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Pregnant? Nursing? Here’s What You Need to Know About Medication

January 17th, 2017

Congratulations! You’re pregnant (or thinking of becoming pregnant). Or you just had the baby and plan to breastfeed. All wonderful news. . . until you think about reaching for the medicine bottle. How do you know if that medication—whether prescription or over-the-counter—is safe for you and your baby?

http://www.recallcenter.com/pregnant-nursing-heres-need-know-medication/

It’s not easy.

The problem is that drug companies are not allowed to test investigational drugs on pregnant women – it’s simply not ethical. So the only information we have about the potential risks of medications during pregnancy or breastfeeding come from animal studies, post-marketing reports to the Food and Drug Administration (FDA) or pregnancy registries. The registries are, essentially, large databases that collect health-related information from women while they’re pregnant. You can view a list of registries by medical condition (cancer, epilepsy, autoimmune disease, HIV/AIDS or a transplant) or by the name of the drug or vaccine here.

You can also learn more about the drug’s possible effects during pregnancy by reading the drug label. All labels must have information about the use of the drug during pregnancy or while breastfeeding. Current pregnancy labeling uses five categories—A, B, C, D, and X.

Pregnancy category A.

This category is for drugs that have been tested in well-designed studies and show no risk to the baby throughout pregnancy. You can find a list of category A drugs here.

Pregnancy category B.

This category is for drugs for which animal studies show no risk to the fetus yet for which there are no well-designed, controlled studies in women. You can find a list of category B drugs here.

Pregnancy category C.

This category is for drugs in which animal studies show harm to the fetus and there are no well-designed studies in pregnant women, yet the benefits of the drug may be worth the risks.

Pregnancy category D.

This category is for drugs for which there is evidence of harm to the baby based on data from studies or real-life experiences, yet the potential benefits may still outweigh the risks (such as a drug needed in a life-threatening situation or serious disease for which safer drugs cannot be used or are ineffective).

Pregnancy category X.

This category is for drugs for which any studies (animal or human) or real-life experiences show harm to the fetus and the risk of the drug clearly outweighs any possible benefit (for instance, safer drugs or treatments are available.)

Drugs to Avoid During Pregnancy

When considering whether to take a medication during pregnancy, it’s important that you and your doctor consider your stage of pregnancy. Certain drugs are classified as “teratogens” because they cause changes in the development of the fetus early in the pregnancy, typically the first three months, but may be safe later in pregnancy. The most common birth defects include neural tube defects such as spina bifida; congenital heart problems; cleft lip or palate; and miscarriage or stillbirths. 1

“Adverse fetal defects” occur later in the pregnancy, and include neurological problems like attention deficit hyperactivity disorder (ADHD) and autism; metabolic abnormalities, such as an increased risk of diabetes; and congenital heart problems. The good news is that just 2 to 3 percent of all birth defects are related to medications. Nonetheless, it’s important to understand the risks associated with certain medications so you can have an informed discussion with your doctor.

Among the drugs associated with birth defects are: 2 3

·      The antibiotic D-penicillamine and tetracycline antibiotic

·      The hyperthyroidism medication methimazole (Tapazole)

·      The anti-anxiety medication diazepam (Valium)

·      Opioids

·      Alcohol

·      Certain high blood medications

·      Certain anti-seizure medications

·      Warfarin (Coumadin)

·      The acne medication isotretinoin (Accutane)

·      The bipolar medication lithium

·      The anti-ulcer medication misoprostol (Cytotec)

·      Certain antidepressants

Talking to Your Doctor or Midwife about Medication

Even if your medication appears safe, make sure you check with your doctor first. The same goes for stopping any medication when you learn you’re pregnant. You and your doctor also need to discuss the pros and cons of the medication you’re taking and the risks to you and your baby if you stop taking it versus the risks if you continue taking it. You should also check with your doctor or midwife before taking any over-the-counter medications, herbal remedies, and nutritional supplements.

When you talk to your doctor about medications during pregnancy or while breastfeeding, make sure you ask the following questions:

  • What does the evidence show about its use during pregnancy/breastfeeding?
  • Does the dose need to be changed?
  • What are the risks of not taking it?
  • Are safer options available?
  • Are there different complications or side effects I should be aware of?
  • Will the drug affect me during labor and delivery?
  • Is there any evidence of later complications, such as in the growth, development and maturation of the baby?
  • Are there ways to minimize the baby’s exposure to the drug through my breast milk?
  • Are there any signs I should watch for that suggest the drug might be affecting the baby while nursing?

Paying attention to everything you put in your body during pregnancy and breastfeeding will help you in your quest to have a healthy baby.

Sources:

 

  1. Burkey BW, Holmes AP. Evaluating medication use in pregnancy and lactation: what every pharmacist should know. J Pediatr Pharmacol Ther. 2013;18(3):247-58. 
  2. Rai D, Lee BK, Dalman C, et al. Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. BMJ. 2013;19;346:f2059.  
  3. Yazdy MM, Mitchell AA, Tinker SC, et al. Periconceptional Use of Opioids and the Risk of Neural Tube Defects. Obstet Gynecol. 2013;122(4):838-844. 

Ask the Experts, Breastfeeding Info

Using herbal supplements to enhance milk supply and breastfeeding

June 2nd, 2015

Written by Clare Boyle, Midwife & Breastfeeding Consultant. (http://breastfeedingconsultant.ie)

[All the herbs mentioned in this post are available to buy from www.onceborn.com]

The vast majority of breastfeeding mothers have no problem with their milk volume and supply; breastfeeding is simply a matter of responding to the baby’s feeding cues and allowing the baby to feed when he or she wants to and for as long as he or she wants and when they have had their fill they will either fall asleep or come off the breast. When breastfeeding is proceeding normally baby will gain weight appropriately and breastfeeding is very rewarding for both mum and baby.

Sometimes however this isn’t the situation, and despite mum putting baby to the breast and allowing baby to feed frequently and for as long as the baby wants to the baby either doesn’t appear satisfied, and or does not gain weight appropriately for his or her age. In this situation it is possible that mum isn’t producing enough milk but this may not be the whole story and we should not automatically assume that the mother just simply can’t produce enough milk because it is quite possible that there is something going on with the baby and breastfeeding that results in low supply.

It is very important to understand that in the vast majority of cases the amount of milk a woman makes comes directly from how frequently and how effectively the baby is feeding and although there are some women who won’t make enough milk they are a very small percentage of the population (around 2%). Making milk is essential to human survival and it is therefore biologically imperative that it is successful most of time. The element that most people don’t realise is that how the baby breastfeeds is the key to a good supply. I like to say that the baby is the foreman of the milk making factory and every time baby feeds he is putting in an order to make more milk! A good example would be a mum who is breastfeeding twins; her body is getting twice the order so will produce twice as much milk. We know that most women will on average be able to easily produce enough milk for up to two babies. During the first three days and up to the first six weeks of breastfeeding it is imperative that baby is feeding frequently (at least 8 to 10 feeds in 24 hours) but just as importantly is also feeding effectively so as to ensure good milk transfer as this is a time of calibration for the body – it is trying to figure out how much milk this baby needs and respond accordingly. However, if baba has a problem and isn’t breastfeeding well then mums body doesn’t receive the order to make more milk and this can result in low supply.

The two most common causes a baby may not be able to stimulate an effective milk volume is that baby is sleepy and or the baby has a tongue tie, essentially the baby isn’t putting in his or her order to the milk making factory properly. Sleepy baby often occurs in the first week after the birth and baby is not breastfeeding the normal 8 to 10 feeds every 24 hours and not feeding for at least 10 to 20 minutes per feed – for more information about sleepy baby please read http://breastfeedingconsultant.ie/index.php/articles/breastfeeding-problems-recognising-and-resolving-them/.   Tongue tie can have a profound impact on the baby’s ability to breastfeed effectively and is a very common cause of low milk supply and for more information about this please read http://www.mommypotamus.com/a-step-by-step-guide-to-diagnosing-tonguelip-ties/ .

Both of these issues can take time to diagnose and rectify and often by the time the problems are being sorted out the milk supply has decreased and is not as plentiful as it needs to be. Using herbal supplements are one of tools I use to help mothers re-establish their supply to full production. The advantage of the herbal supplements are that they are easy to use and they are a really effective method for increasing the supply promptly while the underlying issue or cause of the low supply is being addressed. When I am working with mums with low supply I usually recommend that they take two herbal remedies at the same time because I have found that this has the most beneficial and quickest response. I use GoLacta and Goats Rue, both have an excellent track record for increasing milk supply and the mothers I work with often report an increase in milk supply within four to five days. GoLacta capsules are made up of the Malunggay plant that as well as increasing your milk supply also has many other health benefits. Galega officinalis is the latin plant name for Goats Rue and it has been used to increase milk supply for years http://www.lowmilksupply.org/goatsrue.shtml.

I usually recommend that mum start taking both at the recommended amounts and then we evaluate her milk supply in about 5 – 7 days. Usually by this time mum will have noticed that her breasts feel more full in the morning and that baby is glugging more during a feed and is also coming off the breast satisfied and she may notice that she has more milk leaking from her breasts. We also check in weekly with the weight gains and once we are happy that the supply is on the increase we will start to decrease any supplementing that was put in place. I will also recommend that mum do some pumping during this time as well in order to stimulate more milk production but the frequency and length of pumping times that I recommend varies depending on a mothers individual issues.

Low milk supply is actually quite a complex lactation problem and using herbal supplements is generally just one aspect of a treatment plan so it is a good idea to work with an International Board Certified Lactation Consultant (IBCLC) in order to ensure that breastfeeding is maintained. Dealing with low milk supply issues can be very stressful for a breastfeeding mum and an IBCLC will be able to provide a tailor made plan for her specific situation and provide on-going support and guidance so that the mother can reach her breastfeeding goals. In Ireland most hospitals have breastfeeding clinics run by IBCLC’s https://www.breastfeeding.ie/Support-search/ and there are also IBCLC’s who work in private practice throughout the country http://www.alcireland.ie/find-a-consultant/ . Having the right support can make all the difference.

Ask the Experts, Breastfeeding Info, Increase Milk Supply

Coming soon…Ask the Experts

January 7th, 2015

Coming soon: We are hoping to bring you some articles and information from experts in the field of breastfeeding. We are asking Lactation Consultants, Breastfeeding Counsellors and Doulas. They hopefully, will share with us a bit about what they do.

Ask the Experts