Colostrum harvesting/breastfeeding and antibiotics

[TheBeesKnee]

I am very stressed.

Scheduled for an induction next Wednesday at 39 weeks because of a large baby and GDM (albeit diet controlled).

A doctor has just called me to say that I've got an infection and need to go on antibiotics for a week, which will obviously take me to my induction date. They said there was no need to move the induction day for this.

I have only just (as in yesterday) managed to collect 2ml of colostrum and was hoping to get more before next week. I've had absolutely no luck up until now.

However, Google seems to suggest that milk when you're on antibiotics should be discarded. Does this only apply if you're keeping it frozen or does it also apply to breastfeeding? I really want to breastfeeding my baby and would like to avoid formula if possible, but obviously my body isn't going to be "right" for days/weeks after the antibiotics anyway.

I am going to try for another couple of syringes tonight before taking the first tablet but I'm very worried that I will have nothing to feed the baby if it doesn't latch after birth, 2-4ml isn't going to get me very far, is it?

I feel really stupid and stressed, I didn't think to ask the doctor these things when I was on the phone so I'd really appreciate it if someone knowledgeable could set me straight on these concerns.

Can you express and save some with labels on. Then ask your doctor/ midwife if it is safe for baby to have the milk? Of they say it is safe, used it for the baby. If they say it is not safe then discard it.

Personally I have had antibodies whilst breastfeeding babies, but I told them I was breastfeeding first.

If I was you, I would go to a pharmacist today and ask them for their advice. Then follow that. They are knowledgeable.

Depends on the antibiotics. Some are safe to breastfeed on so double check.

Most commonly used antibiotics are fine but you need to check. The best source of information is the Breastfeeding Network who have specialist pharmacists working with them.

You don’t need to harvest colostrum in advance. I didn’t with DC1 and breastfeed for ages. DC2 didn’t latch initially and they gave me a kit in hospital to harvest some. Also breastfeed her for nearly a year.
your real milk only comes in 2-3 days after giving birth, your antibiotics should be gone from your body by then. You will be fine.

It’s highly unlikely you will manage to pump or harvest tons more given you have not given birth yet. Also being induced does not necessarily mean that you will give birth on that day.

I asked the pharmacist when I was picking up the prescription and she said nope 😭

So I'm going to do one more collection attempt after my shower, then start the course.

I'm absolutely devastated, I was so pleased to finally collect a little bit and thought I could build up a little supply but that isn't possible now. I know I probably sound dramatic but there has just always been some problem or other throughout this pregnancy and I'm not someone who finds it easy to go with the flow much.

I can't believe I'm saying this but now I'm going to be hoping that my induction is on the slower side.

Hello OP: I never managed to get colostrum before birth, then after birth my milk supply was low due to having gestational diabetes so I had to supplement with formula for a month. Now (3 months PP) my baby is fed with 100% breastmilk (I pump). Just because you don't harvest much colostrum before birth and have to supplement with formula at first does not mean you won't be able to breastfeeding.

This. I was on antibiotics for several weeks after having DD and was still able to breastfeed.

Which antibiotics? Almost every antibiotic given in pregnancy is perfectly safe to use when breastfeeding.

If the drug is toxic in breast milk, it is usually toxic to a fetus in utero too as breast milk is made from blood. (There are some very rare exceptions which pass particularly easily into breast milk but none of these are antibiotics)

Also for many of the rare drugs which are unsafe to breastfeed with, breastfeeding with colostrum is still considered safe due to the low volumes.

This is the latest information on breast milk and antibiotics https://www.breastfeedingnetwork.org.uk/antibiotics/

I have GDM too and no one has said anything about it affecting milk supply! Would you mind telling me more about that?

@sandberry it's just amoxicillin but the pharmacist seemed quite firm about not keeping colostrum from when I'm on the antibiotics? Someone suggested that I can keep it for topical uses though, which hadn't occurred to me.

Between last night and this morning I managed to get another few ml and now have 7ml in the freezer, which I hope will be enough as an insurance policy in case baby doesn't latch or I'm in no fit state to feed. I'm also a bit worried because I've heard that antibiotics can affect your milk supply so that feels like another battle to prepare for?

I will ask the doctors when I'm actually in for the induction and see what they say.

Amoxicillin is fine even according to the BNF https://bnf.nice.org.uk/drugs/amoxicillin/#breast-feeding
so not sure why the pharmacist said that.

I’d definitely keep expressing to have colostrum to manage hypoglycaemia. I also had GDM and my youngest had hypoglycaemia at birth, treated easily with a couple of syringes of colostrum.

it’s difficult to pick apart whether it’s GDM itself that causes low milk supply or other factors eg the impact of early hypoglycaemia and supplementation or metabolic syndrome. Basically if you’re obese/have PCOS which are contributing factors to GDM you are definitely more likely to have low milk supply. If you have GDM it’s more important to do everything possible to maximise supply, it’s certainly not a guarantee of low supply.

Yes, unfortunately GDM may delay your milk production, something I was not told either. You can find more information on this link :
https://www.gestationaldiabetes.co.uk/breastfeeding/

If that is your case (but maybe your milk production will be fine), one thing you can do is triple feeding (nurse, then bottle feed, then pump) for few weeks until your milk production fully comes in. Here is a guide of how to do that:
https://exclusivepumping.com/nursing-pumping-and-bottle-feeding/

And finally a guide on supplementing and encouraging story:
https://fedisbest.org/2021/06/i-supplemented-my-baby-until-my-milk-came-in-and-we-are-still-breastfeeding-at-3-months/

As I said, I had to supplement a lot in the first month, but I'm exclusively breastfeeding since the second month. Good luck with everything

Amoxicillin is a safe antibiotic for breastfeeding. If you are worried however about giving it to your baby, you could hand express the colostrum and discard it as I see you are concerned about whether you will have a supply.

Try not to worry too much about the amount you produce as for some women it can be very difficult to hand express and obtain any. This has no bearing on their supply that baby gets once they are feeding directly from the breast.

All the best with your induction x

I could not get colostrum pre birth with either baby. It was all grand and both were ebf. I would not panic..