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Thursday, April 16, 2009

Smoking, Drugs, Alcohol And Breast Feeding

This is Government in the world advice for breast feeding mums:

Smoking And Breast Feeding

If you smoke tobacco, it is best for you and your baby if you try to quit smoking as soon as possible. Talk to your doctor for help. Tobacco from cigarettes contains a drug called nicotine, which transfers to breast milk and may even affect the amount of milk you produce. The risk for sudden infant death syndrome (SIDS) becomes greater when a mother smokes or when the baby is around second-hand (or passive) smoke. Smoking and passive smoke may also increase respiratory and ear infections in babies. If you can't quit, it is still better to breastfeed because the benefits of breast milk still outweigh the risks from nicotine.

Illegal Drugs

If you are breastfeeding, you should not take illegal drugs. Some drugs, such as cocaine and PCP, can make the baby high. Other drugs, such as heroin and marijuana can cause irritability, poor sleeping patterns, tremors, and vomiting. Babies can become addicted to these drugs. If you are having a hard time quitting, ask your doctor or a trusted friend for help.

Alcohol

If you breastfeed, you should avoid drinking alcohol. Alcohol does get to your baby through breast milk, and has been found to peak in its concentration about 30 to 60 minutes after drinking, or 60 to 90 minutes if it is taken with food. The effects of alcohol on the breastfeeding baby are directly related to the amount of alcohol a mother consumes. Moderate to heavy drinking (2 or more alcoholic drinks per day) can interfere with the let-down reflex and the milk-ejection reflex. It also can harm the baby's motor development and cause slow weight gain. For this reason, and for your general health, if alcohol is used, intake should be limited. Light drinking or an occasional drink is okay, but avoid breastfeeding for two hours after the drink.

Medications

Always talk with your doctor before taking any medications. Most medications pass into your milk in small amounts. If you take medication for a chronic condition such as high blood pressure, diabetes or asthma, your medication may already have been studied in breastfeeding women, so you should be able to find information to help you make an informed decision with the help of your doctor. Newer medications and medications for rare disorders may have less information available. The American Academy of Pediatrics has information about many prescription and over-the-counter medications posted on their web site at: www.aap.org.

In general, when breastfeeding it is safe to take:
  • acetaminophen (like Tylenol)
  • antibiotics
  • epilepsy medications (although one, Primidone, should be taken with caution — talk with your doctor about this drug)
  • most antihistamines
  • moderate amounts of caffeine (remember there is caffeine in soda and in chocolate)
  • decongestants
  • ibuprofen (like Advil)
  • insulin
  • quinine
  • thyroid medicines
  • progestin-only birth control pills (the "mini-pill")
Medications that are not safe to take when breastfeeding:

Some drugs can be taken by a nursing mother if she stops breastfeeding for a few days or weeks. She can pump her milk and discard it during this time to keep up her supply. During this time, the baby can drink her previously frozen breast milk or formula. These drugs include radioactive drugs used for some diagnostic tests like Gallium-67, Copper 64, Indium 111, Iodine 123, Iodine125, Iodine-131, radioactive sodium, or Technetium-99m, antimetabolites, and a few cancer chemotherapy agents.

There are drugs that if new mothers have to take them, they need to choose between taking them or breastfeeding. Some of these drugs that should never be taken while breastfeeding include:
  • Bromocriptine (Parlodel) — a drug for Parkinson's disease, it also decreases a woman's milk supply.
  • Cyclophosphamide, Doxorubicin, and most chemotherapy drugs for cancer — these drugs kill cells in the mother's body and may harm the baby.
  • Ergotamine (for migraine headaches); Methotrexate (for arthritis); and Cyclosporine (for severe arthritis and psoriasis, aplastic anemia, Crohn's disease, kidney disease, and for after organ transplant surgery).

Drugs whose effects on nursing infants is not known but may be cause for concern include:
  • Antianxiety drugs — Alprazolam, Diazepam, Lorazepam, Midazolam, Perphenazine, Prazepam, Quazepam, Temazepam.
  • Antidepressant drugs — Amitriptyline, Amoxapine, Bupropion, Clomipramine, Desipramine, Dothiepin, Doxepin, Fluoxetine, Fluvoxamine, Imipramine, Nortriptyline, Paroxetine, Sertraline, Trazodone.
  • Antipsychotic drugs — Chlorpromazine Galactorrhea, Chlorprothixene, Clozapine, Haloperidol, Mesoridazine, Trifluoperazine.
  • Other drugs — Amiodarone, Chloramphenicol, Clofazimine, Lamotrigine, Metoclopramide, Metronidazole, Tinidazole.

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