Medications and Nursing Mothers – Yay or Nay?

Malaysia’s breastfeeding policy advocates exclusive breastfeeding for the first 6 months of an infant’s life. Its benefits extend far beyond providing nutritional needs of a newborn and it is the safest and most cost effective method of providing sustenance.

However, when a nursing mother falls ill, the dilemma faced is whether commencing pharmacological therapy will be harmful for the baby. This common mentality has caused some mothers to ride out the worst of the illness rather than seek medical help for fear of her child’s wellbeing.

In our modern society, extensive research and studies are being done to address this concern by better understanding the secretion of drugs in breastmilk and in turn, their safety in infants. Various references have been published to assist healthcare professionals in this effort.

Most drugs are excreted into breastmilk to a certain degree and the common effects it may have on your child are diarrhoea, changes in sleep pattern and vomiting. This of course, will depend on the type of drug you are taking and its dose and frequency. For example, while on a course of antibiotics, you may notice that your infant have softer stools. This is usually transient and will resolve once the course is completed.

For the most part, risks associated with commencing nursing mothers on medications are overemphasised and continuation of breastfeeding usually poses no harm to infants. That being said, remember to always inform your physician if you are breastfeeding in order for the doctor to select a safer choice of drug therapy as some medications may also affect milk production. In rare cases, if a medication has a potential risk of causing harm to the nursing infant, your physician might advise you to stop nursing temporarily.

Furthermore, studies with data in premature babies and very young infants (below 1 month old) are limited. As they are physiologically different in their ability to process drugs, it is wise to be more careful in these newborns as the drugs absorbed may have long term effects especially in the growth and development of their vulnerable organ systems.

There is no absolute yes or no to whether nursing mothers should be started on drug therapy but steps can be taken to ensure the safest method of administering maternal medications. For instance, a baby may be fed immediately before taking a dose of medication to minimise exposure to the drug. Furthermore, parental awareness is important prior to starting therapy. A physician will discuss the risk and advantages of taking a systemic medication, and advise on monitoring of the infant if there is any altered behaviour.

In a nutshell, a mother’s milk is unequivocally the best form of nourishment that can be given to infants but when maternal medications are needed, whether for a long or short duration of therapy, considerations have to be taken to select the best possible option for the baby. Through proper parental awareness, and the right selection of medication and scheduling of dose, the exposure of the drug to the infant can be minimised and in turn, reduce any harmful effect that it may have on the baby.

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