Or should the GP have known better.

[Pittcuecothecookbook]

Gave birth 7ish weeks ago. I have absolutely incredibly painful piles, to the point I have to BF standing up as I can't sit down without incrutiating pain. Finally got the courage to visit GP. I confirmed I'd been using germaloid cream, regular paracetamol and taking lactulose but it wasn't improving. He told me to up the lactulose and went to the effort to prove to me it was safe while BFing on an app that listed medicines and various details.

He also prescribed a steroid oitment and I've just gone to use it and on the instructions it says in bold: do not use this product if pregnant or breastfeeding

So aibu to be mega pissed that this was prescribed to me when gp was fully aware I was a breastfeeding new mum?! And what do I do now? Call the reception tomorrow to make a new appt, or just call and ask to speak to him on the phone? Or just leave it?

@Want2beSupermum I've been told more rubbish about medication by a midwife than by GPs during my pregnancy. The GPs have my full medical history from birth plus as I put in my previous post actually checked medication they were unsure about, while the midwife just rattled out unhelpful and in my case harmful information. Midwives refer you to GPs if you need anything prescribed, plus GPs in England frequently also do antenatal and postnatal checks.

I have had really bad hemorrhoids all my adult life. I have tried every treatment under the sun. The thing that works the best, in very small amounts and gives pretty much immediate relief and shrinkage to the hemorrhoid is 1% hydrocortisone cream. It's available without a prescription and is safe when breastfeeding. Just rub about a pea size amount on your hemorrhoids and they will shrink up and be gone within hours. It works way better than all the prescription stuff that's been given to me over the years. What I don't understand is why gp's don't just tell their patients to use it....perhaps some gp's on here could weigh in on 1% hydrocortisone cream.

As many others have said drug companies cover themselves by saying medications cannot be used in pregnancy or breastfeeding. As an experienced GP I would have no problem advising the use of proctosedyl or any of the other treatments.
The constant GP bashing is one of the reasons I left the UK and now work overseas.

blue To be clear I'm talking about asking the midwife if they know of any issues of medication causing issues with BF. Most will know. It's not just about the drug passing to the baby but the drug decreasing supply.

Definitely call to check but I was on oral steroids for the whole of my pregnancy and after birth whilst breastfeeding and they stated not to use them, I agree they may be just weighing up the benefit v risk

What the GP has prescribed is completely fine. Pretty much all topical medications are fine to use when bf.

@WonderfulWonders is correct. The warning and advice on meds is due to the testing regulations. I've been covered head to toe in a rash and all my meds say the same as yours but the dr explained they were safe based on how much is transferred to breast milk. I would still double check with the dr and good luck.

There is a HUGE difference between oral steroids and a topical steroid cream.

I haven't seen a health visitor or midwife since my baby was 2 weeks old so no, I while I mentioned I had piles, we all thought the germaloid cream would clear it up soon. It hasn't.

I get the point about testing but in my experience, which isn't that broad (FTM), labelling usually says "do not use product before talking to midwife or Dr" and not do not use if Bfing so it did concern me to read that when I was about to slather it on.

Even if it is safe, considering he went to loads of trouble to show me the proof that lactulose is safe is pregnancy/BF, I don't know why he didn't do the same for this medication. "It'll say not to use when breastfeeding, that's just because it can't be tested on preggos but it's perfectly safe...".

GPs will make mistakes, so I'm not sure it's wrong or unreasonable of me to double check that he had correctly prescribed this to me in spite of the labelling which says
very clearly don't use it.

I've had another night in agony because of it 😞

NoMudNoLotus: no wouldn't prefer to be left in pain, obviously. I take it you haven't experienced this, as anyone who had wouldn't suggest that flippently. I'm saying IF safe, he should have warned me as it's not unreasonable for me to consider it an error given the warning label.

Newbiecat: it's a bit of a leap to say that I'm calling for every GP to discuss every risk for every medication every appt, when I'm suggesting he just confirmed this one was safe for breastfeeding women. My appt slot was 15 mins and I was only in there for less than 10 min (and was left waiting 40mins) so he had time to tell me that within the slot anyway.

Want2bSupermum: not discussed with midwife or HV. No one mentionedsitz baths will look online

Ginandplatonic: your post doesn't make sense. No one is moaning he prescribed something safe for BFing mums. I'm saying IF safe, he could have easily confirmed this to me verbally, and this goes for ALL medications, even stronger more effective ones. If they are all safe, just give me the most effective surely?

I know there is I'm stating it as they said not to be used in pregnancy, like the topical steroid cream did...

Anusol HC is an OTC med and they almost always say not to use in pregnancy or bf. Maybe the doc could have given you a heads up that it's perfectly safe to use, just check with the pharmacist instead of suffering on, will take just 2 mins to give them a quick call. Don't be a martyr!

Poor you. Piles after the birth are horrendos. I'm sorry in advance for the essay. What worked for me:

1. My Doctor recommended applying ice cubes to the area.
2. Drink lots of warm water to soften stools.
3. I got an inflatable O ring cushion from Boots for sitting and driving.
4. I used Preparation H cream and Sheriproct ointment (apply to clean area in small circular movements).
5. A sitze: Fill a bath with lukewarm water (not too hot because it causes piles to get worse) with a few drops of teatree oil. Sit in it for about 15 minutes. Pat dry and apply cream.
6. When going to the toilet raise your feet up slightly to avoid straining. I used a toilet training step.
7. Peppermint tea or drops mixed in water is good for trapped wind.
8. Instead of sitting. Lie on your side with cushions between your knees to keep the pressure off your bottom.
9. Pour witch hazel on the big green maternity pads. It's good for soothing both stitches and piles.

Feel better soon. It will get easier.

I'm not being a martyr, I'm sat at the surgery now waiting to be seen. I called the pharmacy, they said speak to GP and I got the earliest appt I could as no one would speak to me over the phone, apart from the rude receptionists. Advice here has been that it's probably fine but check.

Thanks twins, will start drinking warm water and look for a specialist cushion as the ring I was sitting on put pressure downwards on the area.

Raising feet is a good idea too. Cheers

1% hydrocortisone and you can skip all the donut cushions and everything else. I promise you it works.

Vitamin B6 three times a day OP. I found it on a home remedies page,worked in 3-5days for me. Your GP is an idiot. You don't have to see same GP every time, my trust would be affected with him now. Ask to see diff one when you ring them.

Yes to 1 percent hydrocortisone cream. Mine didn't go in hrs but after two days I was no longer in pain.

OP, I did sympathise with your painful problem but your comment about waiting 40 minutes has just made raise my eyes heavenwards. Please try and gain some perspective here. Your problem is irritating but self limiting and not life threatening. Presuming you are in the UK, this is the NHS. That GP that saw you (and was 40 mins behind 😳) could have been dealing with any of a number of scenarios; breaking bad news to a man with prostate cancer, dealing with calculating painkiller dosages in a palliative patient with lung cancer, calling for help from the mental health crisis team for a suicidal patient. Your appointment time is a guide only. Any time the GP makes up on with you is more time for one of the more complicated scenarios I mentioned above. Think about that for a moment. You never know when you may be in a more serious health predicament.

**BTW all the above scenarios are what came up in 1 morning surgery this week. Guess what? I ran 45 minutes behind ....

Newbiecat, yeah, that's a fair comment. I've never had an appt on time at that surgery so it is really frustrating but you're right to give me some perspective. The annoying thing this time was that I left my 6 week old with my husband having just fed her and thinking I'll be home in less than half hour before she'd likely need another feed (10 mins travelling, 10 min appt, 10 min wait). I was really stressing out thinking about her screaming the house time as every minute ticked on. Turns out baby was fine and didn't even notice I'd gone

you can get anusol without steroid which does help it has a local aesthetic - go to pharmacist & ask their advice they will check their pharmacopeia for you & maybe able to check for something else (also if you can get some glycerine suppositories they really help) I had a breech delivery which was induced & forceps etc so I really "feel" for you - I don't think this is taken seriously enough (personally I wish the bloody things on any dr who discounts them as minor pain!

Pittcue, I’m afraid I always run behind to some degree, there’s just no slack in the system but I’m also usually the one to be booked up first so hopefully that means patients think I listen and do not trivialise what they may feel is very important. Anyway, I feel I could be derailing things a bit here. You ve had lots of good suggestions from other mumsnetters OP so hopefully relief will soon follow!
mumsastudent I have 3 DC and consequently am fully aware of the painfulness of haemorrhoids therefore I think I would be more than empathetic here! I didn’t classify the pain as “minor” and nor would lots of GPs, however, in the grand scheme of what we see each day, haemorrhoids would fall into the “minor ailments” category.

I wasn't directing the comment at anyone other than op. haemorrhoids can become basically a prolapse most women do recover from them some don't & I landed up suffering for years (I had 2 other dc after my first too) breech delivery is more forcefully particularly if they induce you - I wish I had a caesarean but in those days no choice - I wouldn't wish them on my worse enemy - I landed up years later having to have operation to cure them - it was successful

There are very very few medications that are genuinely contraindicated. They include the anticancer drugs, lithium, retinoids and amiodarone.

Steroids are given intravenously to sick and prem newborn babies so the absolutely minuscule amount that will may enter your blood stream and thus your milk absorbed from your skin isn’t going to affect your baby. Your GP didn’t do anything wrong.

Just to add OP, are you struggling to pass what’s there because of the pain?

If so, I’d really recommend glycerine suppositories, available over the counter. They just soften and break down the stool that’s about to exit, so it’s much less painful to pass.