Do Medications Transfer Into Mothers Milk
The breast has milk-producing cells and glands, which are arranged in clusters to help produce milk after the baby is delivered. During the early days of the postpartum period , the gap between these cells increases, allowing some medications to pass through them and mix with milk. Though these gaps close by the second week of lactation, the exposure of the infant to the medications depends on the amount of medicines released in the milk and the amount of breast milk consumed by the infant.
What Should I Discuss With My Doctor
Here are some things you should discuss with your doctor about antibiotics and breastfeeding during your next visit:
- Inform your doctor that youre lactating so they take this information into consideration when prescribing antibiotics.
- If youre taking any other drug, let your doctor know. Some antibiotic, in combination with other drugs, might form compounds that may be harmful to the baby.
- Its important to share your babys health and age with your doctor. This is essential when prescribing antibiotics.
- Discuss any possible alternatives to antibiotics for your condition, if there are any. Your doctor might recommend antibiotic ointments and creams instead of oral medication.
Antibiotics May Blunt Breast
Infants given the drugs were prone to infections and obesity in childhood, researchers say
MONDAY, June 13, 2016 — Early use of antibiotics may dampen some of the benefits of breast-feeding, a new study suggests.
Researchers found that babies who were prescribed antibiotics while they were breast-feeding or shortly afterward were prone to infections and obesity.
“In breast milk, unlike in formula milk, the infant receives bacteria from the mother and specific sugar components that promote the growth of certain bacteria,” explained lead researcher Katri Korpela, from the immunobiology research program at the University of Helsinki in Finland.
The finding indicates that the health benefits of breast-feeding are largely due to how it helps a baby develop intestinal bacteria , and that antibiotics disturb that development, she said.
However, the study could not prove a cause-and-effect relationship between early antibiotic use and infections and obesity, Korpela said.
“But by breast-feeding, the mother guides the development of the infant’s microbiota,” she said. “Antibiotic use disrupts the natural microbiota development, which appears important for the development of the infant’s metabolism and immune system.”
Another expert agreed.
Nearly 97 percent of the babies were breast-fed for at least a month, and the overall average breast-feeding period was eight months.
The report was published online June 13 in the journal JAMA Pediatrics.
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Does Amoxicillin Pass Through Breast Milk
Amoxicillin passes into the breast milk just like any other chemical compound present in the mothers bloodstream. The peak level of amoxicillin in breast milk is found between four and six hours after a single dose of 1g consumed by the mother. The amount of drug present in the breast milk can vary depending on the womans body. The average levels of amoxicillin usually found in the breast milk are 0.5 mg/ml at four hours, 0.81mg/ml at five hours, and 1.64 mg/ml at six hours.
Your Babys Temperament May Temporarily Change
You may have already noticed this fact about antibiotics and breastfeeding if youve already started taking antibiotics.
If taking antibiotics while breastfeeding, you may notice your baby becomes temporarily a bit more unsettled with colic like symptoms.
This does not require any treatment and should resolve soon after the antibiotics are finished.
Your babys poos and temperament temporarily changing are not serious.
It doesnt mean you should cease breastfeeding or the antibiotic course, or pump or dump your milk while taking antibiotics.
Anecdotally, some mothers have found that their antibiotic use can set up some signs of secondary lactose intolerance in their baby.
This is possible since anything that causes gut irritation has the potential to cause secondary lactose intolerance.
Once the antibiotic course has finished and with continued breastfeeding, the gut will return to normal.
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Antibiotics In Combination With Other Drugs
The safety of an antibiotic also depends on the combination of other drugs prescribed by the doctor. It means a safe antibiotic when consumed in conjunction with other drugs may form compounds that could harm the baby . For example, the antibiotic erythromycin can have a cross-reaction with other drugs such as cyclosporin, carbimazole, digoxin, theophylline, triazolam, and some anticoagulants.
Things To Discuss With Doctor
During the consultation, it is important for you to let your doctor know all about your pregnancy, the nature of problems that you have come for and any medication that you are already taking or have been asked to specifically avoid. Also, inform about any medical condition or allergies that you are suffering from.
In addition, following are the things you would like to inform and discuss with your doctor about antibiotics and breastfeeding:
Minimise Risk To The Breastfed Infant By Reducing Drug Exposure
The overall risk of a drug to a breastfed infant depends on the concentration in the infant’s blood and the effects of the drug in the infant. If, after assessment of the risks and benefits, the decision is made to breastfeed while the mother is using a drug, the infant should be monitored for adverse effects such as failure to thrive, irritability and sedation. However, it is difficult to identify adverse reactions occurring in neonates. Feeding immediately prior to a dose may help to minimise infant exposure as concentrations in milk are likely to be lowest towards the end of a dosing interval. However, for some drugs, milk concentrations lag behind plasma concentrations.
For drugs that have an infant dose greater than the arbitrary cut-off of 10% of the weight-adjusted maternal dose, it may be reasonable to reduce infant exposure by alternating breast and bottle-feeding. For drugs that are not considered safe in breastfeeding, breast milk may be expressed and discarded for the treatment duration. Breastfeeding may be resumed after the drug has been eliminated from the maternal blood stream. A period of approximately four half-lives will reduce maternal concentrations to around 10% of steady-state concentrations.
Is It Safe To Breastfeed While Sick
Yes, in most cases, you can safely continue to breastfeed your infant while you are down with an illness. Breast milk provides the perfect nutrients and antibodies your baby needs to boost his immune system. Also, it prevents him from falling ill or developing health problems.
But if you feel too weak to breastfeed, you can express breast milk into a bottle or clean container so that your spouse or caregiver can help bottle-feed your baby. You can take a break from breastfeeding and opt-out of baby formula until you are strong again.
Whether or not you will breastfeed also depends on the nature of your sickness. That is why it is essential to see your doctor and figure out the cause of your symptoms. Also, to prescribe drugs and guide you as a lactating mother. Especially if you are sick and breastfeeding a newborn.
Even though it is safe to breastfeed while ill, there are a few sicknesses or diseases that could cause your doctors to restrict you from temporarily or permanently giving your child breast milk.
The Centers for Disease Control and Prevention advises mothers not to breastfeed or express milk if they are diagnosed with
- Human Immunodeficiency Virus
- Human T-cell Lymphotropic Virus type I or type II
- Ebola virus
- Using illicit drugs like cocaine or PCP
According to CDC, there are other illnesses such as active and untreated chickenpox or tuberculosis that might not require breastfeeding.
Breastfeeding While Sick: Can Sickness Pass-Through Breast Milk?
Can Medicines Affect The Baby
Some medicines can give the baby diarrhoea or vomiting, or make them unusually sleepy or irritable. Other medicines can also cause you to have more or less milk production than normal.
The amount of medicine that enters the breast milk and the effect on the baby depend on the age and health of the baby, the type of medicine, how much you take, and when you take it.
You should take special care if your baby was premature, is sick, or is taking medicines themselves.
Will All The Antibiotics Pass Into Your Breastmilk
Yes, all medicines, including antibiotics, have the potential to pass into breastmilk since the breast receives nutrients from the blood. The quantity of antibiotic passed primarily depends on the frequency of the dosage and concentration of the antibiotic compounds. There is no scientific evidence to suggest that antibiotics reduce the milk supply.
However, you must consult your doctor about it before you consume any antibiotics because numerous factors determine the transfer of the drug compounds to the baby.
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Calculation Of Infant Exposure To Drugs Can Be Used To Help Guide Safe Use
The infant’s dose received via milk can be calculated using the maternal plasma concentration , M/PAUCratio and the volume of milk ingested by the infant :
Dinfant = Cmaternal x M/PAUC x Vinfant
The volume of milk ingested by infants is commonly estimated as 0.15L/kg/day. The infant dose can then be expressed as a percentage of the maternal dose . An arbitrary cut-off of 10% has been selected as a guide to the safe use of drugs during lactation. Drugs such as lithium and amiodarone should be avoided due to high infant exposure and potential for significant toxicity. For drugs with greater inherent toxicity such as cytotoxic agents, ergotamine, gold salts, immunosuppressives and isotretinoin, the cut-off of 10% is too high and breastfeeding is contraindicated.
As a general rule, maternal use of topical preparations such as creams, nasal sprays or inhalers would be expected to carry less risk to a breastfed infant than systemically administered drugs. This is due to lower maternal concentrations and therefore lower transfer into breast milk. However, the risk to the infant must be considered in relation to the toxicity of the drug used, the dosage regimen and the area of application. For example, use of corticosteroids nasal sprays or inhalers in standard doses would be considered compatible with breastfeeding.
Can I Breastfeed While Sick
Yes, you can breastfeed even if you’re sick. Breastfeeding while sick is still healthy for you and your baby. Continuing to breastfeed is also a good reminder to keep yourself fully hydrated. You need ample hydration to make breast milk, and it also helps relieve symptoms.
Things to consider with breastfeeding while sick include:
- Age of the infant
- Potential effects of the drug on breast milk production
- Amount of the drug that will enter the milk supply
- Proportion of the baby’s milk intake that is from breastfeeding
Premature babies and newborns are most at risk for being negatively affected by medicine in breast milk, but the risk goes down around 2 months of age.
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Side Effects Of Amoxicillin In Breastfed Babies
Though the side effects of amoxicillin are not widespread and have a low probability of occurrence, it is useful to know how a baby could be affected by the drug:
- Constant sleepiness or drowsiness
- Excessive colic due to stomach pain with general irritability
Interestingly, diarrhea, vomiting, nausea and other side effects are similar to what a mother or any other individual could have on consuming amoxicillin . Infants can show other subtle side effects such as a change in feeding and sleeping schedule.
If you observe these side effects in the baby or sense something is wrong, then take him to the doctor. Also, find out from your doctor if you should stop taking amoxicillin. However, it is important to ascertain that these symptoms have appeared only after the mothers use of amoxicillin.
Babys Age And General Health
The adverse effects of antibiotics are acutely noticed in babies younger than two months and rarely among those older than six months . Therefore, age plays a significant role in determining the effects. The babys kidney and liver are still developing and are not adept at flushing out the additional antibiotic compounds .
Other infant-related factors are the babys overall health and medical conditions or anomalies such as gastrointestinal reflux, shorter digestive tract, and allergic sensitivity to different compounds.
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What Should You Watch Out For While Taking Antibiotics If You Are Still Nursing
If you prescribed an antibiotic while you are still breastfeeding, here are a few signs that you should watch out for in your baby:
- Keep a watch on your baby to check if your baby looks drowsy or is sleeping more
- In some cases, there may be a reduction in your breastmilk if you take a certain antibiotic. Low breastmilk supply will leave your baby hungry, and he may cry or make sucking motions
Lactating mothers take a lot of caution and care to stay healthy so that their babies are not affected. However, there are some unavoidable situations where they may need to go in for medications. This is completely normal and nothing to panic about. However, until your doctor approves, dont self-medicate and get into trouble. Remember, your infant depends solely on you for food. Stay healthy, stay safe.
Is Taking Antibiotics Safe While Breast
Q: I’m nursing and I have a bladder infection. I need antibiotics to treat it is it safe to take these while breast-feeding?
A: Antibiotics that are used to treat a bladder infection are safe to take while breast-feeding. While it’s true that many of the medications ingested by nursing mothers are passed to their babies through their breast milk, most antibiotics have been checked and have the seal of approval from the American Academy of Pediatrics.
A nursing woman may be at an increased risk for bladder infections because while lactating, she often is producing less estrogen, the vaginal mucosa is thinner, the vagina’s pH changes, and there’s an overgrowth of less-than-normal bacteria. To add to this, thanks to the thinned-out mucosa, the bacteria can more easily enter the urethra and migrate up to the bladder during intercourse. If these bacteria then adhere to the bladder wall and multiply, a full-blown infection occurs and voila! you have a honeymoon-style infection, though I’m assuming you’re not on your honeymoon. The types of antibiotics used to treat this infection, which include sulfa-based antibiotics, Cipro and its derivatives and nitrofurnation, have all been found to be safe to use while breast-feeding.
Finally, we’ve all heard that babies should not be given the antibiotic tetracycline. Indeed, chronic use of this drug can stain the immature teeth of infants. However, short-term use of this antibiotic while breast-feeding, has been guardedly approved.
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Benefits Of Breastfeeding For Immune Health
Breastfeeding has a number of benefits for the baby and the nursing parent. Your body produces antibodies that are passed to your baby, which then protect them from your cold or viral infection.
If you are too sick or weak to breastfeed, you might try pumping milk to keep up your supply.
Supplementing with baby formula is also an option, and it’s absolutely safe. If you are unable to breastfeed, your baby can receive the nutrients they need from formula.
What If Your Baby Has A Reaction
When youre taking medication, including antibiotics, keep an eye on your baby for changes in eating or sleeping habits, fussiness, or a rash. If you notice any changes, notify your doctor right away.
Never, ever self-medicate, not even for the most minor medical condition. Before taking any antibiotics while nursing, consult your doctor to ensure that the drug is safe for the baby.
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Is It Safe For Mothers To Use Prescription Medications While Breastfeeding
Usually. A 2013 clinical report by the American Academy of Pediatrics , The Transfer of Drugs and Therapeutics into Human Breast Milk: An Update on Selected Topics,external icon indicates that most medications and immunizations are safe to use during lactation.
According to the AAP, health care providers should weigh the risks and benefits when prescribing medications to breastfeeding mothers by considering the following:
- Need for the drug by the mother.
- Potential effects of the drug on milk production.
- Amount of the drug excreted into human milk.
- Extent of oral absorption by the breastfeeding infant.
- Potential adverse effects on the breastfeeding infant.
- Age of the infant.
- Proportion of feedings that are breast milk.
Review LactMed®external icon for the most up-to-date information available on medications and lactation when advising breastfeeding mothers on medication safety.
Note to Breastfeeding Mothers
Tell your health care provider and your babys provider about any medications or supplements you are taking, including vitamins, herbs, and over-the-counter products.
Box : Antibacterial Antibiotics And Breast Feeding
Safe for administration:
As a general rule, drugs of the same class are expected to behave similarly in infants, though safety of one agent may not always imply the same for other members of the class. It must be emphasised that side effects of maternal medication are often not reported hence lack of information does not imply safety to the suckling baby. On the other hand, the occurrence of side effects in isolated reports may not necessarily warrant discontinuation of breast feeding or altering the maternal antibiotic prescription. Various academic bodies have tried to compile information about the likely risks to infants such information may guide decisions about antibiotic use.
Among the antibacterial antibiotics, cephalosporins seem to be the safest class. This generalisation seems to hold for all generations and is irrespective of the route of administration. Although third generation cephalosporins have a greater potential to alter bowel flora and individual agents vary with respect to M/P ratio, as a group they are regarded safe. Similarly, macrolides are also safe antibiotics, though they can alter infants bowel flora adversely.
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