Breastfeeding and Medications
Some women have a difficult time deciding if they should avoid a medication and provide their baby with the benefits of breastfeeding or take the medication and stop breastfeeding. If a medication is essential to a mother's health and there are no other options and the medication poses a clear risk to the baby, then the decision is usually clear, although still not easy.
However, what if the medication isn't essential (say, for instance, a medication to treat acne) and the risks are unknown or are small? These are the gray areas -- areas where one informed and loving mother may come to a completely different conclusion compared to other informed and loving mothers. There are usually no right or wrong answers for all women. Take the time to get informed, and make the best decision you can.
If you decide to take a medication while breastfeeding, it's important that your child's doctor knows about it. While you might not want to discuss your medications with your child's pediatrician, it's important in order for your child to receive the best care and to monitor for possible side effects. Most pediatricians don't ask about medications breastfeeding mothers take. You'll need to take the initiative and take it upon yourself to mention it.
"Pumping and dumping" is one way to limit your baby's exposure to a medication. This strategy works well for medications you take rarely; for instance, a medication used to treat a migraine or for medications taken for a surgery. It doesn't work well for medications you take on a daily basis.
In order to pump and dump effectively, you need to know when and how long to pump and dump. This varies from medication to medication, depending on several factors. It works well for drugs that leave the body quickly; it's not practical to pump and dump for days. You also need to know if it's actually necessary to pump and dump.
An alternative strategy is to schedule your medication in a way that minimizes exposure to your baby. In order to do this, you'll need to understand when the drug peaks in your body and in your milk, how long it lasts, and how infrequently you can take the medication. It's best to involve your healthcare provider in this process.
As an example of this strategy, if you take a medication once a day and your baby sleeps through the night, taking the drug at bedtime may minimize your baby's exposure, depending on the drug. However, this doesn't really work for long-acting drugs and doesn't make a difference if you have a young infant who still nurses around the clock.