To be annoyed with pharmacists whilst breastfeeding...probably unreasonably

[Meshy23]

I’ve been breastfeeding for 5 months but in that time I’ve had colds, aches, travel sickness and now quite severe constipation. In that time I’ve gone to the pharmacist for advice (in a bid of easing pressure on GPs) but without fail the minute I tell them I’m breastfeeding they refuse to give me any medicine.

I totally get this but what grated me most was I suffer badly from travel sickness and before a flight I wanted travel sickness medicine. I told the pharmacist that I can give my baby formula and pump and dump until the meds’ were out of my system which they calculated (i give DD a bottle of formula at night so have no issue with this). The pharmacist flat out refused and said they cannot dispense the medicine as I am breastfeeding even if I don’t give my milk to the baby. End of - no alternative advice in either situation.

I love pharmacists but I do feel quite alone suffering (mildly) without any medicinal help for symptoms.

Maybe I should not want any medicines. Maybe I should be happy that there is a stringent level of protection for young children. But I just feel a bit annoyed especially as it’s not like pregnancy where medicines can go straight through the placenta and I can avoid giving my breast milk if necessary. It feels like another example of a new mum being ignored!

But I’m being unreasonable and feeling sorry myself about a first world problem right?

Yabu totally, you can't just say you're going to pump and dump they have no idea if you will stick to this, leave it long enough etc. They do not have the qualifications that a doctor has or the legal liability cover. Once you have informed them that you are breastfeeding that cannot prescribe anything with any possible outcomes. Doctors can judge the risk and prescribe items not allowed whilst feeding but ok in this situation. This is what your doctor is for. As for going and not telling the truth, risk possible issues with supply and having to pump and dump, why would you? Go see your doctor who has the qualifications to direct you to the correct medication in this situation and don't blame someone who is just doing there job.

It’s a product licensing issue. Selling medication to a breastfeeding woman will be against the licence for some over the counter medication. If you had lied to me about expressing and I had sold you the medication I would still be liable for any harm to your baby.

Also some drugs can linger in the system longer than others so you can’t really be sure when they will be 100% eliminated and not harm the baby.

As others have said, Wendy at the Breastfeeding Network is just amazing! Their drug fact sheets are the only resource you should use. I never even mention BF to a pharmacist because I know what the reaction will be. In reality there are almost no medications that are contraindicated with BF.

They are doing their job. Why put it on them? Why not just say you aren't Breastfeeding if you don’t care/know better than them. This is a massive non-issue.

I would be cautious about meds while breastfeeding. I had Amy appendix out when my breastfed baby was 6 months old. I was told that the meds I had would diminish by 50% every 24 hours, so it takes about 5 - 6s days after your last dose to clear out of your system. Plus I agree that the pharmacist is likely not allowed to give you meds, nothing personal or anti-mum or anti-breastfeeding.

‘In reality there are almost no medications that are contraindicated with BF.’

This isn’t true and is dangerous misinformation. Pharmacists can access resources to check for BF contraindications if they don’t know off the top of their head (I’d always double check anyway) so ALWAYS mention it when buying medication.

Jenni the vast majority of regularly prescribed and OTC medications are safe when breastfeeding. There are some that may be preferred, but there really are few that are absolutely contraindicated. Anyone can access the excellent resources prepared by the Breastfeeding Network, they are written in very clear language.

The milk transfer of drugs is so low compared to blood.

If you are going to pump and dump just send someone else to buy for you.

I think there just isn't enough research on breastfeeding for so many drugs that pharmacists just dont risk it.
I needed an OTC medication "A" when about 3 weeks postpartum. I asked pharmacist who looked it up in the little book and said "oh we aren't sure, better to get a drs appointment and ask for drug B instead"

I did all that, picked up my prescription and it was for drug A!

What a waste of my time and the NHS money as I used up a doctors appointment and got the drug free on prescription where i would have happily paid for it.

Worth mentioning also that there are so many unique variables affecting the amount of drug that can be expressed in the milk here too (e.g. age of baby, liver/kidney function of baby and mother, feeding patterns, was the baby premature).

Often there quite simply isn’t the data available to categorically say if a medicine is safe or not, this is why many health care professionals will err on the side of caution and only sell or prescribe medication if the benefits far outweigh the risks.

@PhoenixBuchanan Yes I know they can but I prefer the BNF and Electronic Medicines Compendium as they are more comprehensive when it comes to available safety studies. They are not written in clear language so best have a pharmacist summarise it for you.

Also see my post above about individual variation. There are no OTC conditions that I would class as immediately life threatening so unless you know that there is 0% chance of the drug being expressed in the milk I don’t personally think it would be worth the risk to advise it.

When my daughter was having chemotherapy, the travel sickness wrist bands really helped her. Worth a go?? You can get them cheap on eBay or at the pharmacy.

For constipation after I gave birth, I was given lactulose by a pharmacist. It doesn’t get absorbed by the body so won’t go into milk. I don’t know why the pharmacist wouldn’t recommend that for you?

The pharmacists are back covering. Don’t tell them about the breastfeeding and use your own sense to protect your child.

It's because it's their job on the line. Although you sound like a responsible person who will dump the milk that has the medicine in. They can't be sure everyone will do that so can't take that risk.
I had the same problem and asked the pharmacist and in the end went to my doctor and signed a waiver type of form saying I understand the risks and will pump and dump etc .

‘The pharmacists are back covering. Don’t tell them about the breastfeeding and use your own sense to protect your child.’

Comments like this make me so glad I trained for five years to become a pharmacist 😒. But yes I’m sure ‘your own sense’ is comparable.

I ended up suffering through some really unpleasant symptoms without medication because of this. I'm better informed now and would just do my own research and lie about BF.

Suppose you go to get cyclizine for your travel sickness. The manufacturer's documentation says avoid use in breast-feeding. If the pharmacist dispenses it without taking all reasonable steps to find out whether you are breast-feeding, and if your baby is harmed by it, the manufacturer bears no legal responsibility: the pharmacist becomes legally responsible for the harm to your baby unless he/she can prove to a court that you lied to obtain the medication.

I do wish people would appreciate that all drugs - without exception - have the potential to cause harm. If a drug's licence says it's not to be used by breast-feeding mothers, that's because it's known to get into breast milk in sufficient quantities to be of concern. If the manufacturer's documentation recommends avoiding in breast-feeding it's because there isn't sufficient data available to determine whether it's safe. You may reasonably argue that all drugs need to be fully tested for safety in breast-feeding , and I think all new ones are, but nobody has yet undertaken the massive task of testing all previously licensed drugs for this, which isn't the pharmacist's fault.

Another vote for Breastfeeding Network. Their fact sheets are great.

www.breastfeedingnetwork.org.uk/

This is where you go. Don’t tell them you’re breastfeeding. It’s seriously annoying especially when it’s says on the nhs one website that drugs are safe and the pharmacy says no. I was told I couldn’t take ibuprofen, what do they think they give you after labour?!

I’d also point out that healthcare professionals receive regularly updated information about medicine safety. So if for example there had been case reports of drug x causing harm in babies due to BF mothers taking it I would get an alert for immediate action and revise my advice regarding drug x accordingly.

This might not appear on websites for several days or even weeks so there are limitations to ‘doing your own research’.

For constipation after I gave birth, I was given lactulose by a pharmacist. It doesn’t get absorbed by the body so won’t go into milk. I don’t know why the pharmacist wouldn’t recommend that for you?

A pharmacist has actually just given me this for my constipated 2 year old. The bottle says it suitable for pregnant and breastfeeding women. Might be worth asking about it?

I totally understand how frustrated you are. I’m still feeding my toddler. It’s awful when you’re poorly & the people who are supposed to help you feel better, can’t.

A pharmacist once told me it’s partly due to lack of testing on the drugs. It doesn’t actually mean that the medicine isn’t safe, just that they can’t properly test it. They’d struggle to find people who’d let them use their breastfeeding child as a guinea pig, to test the potential effects of any medicine transferred. Once they know that it transfers to the milk they have to advise against use by breastfeeding mothers. Not sure how true this is though!

‘the pharmacist becomes legally responsible for the harm to your baby unless he/she can prove to a court that you lied to obtain the medication.’

^^ This too!! We aren’t selling sweets! There is a huge legal responsibility placed in pharmacists. ‘Yeah but they said they’d pump and dump’ is not a great defence when hauled in front of the General Pharmaceutical Council when they want to strike you off the register.

You have to weigh up the risks against the symptoms being suffered. The current situation isn't reasonable and I'm pretty angry about what happened to me when I could have taken medication for it.

I seem to remember that the breast feeding network had some good info on medications.