Why can't doctors know what medication can be taken while BF

[slushy]

I have migraines 5 days a week I was referred to a neurologist who seems to think it is hormonal imbalance he did not tests other than ops, So offered me Tramdol due to the amount of pain I feel and because on the odd one I black out, a tablet I can't remember what it is called to balance hormones and a epilepsy drug for something else I was quite confused at the time.

He wrote a prescription then I asked if these were suitable while bf and he told me either stop feeding now or put up with it till I stop and come back. He said you must be finished in 6months so I will make a appointment for then.

I said surely there must be something you can give me and he said you have put up this long, try altering your diet it could be caused by banana.Why don't doctors have any training about safe drugs in bf?

Sorry to hear about your migraines. The problem with medication and breastfeeding is not the lack of knowledge on the part of doctors but the inability to test these drugs on breastfeeding mothers.

Not true, babynumberthree. There is information about bf and medications - plenty of it, collected by experts who know how drugs work, know how bf works, and know how drugs behave (ie do they get into milk and what happens if they do?). Doctors for some reason choose not to access this information - easily available on the internet, or via pharmacological specialists in their local area, or in the world's leading textbook (Hale's Medications and Mothers Milk) and its linked website, or via the NHS's own professional web-based info.

OP - you can check your meds heretoxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT and share your findings with your doc for him to comment.

I understand that I would not let someone test while I am bf.

Thanks tiktok do yo think he would mind if when I go back I suggest this website to him? because I doubt I will have finished feeding in 6 months dd is only 12months and I fed ds till he self weaned.

I don't know but strongly suspect that doctors err very much on the side of caution and would rather not prescribe anything to a BFing mother....

Sorry, I didn't make it clear what I meant. It is true that there are information about many drugs but certainly not all and in many cases the effect isn't known, inconclusive or a doctor doesn't want to risk affecting the baby since they are the ones doing the prescribing. I also don't know how you can say that doctors choose not to access information - it may well be true for those lazy docs out there - but certainly not all or even most.

I think that is the case ViveLaFrak he said something about the epilepsy drug having no known effect but as it slows heart rate down he would prefer not to give it.

Sorry - I did make a generalisation there, which is unfair of me. I am sure there are doctors who do check these sources.

Even when the effect of the drug has not been actively tested on bf women and babies, it is still possible to know how it will work - it's all explained in the intro to Hales. For instance it can always be known how quickly the drug may cross into the bloodstream and whether it will go from there to the milk (because of the size of the molecule). It is always known if the drug is destroyed by stomach acids (which would mean the baby's own stomach acid would destroy it, if it did reach the milk). It is always known how long the half-life is (when it starts to stop having an effect). And so on.

Doctors may feel they are erring on the side of caution. But i) not prescribing has risks and ii) a woman giving up bf has risks.

So refusing to prescribe to a bf woman has risks of its own - known risks. These may not be taken into account always

slushy - I would suggest you do the web research yourself, print it out, and then ask to see him to show him the results so he can discuss them with you.

Yes, babynumberthree, but it's astonishing how often you see posters on MN told "No, you can't take this medication with breastfeeding, you will have to stop breastfeeding immediately" when a quick check of the expert sources will show that actually, yes, studies have shown that it's absolutely fine to breastfeed at that dosage. Or are told that there is no suitable medication that they can take while breastfeeding when in fact there are several alternatives to the standard, unsuitable, drug. And those are just the women who (a) have access to MN and (b) think "that doesn't seem right to me..." and ask for advice, so the true size of the problem must be far greater.

So not all, and probably not most, but far, far more than there should be.

And there does seem to be a feeling among many doctors that breastfeeding isn't really important that faced with a tiny theoretical risk even though studies have been done and have found no ill effects the correct answer must always be to stop breastfeeding so the physical and emotional risks of stopping breastfeeding early are ignored and the patient isn't given the opportunity to make an informed choice.

(That also isn't "all" doctors or HCPs I know I've had some very interesting discussions with my GPs' practice about getting some specific vaccinations when breastfeeding, including their telephoning the drug company to discuss and the relative levels of risks of various options, specific enough that we came to different conclusions on the same question I was bf DD from when I was bf DS because some of the surrounding circumstances were different but again it's not at all uncommon)

Ok thanks I have to admit I have considered giving up bf because of this I just want my life back and until I get the medication I am gonna keep having the migraines, I feel like I am snappy with my partner and my children . I will give him a call and see if I can get him to approve a medication so I can get back to being me thanks tiktok.

Slushy sorry you've had such a bad experiance with your neurologist. I can syspethise as to where you are comeing from with your migraines. Luckly for me I know mine are hormonal linked and I don't get them when pregant and didn't during the first year of BF either.

I mite be able to point you in a better direction in order to get some more help. You said you'd seen a neurologist do you know if this was a headace specialist. I ask as I know a lot of people who have seen a neurologist but unless they are a specialist in headaces/migraines they aren't always any more help then a GP.

Another thing is that there are preventive medications and migraine meds that you can now take when BF. If you have a willing GP you maybe able to get them to prescibe them. As for the hormonal side of things actualy offten the best thing is the right form of controception which again you can get from your GP. The problem with taking any medication for migraines is that they are all hit and miss depending on what course your migaines, you need to take any proventative for at lest three months to see if it has an effect and keep a migraine diary.

For information on migrines see
www.migraineclinic.org.uk/ City of London migrain clinci which you can go visit if you are close enought to london.

www.migrainetrust.org/ Another good source of information

www.migraine.org.uk/ Migrain action association which I've found very supportive.

And a good source of finding out wearther drugs are compatable with BF is
www.breastfeedingnetwork.org.uk/drugs-in-breastmilk.html
There helpline is aimed at doctors and indivduals so you could point your doctor to this one to.

There is probably loads more info I could give you but I'd be hear all day. Hope that helps.

Thanks he was not a migraine specialist my gp referred me because there have been a few cases of tumors in my family at a young age (between 18 and 30), my family became concerned because I was showing many of the symptoms. So he is a specialist in this field.

I take no hormone contraceptive as they give me migraines, and the migraines started as soon as I got pg and have continued. The doctor said it was a bad reaction to hormones and that migraines usually disappear with pg but mine have not which is why they are a reaction to the pg hormone he said.

Thank you when dd goes to sleep I will definitely look at those links no where near London sadly. I asked my gp about preventative meds but he wont prescribe them.

slushy- ok that explains why you sour a neurologist. If this other problem has been rulled out I'd go back to your GP and ask for a refural to a specalist in headace/migraines. I think you'll find a list someware on the migrain action associations website, with anyluck there is one near you someware.

Luckly I've had a very supportive and helpfull GP and if I was you and you have any problems with your GP I'd see another one. I do know that there is at lest two preventatives you can take while BF and one you can take while PG to as I discused these options with my GP before I even got PG first time round. My GP was willing to prescibe them to.

It really is important to get a supportive GP while trying to treat migranes, I think to many of them don't realise how big an impact they can have on your life. Plus they are a health risk to.

Thanks I think he ruled it out as I said he didn't do any tests, he said they are very rare and we will try some other reasons first.

I assume I can be referred over as he seemed very confidant it was not that, so I will go and ask my gp thank you it helps a lot just to know how and what to push for. I don't think they do realize how much of a nightmare it can be to be ill more than you are well and migraines are very painful to.

Are they really a health risk? I thought they were just painful?. Thanks again for your help, it is good to know that there are in fact things I can do.

Hum yes they are a health risk, your more lickly to suffer from stock at an early age if you suffer migraines espically if you have any aura symtems, i.e. numness, visual disturbences ect. GP's should really take them more seriously.

They can be so debilitating, there has been time's when i've not suffered to badly with them and then time's where it's be so hard to even function on any sort of normal level. I tell you now if I didn't get PG easily I probably wouldn't have children as having to come off any form of medication I find helpfull is really difficult for me. Mainly hormonal contraception.

Luckly there is a lot more you can take when BF and they have recently cleared one of the migrain treatments for use in BF women to. It's hum don't seem to have the link on this PC must be on my laptop will add latter.

Have just found this though
www.kellymom.com/health/meds/migraine-meds.html

One off the prevetative that you can take is on that list, Propranolol in fact it's the one you can take when PG to. I ruled this out for me as had taken it in the past to limited effect but they work differently for everyone so worth giving it a go if you don't have any other health problems that would rule it out.

You've cought me at a good time I've recently been doing more reseach for myself on this as although I was well at the start of BF DD, they where starting to get bad again towards the end and want to know this time round if there is anything else I could take. So got quit excited when I found there is one of the mirgrain durgs that they have now cleared for use.

Thanks yes I have the auras, the blindness, the numbness, the vomiting, and black eyes with about 2 of 5 and it really is a nightmare. I also hate it when people say "what are you complaining about I have a bad migraine now and I am still up and about". Congratulations on your pg I hope the migraines stay off for you.

Testing drugs on BFing women is very different to testing on pregnant women as it can be done safely by seeing whats in the milk eg by pumping and dumping etc. The same is not possible when pregnant.

I was told by specialist last week I couldn't use a certain cream I need to use (for an anal fissure) and I should come back when I have stopped feeding. He said he was very sure about this as its a common post pregnancy complaint. DS2 is 3 months and I am open to stopping at 6 months. But over the next few days I was in more discomfort and discussed stopping sooner with DH - then I called the BFN they said it was ok .

Armed with this knowledge went to GP today (who had letter saying specialist would prescibe the cream when I stopped feeding) and my GP has prescribed it. I can't see any point in going back to specialist. Take the evidence that its ok etc and go back to GP.

Slushy - also my friend who had bad migraines swore by acupuncture which would be fine when pg or BFing.

Thanks I will go back and I will try the acupuncture hopefully it will help .

Sorry about your anal fissure that sounds painful (ouch).

It's mostly laziness or ignorance on the part of doctors IMO. They often won't look up what information there is - and these days that's alot of info. I definitely recommend looking up everything yourself. The BNF is available online with free registration. Or for specialist breastfeeding & meds info, check out Motherisk and KellyMom.

Thanks japhrimel I now have loads of different sites which I shall look on and print and shall go to the doctors armed with information .

I bought my own copy of "Medications and Mother's Milk" by Thomas W Hale. It's great. Get yourself one online. Not cheap, but worth it.

Ha finialy found link
www.nelm.nhs.uk/en/NeLM-Area/Evidence/Medicines-Q--A/What-is-the-preferred-triptan-for-the-treatment -of-migraine-in-breastfeeding-mothers/

Sumatriptan is the drug you can now take to treat migrians while BF, this is new data out this year.

I know what you mean about people saying they can copw why can't you. It ture I can if I take the right medication at the right time, but I still feel like I walking round like a total zombi. I also Have to go to bed with bad migrains to. Good luck.