remainder of my post re research I can see now that I am being unreasonable because of course there is no safe way to conduct such research.

Could be worse. I was sent home from hospital with a bag of medicine unsuitable for nursing mothers. They knew I was nursing because they'd tested my expressed milk and carefully checked the medication I was taking on the ward.

It's massively annoying. And they get annoyed if you try to get the leaflet out in the shop before you buy it.

Glaikittfizzog, yes I was reading about that - it is fascinating isn't it! It was something to do whilst I was awake all night with a blocked nose lol!. Well that and reading endless MN threads anyway. I only have baby olbas oil which I discovered is no where near as strong as the regular stuff so another trip to the chemist for DP when he gets back from work.

sometimes 'unsuitable for children under x years' is only due to the formulation.
take cetrizine (antihistamin) it is ok for children of all ages, but the tablets are only for children over 6, as smaller children might have difficulties taking them.
my guess with strepsils is that as well. very difficult and maybe a choking hazard for small children, even though the active ingredient would be fine.

Horryisupduffed - oh no!

Yabu. There are far too many variants in what medicines are suitable for different people. Why do you think breastfeeding, which is a temporary thing and not an actual medical condition, should be ranked higher than any of those? There are things asthmatics and diabetics can't take, it's up to the individual or their doctor to make sure any medicine they take is suitable.

Pharmacists are very easily accessible, and they usually know what medicine can be taken by which groups of people.

When doctors are giving out unsuitable medicine however, then there's a problem.

Oh CloudsandTrees, I might not have expressed myself very clearly based on your response. I simply meant that if the leaflet inside the packets states that a medication is not suitable for breastfeeding, why not put this on the outside of the packet as well? My (clearly inarticulately made) point with the strepsils is that they put some of the people the medication is not suitable for (the example I gave was children under 6 - the leaflet lists the children under 6 and other categories of people too) on the outside of the packet so why not the other people too?

The information leaflet on diclofenac says it shouldn't be taken when breastfeeding, but it is routinely given to bfing mothers post c-section and the breastfeeding network fact sheet says it's ok as it only transfers into breast milk in small quantities.
The breastfeeding network also says that strepsils are fine.
As they're the drugs and breastfeeding experts, I'd take their word over the information leaflet which has to be as cautious as possible.