Pumping and discarding when on meds ... I'm confused!

[BorgLady]

To cut a long story short, my migraines have got to a stage where they and DS are unmanageable, but I don't want to give up breastfeeding.

DS is 9 months and has never drunk from a bottle, not even expressed milk, so I'm not sure whether he will take to it at this late stage.

After a discussion with my HV, I have decided to build up a store of EBM in the freezer and use it when I have a migraine so I can take sumatriptan.

I'm going to try him with a bottle over the weekend and see how it all goes. I'll probably be back on here with woes sometime then!

HV sent me to the pharmacist to ask how long sumatriptan stays in the body, and he said 12 hours, so I know I will have to withhold feeds for that long.

What I am confused about is discarding the milk that is produced over that time. HV said to pump it all off at the end of the 12 hour period (which I think would be bloody uncomfortable as DS still feeds quite a bit) but the pharmacist laughed and didn't think I would have to pump and discard at all! He said when it's gone from your body, it's gone from everywhere.

I don't think that's right, but I know people on here must have been through this procedure, please can you enlighten me?

I'd basically like to know how often do you pump your milk off during the 12 hours?

I agree with the pharmacist - if it's gone from your body it's gone from your milk

but you might be uncomfy after 12 hrs

borglady - it's not as simple as that, though. Some substances move very freely in and out of the milk (like alcohol); some metabolise into other substances and hang about (like pethedine or diamorphine) . You cannot say in a blanket way what meds will do....and many meds don't reach the milk in any significant way at all.

Best to check out this particular med .

toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT is a site you can use - it's not regarded as a problem here, though some of the studies are looking at injections of it.

It doesn;t seem to me, on that info, that pumping is something you need to do at all - esp not for an older baby. So check with the pharmacist again, maybe?

The BfN Drugs in Breastmilk line might be able to help you if you want 1-2-1 advice. You can ring or email them. See here

I think your HV was being overly cautious. Sumatriptan is one of the most commonly prescribed meds for migraines with breastfeeding. Some is in the system for a fair amount of time, but that doesn't mean you can't breastfeed. It decreases rapidly to where the milk half-life averages a little over 2 hours...which is still considered low. If you wanted to be cautious, you could feed right before you take the med, then you would have a span of time before the next feeding.

I agree with tiktok....it is even less of a concern since baby is 9 months old, but you may want to check with the pharmacist so that you can be comfortable with whatever you decide to do.