To expect not to be told to stop breastfeeding in order to take a drug that has been classified as SAFE for breastfeeding

[BeyondTheLimitsOfAcceptability]

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?

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.

X-post with Nancerama

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.

Mc new kids vary.

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....