BF and medication

[Janoschi]

Just been to the docs and have been prescribed a medication non-compatible with breastfeeding. I asked for an alternative but the doctor (a young woman) seemed to think I was being odd. My DD is 9.5 months and thriving on a wide mix of real food plus some BM. The doctor was surprised I was still feeding her and said babies should be weaned between 3-6 months (???) and drinking cows milk from that point. I thought the recommended weaning age was 6 months and that cows milk shouldn't be introduced til 12 months.

I'm dead set against introducing formula when BF is so easy and convenient, especially as in a few weeks she can take cows milk. Little DD doesn't take a lot now but she likes it at night (she still feeds to sleep) and first thing in the morning. I'd feel so mean going cold turkey on her.

The meds are important though....

Any advice?

Oh, these doctors... I've met a few like that. She's talking bollocks. (The WHO recommends breastfeeding until 2 years old!)

Ask to see another doctor, and in the meantime take a look at www.kellymom.com - most of the times there is no need to wean your baby/child - but GPs tell you to, because it's easier for them. Trying to find an alternative that works with BF is too much hassle...

She is talking bollocks, and you ought to get in touch with the head of the practice because there are impressionable mothers out there who would take it as gospel. You're absolutely right - weaning should be at 6 months and no cows' milk till 12 months. BFing till 12m is recommended. Ask to speak to another doctor (get them to phone you so you don't have to go in).

You might need to bear in mind, though, that there may not be a bf-friendly alternative to the medication, so it's either express like crazy for a couple of weeks to provide enough to last you the remaining eight weeks or so, then take the meds, or don't take the meds at all.

ring the bf network drugsline on 0844 412 4665 , Wendy Jones their pharmacist is excellent and will be able to tell you about alternatives and confirm that the medication really isn't compatible with breastfeeding, I have heard GPs tell women that drugs are not compatible with breastfeeding that definitely are.

or check out the bf network website to see if the drug has a factsheet www.breastfeedingnetwork.org.uk/drugs-in-breastmilk.html

Thanks guys. The meds are a long-term thing - 6-8 weeks at least, probably longer. But was good to get the back-up from you that I wasn't being a hippy Earth mother for breastfeeding a 9 month old baby. My mother and sisters all consider me weird (conversation with mother last night featured the line 'at 9 months, babies aren't getting any nutritional value from breastmilk anyway, it's just a bad habit you need to break'. Which I found a bit depressing really!

Sorry to contradict your mother but she's, um, wrong. A 'bad habit'???? When ALL the literature talks about is how incredibly good for babies and mothers breastfeeding is - ideally until at least a year. And your baby is still getting all your immune-system support, perfectly-balanced nutrition and all. You've been doing really well, it'll be a shame if you have to give up because of medication. That BF network drugsline sounds fantastic - I shall have to make a note of the number.

I had to change around the same time (due to operation) but we went onto formula as I was not keen on him having cow's milk so early. If they're important, then I think you need to put your health first. It's not essential that she's BFd now, you've covered the most important ages and formula is not as evil as it is made out to be. There is even strong evidence that unless the mother eats a perfect diet then children are at a risk of missing out on vital nutrients at the stage when they're weaning. But at the end of the day it's up to you. Definitely query what the doctor said though, because if she could be so wrong about weaning at 3 months, I'd not trust her to know if the meds are BF compatible or not.

Get in touch with the BfN drugs line (OP posted the link) they are fab and chances are you probably can take the meds. There are very few you can't take while feeding ro there are usealy alternatives that are compaterable.

The WHO recomends BF untill at lest 2years and there is still lots of goodness in BM. It's not just for her health but yours to the longer you feed the lower your risk of breast and ovarian cancer.

Thistl - there is no need for mum to be on any special diet even women in aftica who are on stavation diet's can feed there baby's, the only person in the equation who suffers from a poor diet is mum as the body priorites BM production and draws on your natrual stores. The only vitamin that is recomend is Vit D which is due to our indoor life style not poor diet. Plus you can't replace the benafit of antibodies in BM which can not be replaced by anything else. A child imune system is imature untill around 6years of old and while still BF you are supporting that imature imune system.

Email or ring the bfn. They are marvelous! I've been given incorrect info several times. Drs, even consultants tend not to know about bm, med compatibility. Do not take their word for it.

Try googling lacmed. They have a database.

I agree wholeheartedly about the antibodies - DD has only had one cold in her life and she caught it from her formula fed cousin (who seems to be constantly down with something). I also want to keep feeding her for a while longer because she's a lousy sleeper and I can't get her off without a bedtime feed.

The meds are for bronchitis and depression. I think the bronchitis ones are okay but it looks a bit dodgy on the others. I have both boxes in my bag unopened - just not sure what to do. Will ask for another doctor tomorrow, I think.

Many thanks everyone!

I don't deny that BF at the beginning is best for the child. But at some point the mother's health has to take a priority. The WHO guidelines are just that, guidelines which have to cover the whole world. But we are not living in an area with a dodgy water supply etc. We have access to clean drinking water on tap (and even some infant-safe bottled water). If you google research for example from the IDD there are surveys showing that western countries have diets which are deficient in Iodine which is a very important nutrient. If the mother is not eating enough, then the child will not get enough and this can be very detrimental and the time most at risk is the weaning stage. I'm not saying that the OP has a bad diet (in fact that she cares enough to post on here probably means that she does watch what she eats), but I don't know many people in real life who eat exactly what they're recommended to all of the time and if the mother isn't consuming all the nutrients that she needs, then the baby certainly won't.

As far as I'm aware, most drugs are not tested on pregnant, BF women or on infants because it is simply not ethical to do so. Presumably this means that the ruling on whether or not a drug is safe during BF is based on the assessment of related drugs, which may or may not behave in the same way. We decided that for us to switch him to formula was the safest option because we weren't happy with the idea that any drugs I was taking could pass on to him. In our view, drugs vs. formula just wasn't worth the risk.

I am all for BF as long as possible, in fact I put off having the operation (tumour removal) until the doctor effectively ordered me to have it done, so I do understand the reluctance to give up BF unless it is absolutely necessary.

Actually the UK isn't at risk from iodine deficiency - the populations that are at risk have a high incidence of goitre, which is caused by iodine deficiency. Our salt during the war was automatically iodised just in case but then it was deemed unnecessary. (I only know this because I've just read Mark Kurlansky's book 'Salt'.)

Yes it is according to the new research.

From the ICCIDD website:
ICCIDD leaders, in a letter published in the November 5 issue of The Lancet, reminded that iodine deficiency is not a problem confined to low-income nations; it has now been documented in the UK. ICCIDD board members Frits van der Haar and Gregory Gerasimov, former ICCIDD executive director and current Board member David P. Haxton and current ICCIDD executive director Michael Zimmermann added that the UK results paralleled the experience in Australia and New Zealand where IDD has re-emerged as a significant public health priority after long-presumed success in overcoming iodine deficiency.

May I suggest..?
If DD hasn't read any of the reports herself then don't mention it to her. She'll be happier that way. As will you. Put more trust in your instincts

thistlemunchher I would be extremely wary of advising mother to go against the UK or indeed the WHO guidelines on breastfeeding on the basis of one study, finding mild iodine deficiciency in schoolgirls and women of childbearing age. This group would be less likely to have been breastfed past 6 weeks, let alone 6 months, and so to formulate a recommendation based on this that babies should be weaned from the breast early is, frankly, poor science.

Particularly when the following two letters to the one you quote are criticising the methodology of said study.

I think perhaps simply increasing iodine consumption might be a more advisable course of action, not that I am advising anyone of anything, since I am not an HCP.

It's easy to buy iodised salt, if you are worried about it, in any case.

Yes, quite-meant to add that!

I think it's also worth pointing out that at 9.5 months, my DD has a very varied diet of veggies, meat, fish, dried and fresh fruit, pasta, bread, cheese etc. So it's not as if her entire nutrition comes from BM now. I'm visiting my HV in an hour - she was appalled by the advice I got from the doctor!

thist - all you are considering though is the nutrinal aspect of BM if that where the only case then formula is a perfectly adiuate subsitute. BUT BM contains hundrades of live componets which support the imune system and provide alsorts of other good stuff which we don't even understand. There are over 300 known componets of BM, formula can't even come close to that.

Plus the maternail health benafist to. Stoping BF can accualy be quit detramental to women who are suffereing PND due to the hormones that are produced while feeding, so mental health should play a large part to.

It's true drugs are not tested on nursing mum's but there is info out there on mum's who have taken it. Also milk can be analised to see if any drug enters the milk (often a lot don't or only do in very small amounts) and whearth they are then bio-avaible to the baby makes a big difference to.

What I know about how they add ingredents into formula without testing it (they are allowed to do in product testing) acutaly give's me less confidance in what they use for formula then the possiblity of a small amount of a drug being passed into BM which they seem overaly carefull with.

I'm not trying to say you didn't make the right decision for your situation just trying to give OP all the correct facts so she can make an informed decision for herself.